A 70-year-old patient with a history of having undergone Heller cardiomyotomy and Dor fundoplication by open approach 30 years prior for a diagnosis of Achalasia, 06 months before his current surgery presents with intense gastroesophageal reflux with an upper endoscopy showing Los Angeles D esophagitis, esophagogram showing a mixed hiatal hernia Type III with marked esophageal dilation (due to the history of Achalasia), esophageal manometry with a Normotensive Lower Esophageal Sphincter and absent esophageal contractility. It is decided to perform an exploratory laparoscopy with adhesiolysis- release of adhesions (due to previous surgical history of open surgery) reduction of the valve of the Dor Fundoplication done 30 years ago (Hiatal hernia) closure of the crura defect (correcting angle of hiss) plus a Gastropexy type Dor Fundoplication.
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