Unfortunately, in addition to the problematic endoscopic landmark of the mucosal EGJ discussed above, many additional confounding factors, such as hiatal hernias
, respiratory movement, and active or ulcerative esophagitis, make an accurate determination of precise biopsy sites almost impossible.
12, 13) Other findings, such as a widened hiatus, shortened esophagus, spontaneous reflux, esophagitis, stricture, and a hiatal hernia
are often present in Barrett's esophagus but nonspecific (Figures 6 and 7).
Low LES pressures and hiatal hernias
are the predominant mechanisms for patients with severe reflux disease.
Feiz can perform the Lap Band surgery and the hiatal hernia
repair in one procedure.
The diagnosis of hiatal hernia
was made if gastric folds were observed to extend at least 2 cm above the hiatus during respirations.
Some doctors believe a hiatal hernia
may weaken the LES and cause reflux.
The mechanism of the increased prevalence of atrial fibrillation in patients with hiatal hernia
is not known but likely involves the direct mechanical effects of the hiatal hernia
pressing on the left atrium or indirect effects through activation of the autonomic nervous system or inflammation, Dr.
It is now known that small hiatal hernias
are common and usually harmless.
Undiagnosed hiatal hernias
or large hiatal crural defects account for many failed laparoscopic adjustable gastric banding procedures, and correcting these defects can obviate the need for band removal, George A.
Patients with Barrett's esophagus, motility disorders, or large hiatal hernias
, as determined by endoscopy, were excluded as candidates.
Primary current Veritas applications are as a staple line buttress in gastric bypass surgery for obesity, the repair of ventral and hiatal hernias
, for use in breast reconstruction and several OB/GYN applications.
The ELF procedure, performed using the EsophyX(TM) device, mimics many of the principles of the laparoscopic fundoplication, including that EsophyX(TM) reduces hiatal hernia
, restores the angle of His and creates a gastroesophageal valve.