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Fig. 4 | Surgical Case Reports

Fig. 4

From: Hiatal hernia involving prolapse of the entire stomach into the mediastinum after distal gastrectomy: a case report

Fig. 4

Port setting for hernia repair and operative findings. In total, five ports and Nathanson liver retractor were placed in the abdomen (a). A loose adhesion was observed just under the operative scar in the abdominal cavity; in contrast, the adhesion in the hernial sac was stronger. The esophageal hiatus was dilated to 7 cm in diameter (arrow heads). The hiatal hernia was identified and found to contain the entire postoperative stomach (b). We converted laparoscopic surgery to open surgery, and upper midline abdominal incision was added (c, red line). After manual reposition of the herniated content (d), cruroplasty with non-absorbable 2–0 sutures and Toupet fundoplication were performed

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