# Robotic Repair of a Paraesophageal Hernia After an Open Nissen Fundoplication: Case Presentation and Clinical Discussion

## TL;DR

A robotic repair successfully treated a complex hernia in a patient who had prior abdominal surgery, showing it can be a viable option for reoperations.

## Contribution

This case demonstrates the feasibility of robotic repair for recurrent paraesophageal hernias after open Nissen fundoplication.

## Key findings

- Robotic surgery successfully repaired a paraesophageal hernia after multiple prior procedures.
- The patient had an uneventful recovery following the robotic intervention.
- The case highlights robotic repair as a viable reoperation option for complex hernias.

## Abstract

We present a female in her sixties with a recurrent paraesophageal hernia status post open Nissen fundoplication and multiple esophageal dilations who underwent a robotic paraesophageal hernia repair, with extensive lysis of adhesions. The stomach and esophagus were dissected off the crura and the previous wrap was undone. Once the entirety of the stomach and esophagus were freed from their surrounding structures, the hernia sac was able to be excised. The crural defect was closed and gastropexy was performed. The patient had an uneventful postoperative course and was discharged home. This case is presented to provide evidence that robotic repair presents a viable option in the reoperation of patients following an open Nissen fundoplication as well as provide an overview of the types of hiatal hernias and the indications and options for surgical intervention.