Ann Surg Treat Res.  2014 May;86(5):264-269. 10.4174/astr.2014.86.5.264.

Hiatal hernia in pediatric patients: laparoscopic versus open approaches

  • 1Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, Seoul, Korea.


The aim of this study was to evaluate the surgical outcomes of laparoscopic approach for hiatal hernia (HH) in pediatric patients.
This was a retrospective study of 33 patients younger than 18 years who underwent an operation for HH between January 1999 and December 2012.
The HH symptoms were various and included regurgitation, vomiting, weight loss, cough, hoarseness, and cyanosis. Among the 33 patients, there were 25 sliding types, 1 paraesophageal type, and 7 mixed types. Open surgery (OS) and laparoscopic surgery (LS) were used in 16 and 17 patients, respectively. There were no statistically significant differences in sex, age, or body weight between the groups. The median operating time was longer in the LS group (150 minutes; range, 90-250 minutes vs. 125 minutes; range, 66-194 minutes; P = 0.028). Time to oral intake was shorter in the LS group than in the OS group (1 day; range, 1-3 days vs. 2 days; range, 1-7 days; P = 0.001) and time to full feeding was shorter in the LS group than in the OS group (6 days; range, 3-16 days vs. 10 days; range, 3-33 days; P = 0.048). There were no differences in length of hospital stay and complications between the two groups. There was no perioperative mortality or recurrence of HH.
A good surgical outcome for laparoscopic correction of HH was seen in pediatric patients.


Hiatal hernia; Child; Laparoscopy; Fundoplication; Minimal invasive surgical procedures

MeSH Terms

Body Weight
Hernia, Hiatal*
Length of Stay
Retrospective Studies
Weight Loss


  • Fig. 1 Type of hiatal hernia. (A) Sliding hernia, (B) paraesophageal hernia, and (C) mixed hernia.

  • Fig. 2 Location of trocars for laparoscopic approach to hiatal hernia in children. We usually use 5-mm trocars and laparoscopic devices for laparoscopic surgery for hiatal hernia. However, we use 3-mm trocars for neonates and infants. The trocar pointed with the normal arrow is used as the main working port for the operator, and is also used as the gastrostomy site at the end of surgery. The trocar pointed with dashed arrow is used for traction of stomach, if necessary.


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