INCISION:
Primary port put in by open Hasson technique using blunt Hasson port.
Secondary ports put in with direct visualisation.
Five ports were used: one 12mm port in the umbilicus, and four 5mm ports in the left upper quadrant, right upper quadrant, left mid-clavicular line and right mid-clavicular line.
FINDINGS:
PROCEDURE:
The stomach was mobilized and the esophagus was identified.
The hernia sac was dissected and reduced back into the abdominal cavity.
The crural diaphragm was reinforced with non-absorbable suture.
The hernia defect in the diaphragm was closed using non-absorbable suture.
The esophagogastric junction was tested for competence with a bougie.
Haemostasis was ensured.
CLOSURE:
No.1 PDS box stitch to fascia for primary port site.
3.0 monocryl subcuticular sutures.
Interrupted sutures to skin.
Dressings applied.