Hill Repair

    This consists of restoration of the gastroesophageal junction with posterior anchoring to the mediabn arcuate ligament, and reconstruction of the gastroesophgeal flap valve.

Operation

This procedure is performed via  a midline incision and utilises intraoperative manometry to achieve accurate results.

Identification of the oesophageal hiatus, and dissection of the pre aortic fascia with a finger / instrument infront of the aorta will prevent aortic injury.

The right crus is then closed with Teflon pledgets

The stomach is then anchored to the pre aortic fascia with a non absorbable O suture

Sutures are tied with a single throw to perform introperative manometry

Finished repair. The fundus is in addition attached to the hiatus with non absobable sutures.