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Laparoscopic repair of a large paraesophageal hernia is built around a few non‑negotiable principles: complete sac reduction, aggressive mediastinal mobilization to obtain ≥2–3 cm tension‑free intra‑abdominal esophagus, meticulous crural reconstruction, and a tailored fundoplication or gastropexy. Preoperative evaluation and case selection Patients usually present with a mix of reflux and obstructive symptoms (post‑prandial pain, […]
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