Skip to main content
. Author manuscript; available in PMC: 2014 Jul 29.
Published in final edited form as: J Gastrointest Surg. 2011 Dec 9;16(2):417–426. doi: 10.1007/s11605-011-1690-8

Figure 2.

Figure 2

Reduction of the hernia sac without retraction on the stomach. The operation begins with the surgeon and the assistant everting the hernia sac just beyond the lip of the anterior crura. The sac is incised, allowing entry into the anterior mediastinum. Dissection proceeds using a combination of blunt dissection and coagulation of the fine areolar attachments of the hernia sac to the surrounding mediastinal structures (inset). During this dissection, care is taken to maintain the integrity of the crural lining and avoid damage to the crural muscle, vagus nerves, or pleura. Note the stomach is not being retracted during this dissection. (Video 1)