A 65-year-old man developed a recurrent hiatal hernia that contained the entire gastric sleeve. His symptoms include chronic reflux and regurgitation of solids and liquids. We confirmed a large hiatal hernia on preoperative upper endoscopy, CT, and UGI. Objectives: We demonstrate a laparoscopic technique of repairing the hiatal hernia repair with conversion of sleeve gastrectomy to gastric bypass.


Four laparoscopic ports were placed in the periumbilical and subcostal areas. We took down multiple adhesions to reduce the hernia sac and sleeved stomach into the abdomen. We used intraoperative upper endoscopy to confirm that the gastroesophageal junction was in the abdominal cavity. Lastly, we performed a posterior cruroplasty and converted the sleeve to a gastric bypass to repair the hiatal hernia.


He had an uneventful postoperative course and was discharged home on postoperative day two. He was seen in the office for his two week follow up and noted to be asymptomatic. No complications were noted > 30 days postoperatively.


Recurrent hiatal hernias after sleeve gastrectomy can be repaired by laparoscopic approach with posterior cruroplasty and conversion to gastric bypass to prevent recurrence.