ABDOMINAL-SURGERY .1.

(First of Three Parts) THIS article summarizes some of the important advances in gastroenterological surgery since the last report three years ago. Hiatus Hernia and Gastroesophageal Reflux The presence of gastroesophageal reflux is more important to the patient than whether or not he has a sliding hiatus hernia. Except in unusual cases (such as short esophagus, Barrett's ulcer or stricture, and previous hiatal surgery) reflux may be corrected by restoration of an adequate length of abdominal esophagus. The three common repairs have been described by Nissen, Belsey and Hill; all attempt to achieve their goals using whatever tissue is available. © 1979, Massachusetts Medical Society. All rights reserved.