RT Generic T1 Applying traction to fundoplication by means of a Penrose drain in gastro-oesophageal reflux surgery in difficult cases of hiatal hernia A1 Perez-Lara, F. J. A1 Ferrer-Berges, A. A1 Oehling-de-los-Reyes, H. A1 Oliva-Munoz, H. K1 Penrose K1 Difficult hiatal hernia K1 Funduplication K1 Área de Gestión Sanitaria Norte de Málaga AB Gastroesophageal reflux disease (GERD)-associated symptoms, such as pyrosis and regurgitation, are common and affect about 20% of subjects in the general population [1]. Laparoscopic surgery has revolutionised the field of hiatus surgery, particularly in treatment of gastro-oesophageal reflux byfacilitating the procedureandreducingpostoperativecomplications[2]. The surgeon's preference and preoperative radiographic findings on esophageal motility determine whether to perform a circumferential ‘floppy’ fundoplication [3] or a partial fundoplication [4,5]. One of the most complex steps in this type of surgery is to pass the gastric fundus through the retro-oesophageal tunnel, a manoeuvre which in certain circumstances (for example, in patients with obesity, or in reinterventions) can be highly problematic. We propose a surgical manoeuvre using a Penrose drain to overcome this problem. PB Elsevier SN 1743-9191 YR 2017 FD 2017-03-18 LK http://hdl.handle.net/10668/18800 UL http://hdl.handle.net/10668/18800 LA en NO Pérez Lara FJ, Ferrer Berges A, Oehling de Los Reyes H, Oliva Muñoz H. Applying traction to fundoplication by means of a Penrose drain in gastro-oesophageal reflux surgery in difficult cases of hiatal hernia. Int J Surg. 2017 May;41:12-13 DS RISalud RD Apr 12, 2025