Perez-Lara, F. J.Ferrer-Berges, A.Oehling-de-los-Reyes, H.Oliva-Munoz, H.2023-02-122023-02-122017-03-18Pérez 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;41:12-131743-9191http://hdl.handle.net/10668/18800Gastroesophageal 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.enPenroseDifficult hiatal herniaFunduplicationÁrea de Gestión Sanitaria Norte de MálagaFundoplicationGastric FundusHeartburnGastroesophageal RefluxObesityletterRestricted AccessReflujo gastroesofágicoCirugía generalFundus gástricoLaparoscopíaObesidad10.1016/j.ijsu.2017.03.0261743-9159https://doi.org/10.1016/j.ijsu.2017.03.026402490600003