Laparoscopic paraesophageal hernia repair with mesh.

A type II paraesophageal hernia is usually an asymptomatic condition found incidentally in an elderly patient. It is a potentially devastating problem because it can present as severe blood-loss anemia or acute, life-threatening gastric volvulus. The medical and surgical literature is replete with recommendations for surgical repair, but underlying medical illnesses have led to delays in the use of this treatment of choice. Five extreme elderly patients safely underwent the standard "Boerema" repair with gastropexy under laparoscopic guidance. With the advent of laparoscopy, a safe, minimally invasive approach is available to the high-risk patient group.