Abstract:
Hiatal hernia repair is one of the most commonly performed surgical procedures for the treatment of gastroesophageal reflux disease (GERD), and postoperative pain remains a frequent clinical problem despite the widespread adoption of minimally invasive techniques. Although laparoscopic and robotic approaches are associated with reduced postoperative pain and faster recovery compared with open surgery, dissection and suturing of the diaphragmatic crura may still result in significant postoperative discomfort. Intraoperative local anesthetic infiltration of the crura under direct visualization has therefore been proposed as a simple and safe method to reduce postoperative pain. In this retrospective two-center study, 196 patients who underwent laparoscopic hiatal hernia repair between 2023 and 2025 were divided into two groups according to whether intraoperative crural infiltration with bupivacaine was performed. Postoperative pain during the first postoperative day was assessed using a visual analog scale (VAS) ranging from 0 to 10, and postoperative analgesic requirements were also compared between groups. Patients who received intraoperative crural infiltration demonstrated significantly lower postoperative pain scores and reduced analgesic consumption compared with the control group, and statistical analysis performed using SPSS software revealed a significant difference between the two groups (p < 0.001). These findings suggest that appropriately performed intraoperative bupivacaine infiltration of the diaphragmatic crura is a safe and effective adjunct technique for reducing early postoperative pain following laparoscopic hiatal hernia repair.
Biography:
Dr. Rafail Ibayev was born in Azerbaijan in 1991. He completed his primary, secondary, and high school education between 1996 and 2007. From 2007 to 2013, he studied at Azerbaijan Medical University. Between 2018 and 2023, he completed his specialization in general surgery at Kocaeli University Faculty of Medicine in Turkey. Since 2023, he has been working as a general surgeon at Chakmak Erdem Hospital
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