Vascular perils during laparoscopic dissection of the oesophaeal hiatus

Laparoscopic antireflux surgery has many advantages over equivalent open procedures. While exposure is generally better, the loss of the third visual dimension may contribute to inadvertent tissue damage. During brisk haemorrhage it is difficult to coordinate laparoscopically the three manoeuvres of suction, pressure and rapid suture. This report is of three cases, from a series of over 400 patients, with significant haemorrhage during laparoscopic dissection at the oesophageal hiatus, one of which was nearly fatal