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A 64-year-old woman with significant gastroesophageal reflux disease (GERD) was taken to the operating room for a laparoscopic Nissen fundoplication fundoplication (see laparoscopic Nissen fundoplication for port positions). The fundus of the stomach was grasped with an atraumatic clamp and the hiatal hernia reduced, putting the gastrohepatic ligament (lesser omentum) on stretch.
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The right crus was exposed (anatomically, the esophageal hiatus is comprised of fibers of the right diaphragmatic crus, but for surgical descriptive purposes, the right and left side of the hiatus are referred to as right and left crus, a convention that will be used in this narrative).
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