[The upside-down stomach. Laparoscopic treatment is possible].

An upside-down-stomach, usually occurring in eldery patients describes an extreme case of paraesophageal hernia. Due to the possibility of life threatening complications there is an urgent need for surgical intervention. In 1998 three patients suffering from complete upside-down-stomach were treated by laparoscopic surgery at our hospital. Two of them received a hiatoplastic with fundo- and corpophrenicopexy. In one case we did a 360 degrees-floppy Nissen's-fundoplication. Perioperatively, one patient developed a left sided pneumothorax Long-term follow-up 6 months postoperatively in our out-patient department revealed unconspicuous clinical and gastroscopical findings and high patient satisfaction with postoperative outcome. Our case reports show the possibility of adequate operating on upside-down-stomach by means of laparoscopic surgery. Minimal invasive methods provide a good overlock on the operating field and are poor in complications when done by an experienced surgeon, so that patients may profit from comfort of laparoscopic surgery.