Laparoscopic Nissen operation with mesh reinforcement remains being the most popular operation for large hiatal hernia repair. Complications related to mesh placement have been widely described. Cardiac complications are rare, but have a fatal outcome if they are misdiagnosed. We sought to outline our institutional experience of three patients who developed cardiac complications following a laparoscopic Nissen operation for large hiatal hernia repair. Laparoscopic hiatoplasty and Nissen fundoplication are safe and effective procedures for the hiatal hernia repair, but they are not exempt from complications. Fixation technique and material used must be taken into account. We have conducted a review of the literature on complications related to these procedures. In the differential diagnosis of hemodynamic instability after laparoscopic hiatal hernia repair, cardiac tamponade and other cardiac complications should be considered.

Minimally Invasive Surgery (MIS) for esophageal carcinoma has improved the outcome of patients. This approach has been shown to decrease the rate of respiratory complications, the intensive care unit (ICU) stay, and to allow a faster recovery of patients. Also, an improvement in perioperative care has contributed to better outcomes compared to the open approach. MIS has been shown to be as safe as open surgery in terms of resectability, harvested lymph nodes, and overall survival.