A Case of Cardiac Tamponade after Laparoscopic Hiatal Hernia Repair

A 70-year-old woman visited our hospital with repeated vomiting for about 2 months. After examination, she was diagnosed with type III hiatal hernia and underwent elective laparoscopic hiatal hernia repair. The crus was closed with suture, followed by reinforcement with a prosthetic mesh and circumferential fixation into the diaphragm using a hernia stapler. On the day after surgery, oxygenation decreased, blood pressure dropped rapidly, and tachycardia was observed. Cardiac tamponade was immediately diagnosed and percutaneous cardiocentesis was performed. On postoperative day 18, the patient developed cardiac tamponade again. The patient was discharged from hospital on postoperative day 45 without recurrence. A retrospective review of the surgical video showed that the patient had a medically-induced cardiac tamponade caused by a hernia stapler with mesh fixation. This disease has an extremely high mortality rate, making it important to prevent its onset by use of correct equipment and to respond promptly to any postoperative abnormalities in vital signs.