Simultaneous laparoscopic hiatal hernia repair and pyloroplasty for a type 3 hiatal hernia with post‐ESD pyloric stenosis for early gastric cancer

We present a case of early gastric cancer in the pylorus with a type 3 hiatal hernia, which was treated by endoscopic submucosal dissection (ESD). A 70‐year‐old man was referred to our hospital with a hiatal hernia. Endoscopy revealed early gastric cancer, and we performed an ESD adaptation at the pylorus. The ESD was successful, but post‐ESD pyloric stenosis occurred. Symptoms of hiatal hernia worsened because of the pyloric stenosis. Laparoscopic hiatal hernia repair with Toupet fundoplication and Heineke‐Mikulicz pyloroplasty was simultaneously performed. The postoperative course was good, and follow‐up after discharge was uneventful. To our knowledge, there have been no reports in which laparoscopic hiatal hernia repair, fundoplication, and pyloroplasty were simultaneously performed for a substantial hiatal hernia with post‐ESD pyloric stenosis.