Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

In the surgical correction of a hiatal hernia, tightening the diaphragm crura is a critical step. The crura are muscular structures that anchor the diaphragm to the spine and play an essential role in maintaining the integrity of the lower esophageal sphincter. When a hiatal hernia occurs, part of the stomach moves above the diaphragm, compromising the function of the esophageal sphincter, which is responsible for preventing the reflux of stomach contents into the esophagus.

By tightening the diaphragm crura, surgeons create a more supportive environment around the esophagus and its junction with the stomach. This maneuver helps to restore the normal anatomical position of the esophagus and stomach, minimizing the risk of future herniation and significantly reducing gastroesophageal reflux, which is a common complication associated with hiatal hernias.

Other structures mentioned, such as the esophageal sphincter or the pylorus, do not undergo tightening during this procedure. The primary objective is to strengthen the diaphragm's support of the stomach, making the reinforcement of the diaphragm crura the most appropriate and effective action during the surgical correction of a hiatal hernia.