When should we use mesh in laparoscopic hiatal hernia repair? A systematic review

2020 ◽  
Author(s):  
Francisco Laxague ◽  
Emmanuel E Sadava ◽  
Fernando Herbella ◽  
Francisco Schlottmann
Keyword(s):  
Systematic Review ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Symptom Improvement ◽  
Morbidly Obese ◽  
Hiatal Hernia Repair ◽  
Recurrence Rates ◽  
Mesh Placement ◽  
Mesh Reinforcement ◽  
Laparoscopic Hiatal Hernia Repair

Summary The use of mesh in laparoscopic hiatal hernia repair (LHHR) remains controversial. The aim of this systematic review was to determine the usefulness of mesh in patients with large hiatal hernia (HH), obesity, recurrent HH, and complicated HH. We performed a systematic review of the current literature regarding the outcomes of LHHR with mesh reinforcement. All articles between 2000 and 2020 describing LHHR with primary suturing, mesh reinforcement, or those comparing both techniques were included. Symptom improvement, quality of life (QoL) improvement, and recurrence rates were evaluated in patients with large HH, obesity, recurrent HH, and complicated HH. Reported outcomes of the use of mesh in patients with large HH had wide variability and heterogeneity. Morbidly obese patients with HH should undergo a weight-loss procedure. However, the benefits of HH repair with mesh are unclear in these patients. Mesh reinforcement during redo LHHR may be beneficial in terms of QoL improvement and hernia recurrence. There is scarce evidence supporting the use of mesh in patients undergoing LHHR for complicated HH. Current data are heterogeneous and have failed to find significant differences when comparing primary suturing with mesh reinforcement. Further research is needed to determine in which patients undergoing LHHR mesh placement would be beneficial.

scholarly journals Hiatal hernia repair: prevention of mesh erosion and migration into the esophagogastric junction

2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Italo BRAGHETTO ◽  
Owen KORN ◽  
Jorge ROJAS ◽  
Hector VALLADARES ◽  
Manuel FIGUEROA
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Late Complications ◽  
Mesh Erosion ◽  
Hiatal Hernia Repair ◽  
Hernia Sac ◽  
Mesh Placement ◽  
Early Postoperative Complications ◽  
Laparoscopic Hiatal Hernia Repair ◽  
And Migration

ABSTRACT Background: Erosion and migration into the esophagogastric lumen after laparoscopic hiatal hernia repair with mesh placement has been published. Aim: To present surgical maneuvers that seek to diminish the risk of this complication. Method: We suggest mobilizing the hernia sac from the mediastinum and taking it down to the abdominal position with its blood supply intact in order to rotate it behind and around the abdominal esophagus. The purpose is to cover the on-lay mesh placed in “U” fashion to reinforce the crus suture. Results: We have performed laparoscopic hiatal hernia repair in 173 patients (total group). Early postoperative complications were observed in 35 patients (27.1%) and one patient died (0.7%) due to a massive lung thromboembolism. One hundred twenty-nine patients were followed-up for a mean of 41+28months. Mesh placement was performed in 79 of these patients. The remnant sac was rotated behind the esophagus in order to cover the mesh surface. In this group, late complications were observed in five patients (2.9%). We have not observed mesh erosion or migration to the esophagogastric lumen. Conclusion: The proposed technique should be useful for preventing erosion and migration into the esophagus.

scholarly journals Iatrogenic cardiac tamponade after laparoscopic hiatal hernia repair requiring emergency sternotomy

2018 ◽  
Vol 56 (1) ◽  
pp. 215-215 ◽  
Author(s):  
Samuel Heuts ◽  
Walther N K A van Mook ◽  
Eric J Belgers ◽  
Roberto Lorusso
Keyword(s):  
Hernia Repair ◽  
Cardiac Tamponade ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

532 OUTCOME OF QUILICI’S HEPATIC SHOULDER PROCEDURE TO AUGMENT LAPAROSCOPIC HIATOPLASTY IN LARGE OR RECURRENT HIATAL HERNIA

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Johannes Zacherl ◽  
Viktoria Kertesz ◽  
Cordula Höfle ◽  
Lisa Gensthaler ◽  
Bernhard Eltschka ◽  
...  
Keyword(s):  
High Risk ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Hernia Repair ◽  
Perioperative Complications ◽  
Recurrent Hernia ◽  
Hernia Recurrence ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

Abstract   Laparoscopic hiatoplasty and fundoplication is the gold standard of surgical treatment of GERD and hiatal hernia. However, the main drawback of laparoscopic hiatal hernia repair is a substantial recurrence rate. Hence, prosthetic meshs have been used to reduce the risk for recurrence. But meshs may cause major complications. As a consequence we adopted the hepatic shoulder plasty described by Quilici to augment the hiatal hernia repair in patients with a high risk for hernia recurrence. Methods Patients with large (>4 cm) axial hiatal hernia, giant paraesophageal or with recurrent hernia consecutively underwent laparoscopic hernia repair with crural sutures and hepatic shoulder plasty. A Toupet or a floppy Nissen fundoplication was added. In patients with giant paraesophageal hernia the hernia sack was resected. Perioperative complications were recorded. Follow-up comprised endoscopy and/or radiography and QoL-evaluation with the Eypasch score (GIQLI). Results Between 2012 and 2018 51 patients (mean age 71 years, 65% female) underwent Quilici’s procedure. Among them 33,3% had one or more previous hiatal hernia repair. There were no conversions. Postoperative complication rate was 7.8%. At follow-up after 2 years 6 recurrences (12%) were encountered, 4 of them were symptomatic (8%). One patient underwent reoperation due to hernia recurrence. In 84% QoL was significantly improved at follow-up. Conclusion In patients with high risk of recurrence, biological augmentation of the hiatal closure with the left lobe of the liver may be a valuable alternative to prosthetic reinforcement. We observed no complication attributable to liver lobe transposition.

A646 Laparoscopic Hiatal Hernia Repair With A Fundopexy In a Post Sleeve Gastrectomy Patient

2019 ◽  
Vol 15 (10) ◽  
pp. S263
Author(s):  
Vicente Cogollo ◽  
Juliana Henrique ◽  
Luis Felipe Okida ◽  
Maria Fonseca ◽  
Emanuele Lo Menzo ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

Permanent mesh results in long-term symptom improvement and patient satisfaction without increasing adverse outcomes in hiatal hernia repair

2014 ◽  
Vol 207 (3) ◽  
pp. 445-448 ◽  
Author(s):  
Lindsay F. Petersen ◽  
Shannon L. McChesney ◽  
Shaun C. Daly ◽  
Keith W. Millikan ◽  
Jonathan A. Myers ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Adverse Outcomes ◽  
Symptom Improvement ◽  
Hiatal Hernia Repair

Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

2019 ◽  
Vol 34 (7) ◽  
pp. 3072-3078 ◽  
Author(s):  
Alex Addo ◽  
Andrew Broda ◽  
H. Reza Zahiri ◽  
Ian M. Brooks ◽  
Adrian Park
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair
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