Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

Abstract

Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.

3D laparoscopic surgery: a prospective clinical trial

“…After correct and complete diaphragmatic pillars exposition we given nonassorbable suture to primary closure of the esophageal hiatus. In our experience we used also a Gore Bio-A Tissue reinforcement adsorbable mesh with a “U” shape to reinforce hiatoplasty [ 22 ]. In the end a Nissen fundoplication was realized with a wrap of 2 cm long.…”

Clinical and Quality of Life Assessment of Patients Undergoing Laparoscopic Hiatal Hernia Repair

“…21,22 Prior studies have demonstrated satisfactory short-term results, including low rates of hiatal hernia recurrence. [22][23][24][25][26][27] The aim of the present study was to evaluate clinical outcomes and patient-reported symptoms among patients who underwent LHHR with PGA/TMC mesh and to compare outcomes among hernia types.…”

Diaphragmatic Hernia Repair Using Biosynthetic Tissue Reinforcement Patch: A Case Series Experience

“…Considering the risks of infection in our cases above, the decision was made to use an implant with enough strength to hold the repair and to work as a scaffold for the patient’s own tissue to fill the defect and later become gradually absorbed. GORE® BIO-A® Tissue Reinforcement patch has been shown in several studies to be a promising material that promotes vascularization, regeneration, and tissue growth while providing strong structural support in inguinal hernia and hiatal hernia repairs [6-9] (Figure 2).…”