Hiatal hernia repair with mesh: a survey of SAGES members

Frantzides, Constantine T.; Carlson, Mark A.; Loizides, Sofronis; Papafili, Anastasia; Luu, Mihn; Roberts, Jacob; Zeni, Tallal M.; Frantzides, Alexander T.

doi:10.1007/s00464-009-0718-6

Cited by 138 publications

(96 citation statements)

References 49 publications

(60 reference statements)

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“…The 0% recurrence rate after mesh repair in this study was not replicated in the other trials, perhaps reflecting the encirclement of the esophagus by the mesh prosthesis. However, many surgeons remain reluctant to place mesh fully around the esophagus because of the perceived risks of mesh erosion and hiatal fibrosis at longer term follow-up 5 . Unfortunately, because late follow-up from this study has not been reported, Frantzides et al's results have not addressed this issue.…”

Section: Discussionmentioning

confidence: 99%

“…tension-free repair with prosthetic reinforcement, and it is technically straightforward to perform laparoscopically. Whilst good results have been reported from case series of mesh repair, some surgeons are concerned that the potential advantages of mesh repair might be offset by the risk of the mesh eroding into the esophageal lumen, and other complications 5 . Difficulties also occur when assessing the outcomes of mesh repair, as there is great variability between mesh types and configurations, and little standardization of surgical techniques.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Mesh Versus Nonabsorbable Mesh

et al. 2015

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Hiatus hernia, Mesh repair, Laparoscopy, Randomized controlled trial. Trial registration -This trial is registered with the Australia and New Zealand ClinicalTrials Registry ACTRN12605000725662 Determine whether absorbable or non-absorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared to suture repair. Summary Background Data:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. Previous trials have shown less short term recurrence with mesh, but adverse outcomes limit mesh use. Methods:Multicentre prospective double blind randomized controlled trial of 3 methods of repair; sutures vs. absorbable mesh vs. non-absorbable mesh. Primary outcome -hernia recurrence assessed by barium meal X-ray and endoscopy at 6 months. Secondary outcomes -clinical symptom scores at 1, 3, 6 and 12 months. Results:126 patients enrolled -43 sutures, 41 absorbable mesh and 42 non-absorbable mesh. 96.0%were followed to 12 months, with objective follow-up data in 92.9%. A recurrent hernia (any size) was identified in 23.1% following suture repair, 30.8% -absorbable mesh, and 12.8%

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Mesh Versus Nonabsorbable Mesh

et al. 2015

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“…In his survey, 24% placed mesh for defects [5 cm, 13% for defects [8 cm, and 9% for [3 cm. Tension on the crura (10%), recurrent hernia (5%), poor crural tissue (5%), and obesity (0.8%) were other indications for mesh placement in this survey [17].…”

Section: Discussionmentioning

confidence: 97%

Use of mesh for hiatal hernia repair: a survey of SAGES members

et al. 2012

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“…Several repair techniques have been described, the most common one involving the reinforcement of the hiatal closure by implantation of mesh around the esophageal hiatus. Although studies have demonstrated a decrease in the PEH recurrence rate with mesh reinforcement [17,18], this technique remains controversial [15,19,20]. The use of synthetic mesh can lead to dysphagia or odyngophagia in up to 21.7% of patients, likely due to esophageal stenosis and periesophageal mesh-induced fibrosis [5,12,21,22].…”

Section: Discussionmentioning

confidence: 99%

New Surgical Approach for Giant Paraesophageal Hernia Repair: Closure of the Esophageal Hiatus Anteriorly Using the Left Triangular Ligament

et al. 2015

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Background: Obtaining a tension-free repair for giant paraesophageal hernias (PEH) is often challenging. Many different techniques have been proposed, including laparoscopic posterior hiatoplasty with the use of prosthetic or biologic mesh as well as the use of autologous teres or falciform ligament flaps. In this report, we describe the use of the left triangular ligament as an onlay autologous vascularized flap to bridge the anterior residual defect after posterior cruroplasty. Methods: A novel technique of paraesophageal hiatal hernia repair is described. Posterior hiatoplasty is performed, including the approximation of the diaphragmatic crural fibers to the extent possible. The left triangular ligament is then mobilized and sutured to the right and left crural fibers lining the esophageal hiatus to seal the anterior residual diaphragmatic defect. Results: This technique has been performed in 4 patients with a mean age of 71 years and a 3:1 female to male ratio. The average hiatal defect size was 5.5 cm and the average length of operation was 122 min. There was no evidence of radiologic or clinical recurrence on follow-up. Conclusion: The use of the left triangular ligament flap is feasible and may be a valuable tool for closure of an anterior diaphragmatic defect in giant PEHs. Additional studies to validate its long-term function are needed.

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Hiatal hernia repair with mesh: a survey of SAGES members

Abstract: The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.

Cited by 138 publications

References 49 publications

Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Mesh Versus Nonabsorbable Mesh

Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Mesh Versus Nonabsorbable Mesh

Use of mesh for hiatal hernia repair: a survey of SAGES members

New Surgical Approach for Giant Paraesophageal Hernia Repair: Closure of the Esophageal Hiatus Anteriorly Using the Left Triangular Ligament

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