Prosthetic mesh repair of large and recurrent diaphragmatic hernias

Abstract

Laparoscopic repair of large PEH with reinforcement mesh is feasible and safe with excellent short-term results. Long-term followup shows a low PEH recurrence requiring reoperation, but a significant number of patients develop symptomatic recurrent small hiatal hernias that can be managed nonoperatively.

Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence

“…Ringley et al [13] 2006 Prospective 22 Hiatal defect >5 cm Granderath et al [14] 2007 Prospective 23 Symptomatic GERD Kepenekci et al [15] 2007 Prospective 164 GERD Jacobs et al [16] 2007 Retrospective 92 NR Lubezky et al [17] 2007 Retrospective 59 Primary or recurrent paraesophageal hernia Zaninotto et al [18] 2007 Retrospective 35 Type III hernia Granderath et al [19] 2008 Prospective 33 Hernia and symptom recurrence Hazebroek et al [20] 2008 Prospective 40 Large hiatal defects Lee et al [21] 2008 Retrospective 52…”

Laparoscopic right hepatectomy and partial resection of the diaphragm for liver metastases

“…Most of the literature discusses the results after paraesophageal hernia repairs, with the recurrence rate estimated at 10% in the open surgery literature and ranging from 10 to 42% after laparoscopic repairs [6]. To reduce the incidence of recurrence, laparoscopic surgeons have begun to buttress most paraesophageal hernia repairs with prosthetic material [6,7].…”

“…To reduce the incidence of recurrence, laparoscopic surgeons have begun to buttress most paraesophageal hernia repairs with prosthetic material [6,7]. A group from Israel reported on 59 patients who had either recurrent or large paraesophageal hernias repaired laparoscopically with mesh reinforcement.…”

“…A group from Israel reported on 59 patients who had either recurrent or large paraesophageal hernias repaired laparoscopically with mesh reinforcement. During a mean follow-up period of 28 months, six patients (13%) experienced a recurrent hernia [6]. Palanivelu et al [7] reported on 21 cases of adult diaphragmatic hernias repaired laparoscopically, with mesh used in 18 patients (86%).…”

Thinking About Hiatal Hernia Recurrence After Laparoscopic Repair: When Should It Be Considered a True Recurrence? A Different Point of View

“…[1][2][3][4][5][6] A critical analysis of the reported results at 1 year has shown less recurrence after a mesh repair, but this issue is still controversial because of the great variability in technique, type of mesh, and size and shape of the hernia. [4][5][6][7][8][9] A higher rate of recurrence has been reported after laparoscopic repair, especially in giant hiatal hernias. The use of mesh can reduce the recurrence rate, and other authors have suggested performing the Collis Nissen procedure in patients with a hiatal hernia and short esophagus, reporting lower recurrence rates after this procedure.…”