Teflon pledget reinforced fundoplication causes symptomatic gastric and esophageal lumenal penetration

Long-term results of hiatal hernia mesh repair and antireflux laparoscopic surgery

“…The most debated issue is the risk of visceral erosions or adhesions related to the presence of a foreign body, with an incidence rate varying from 0.1 to 20% in the literature [3,13,17,[20][21][22][23][24]. It must be noted that the incidence of this complication is significantly lower in series with a large number of patients than in small series.…”

“…What shape, size, type, and composition of mesh should be used? The most debated and worrisome issue is the risk of complications related to the use of the prosthesis such as erosion or migration of the mesh into the esophagus or stomach as well as the development of fibrotic strictures or adhesions in the hiatal area over the long term [3,13,17,[20][21][22][23][24].…”

Is a circular polypropylene mesh appropriate for application at the esophageal hiatus? Results from an experimental study in a porcine model

“…In accordance with this hypothesis, most cases of stenosis, migration, and erosion published in the clinical literature occurred with other types of meshes [1,2,7,8,10,15,33,35,37,41].…”

“…Polytetrafluorethylene, for example, is associated with less adhesion formation [31]. Accordingly, in 8 of 11 clinical publications known to us that report the material which provoked erosion of the esophagus, mesh reinforcement was done with polytetrafluorethylene [1,2,7,8,10,15,33,41].…”

Late Gastric Perforations After Laparoscopic Fundoplication

“…This may explain the two perforations for which suture material was used to oversew previous perforations. Dally and Falk [5] described 11 patients from a total of 1,175 fundoplications with symptomatic Teflon pledget erosion. In five patients, the pledget eroded into the stomach, and the remaining cases involved the esophagus or cardioesophageal junction.…”