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. 2022 Apr-Jun;18(2):248-253.
doi: 10.4103/jmas.JMAS_26_21.

Laparoscopic giant hiatal hernia repair with absorbable mesh

Massimiliano Ardu  1 , Damiano Bisogni  1 , Alessandro Bruscino  1 , Rosaria Tucci  1 , Massimo Falchini  2 , Andrea Valeri  1 , Paolo Prosperi  1
Affiliations

Laparoscopic giant hiatal hernia repair with absorbable mesh

Massimiliano Ardu et al. J Minim Access Surg. 2022 Apr-Jun.

Abstract

Background: The best operative approach to large hiatal hernias still remains controversial between suture cruroplasty and prosthetic hiatal herniorrhaphy. This study aims at analysing results from a single institution in Italy in terms of subjective and objective outcomes.

Methods: Retrospectively collected data of all patients that underwent laparoscopic hiatal hernia repair since 2011 were considered. Sixty-five patients were included overall; 17 of them fit the criteria of large hiatal hernia. Follow-up (FU) was assessed by visit, questionnaires and X-ray imaging.

Results: No major complications occurred in the post-operative course. No patient was lost during the FU period. Out of all the patients included, 13 agreed to have an X-ray with water-soluble contrast. The questionnaires showed a 76.5% rate of satisfaction (13 patients), and the recurrence rate demonstrated by radiology was 29.4% (five patients). There were no major mesh-related complications.

Conclusion: The best operative approach for large hiatal hernias remains far from standardised: There is a lack of evidence on the use of a mesh for this kind of surgery as well as substantial controversy over the definition of what a giant hiatal hernia is. Nevertheless, the results from this study and the main studies in the literature seem to be encouraging in improving giant hiatal hernia repair outcomes.

Keywords: Hiatal hernia; laparoscopy; upper gastrointestinal.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
GERD-HRQLQ questionnaire
Figure 2
Figure 2
Position of the ports
Figure 3
Figure 3
Mesh in its U-shaped configuration
Figure 4
Figure 4
Results of the SF-36. Physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH)
See this image and copyright information in PMC

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