Laparoscopic hiatal hernia repair with a Composite mesh

Daniel Gomez, MD, Pedro Villadiego, MD, Cesar Guevara, MD, Cristian Gomez, MD. CPO

Primary repair of hiatal hernias has a high rate of recurrence making the use of mesh for this procedure a valid alternative in order to reduce this rate.
Its indication, types, or technique to use are still manner of controversy.

We present a consecutives case series of laparoscopic hiatal hernia repair using a single type of composite mesh ( PARIETEX, Covidien).

13 patients underwent laparoscopic hiatal hernia repair using a single type of composite mesh (PARIETEX, Covidien) in a prívate practice clinic in Colombia (November 2013 – August 2014). Récords were reviewed for demographic data, type and size of hernias, mean operative time, length of hospital stay and intra or postoperative complications.

All procedures were carried out succesfully
Endoscopic size of all hiatal hernias average > 3 cm and the most common type found was type 3
Mean operative time: 92.6 minutes
Mean hospital stay: 26.3 hours
No conversions
No hernia recurrence in follow up
We registered no major complications or re-intervention

There are few available data supporting the use of mesh for laparoscopic hiatal hernia repair, and despite the good results showed in those well design studies controversies remain respect to in wich cases use it, type of mesh, configuration respect to hiatus and esophagus or technique for anchorage.
At this point no firm recommendation can be make, however as we showed in this serie, one strong message persists and this is that there is a clear tendency to recurrence when mesh it is not used for larger hiatus defects.

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