Dysphagia after using a Biological Mesh to Repair a Recurrent Hiatal Hernia

Introduction: It has been recently demonstrated in a controlled trial that reinforcement of the crura with a biological mesh decreases the incidence of recurrence of paraesophageal hernias after hiatal repair. This technique is therefore increasing in popularity. Complications from this type of mesh have not been reported, but an animal study has suggested that a hyper-inflammatory reaction to this prosthetic material may occur in mice. Is this possible in humans and if so with what frequency?
Video: The following video is a presentation of a case in which a biological prosthesis (Surgisis ES, Cook) was used to repair a recurrent hiatal hernia and within 17 days the patient developed severe dysphagia requiring laparoscopic re-exploration. Both the original operation utilizing the prosthetic repair and the subsequent re-exploration for dysphagia are presented. The techniques used for both operations and the patient’s response to the biological mesh are well demonstrated by the sequential videos.
Conclusion: Was the patient’s unusual response to the prosthetic material and the subsequent dysphagia due to surgical technique or the prosthetic material itself? These are important questions raised by the video which must be discussed and possibly studied further.

Session: Podium Video Presentation

Program Number: V047

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