• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Laparoscopic Lightweight Mesh Repair vs Primary Repair With Teflon Patch Buttress for Large and Giant Hiatal Hernias: Prospective Randomized Trial

V.v. Grubnik, Prof, A.v. Malynovskyy, PhD, O.v. Grubnik, PhD, V.v. Ilyashenko, PhD. Odessa national medical university

 

Background. Mesh repair of large and giant hiatal hernias may reduce recurrence rate compared to primary repair. However, it may cause prosthesis-related esophageal strictures and erosions. It was suggested that primary posterior suture repair with buttressing by teflon patches may substitute mesh repair and decrease or completely exclude esophageal strictures.
Design of study. Prospective randomized study was conducted to compare these two methods of laparoscopic repair. There were 36 patients in lightweight mesh arm (I), and 36 patients in teflon patch arm (II), operated from 2007 to 2009. Time frame – 20 months. Inclusion criteria: type I, II and III hiatal hernias, including complicated by GERD; diameter of hernia defect measuring 8 to 12 cm. Exclusion criteria: unable to undergo laparoscopic hiatal hernia repair due to severe comorbidities (ASA III and more), previous major surgery with severe adhesions; age < 20 years and > 80 years; BMI < 16 and > 39 kg/m2; oesophageal motility disorders, peptic strictures, shortening; history of oesophageal/gastric/duodenal surgery; relapsing course of ulcer disease.
Methods. The lightweight mesh repair was performed using original technique (“sandwich” technique): the mesh was fixed to the crura posteriorly to the esophagus, and then crura were sutured to each other covering the mesh and thus preventing the contact of esophagus with the mesh. Primary outcome measures were: rates of anatomical and functional recurrences of hiatal hernia and GERD; rates of repair-related dysphagia/oesophageal stricture/prosthetic erosion. Recurrence of hiatal hernia, i.e. anatomical recurrence, were assessed by symptom questionnaire with visual analogue scales, mainly by barium study. Recurrence of GERD, i.e. functional recurrence, will be evaluated by symptom questionnaire with visual analogue scales, endoscopic examination, and 24 hour pH-testing. Short- and long-term dysphagia, including due to repair-related oesophageal stricture, will be assessed by symptom questionnaire with visual analogue scales, barium study, and endoscopic examination. Secondary outcome measures were: quality of life and satisfaction assessed by GERD-HRQL score, operative time, morbidity, and postoperative hospital stay.
Results. Two arms were statistically comparable by demographic and preoperative data. 1 patient from lightweight mesh arm (I) and 2 patients from teflon patch arm (II) lost from follow-up. There were 2 anatomical and functional recurrences in I arm (5,7 %), and 4 patients in II arm (11,7 %) (p < 0,05). There were no cases of repair-related dysphagia/oesophageal stricture/prosthetic erosion in both arms.
Conclusion. Although there were no differences between arms in terms of repair-related esophageal complications, laparoscopic lightweight mesh repair of large and giant hiatal hernias using original “sandwich” technique results in better long-term outcome compared to primary repair with teflon patch buttressing in terms of anatomical and functional recurrence rate.
 


Session Number: SS15 – Hernia
Program Number: S088

160

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons