Mesh repair in hiatal hernia surgery: Surgical technique and early results in hiatal hernia repair

Abstract

Purpose: The recurrence rates after laparoscopic hiatal hernia repair are very high. In the recent years, hiatal hernia repair using mesh has gained popularity because of the recurrences. In this study, the application technique, prosthetic indications and early results are discussed in accordance with the current literature.

Methods: Forty five patients, ages between 29-71, underwent laparoscopic hiatal hernia repair between June 2008-July 2011. In fourteen (9 male, 5 female) patients cruroplasty was supported by mesh. Five of these patients underwent redo surgery.

Results: We performed mesh repair in 14 patients with weak crus structure, recurrence hernia and wide hiatal defect. In redo surgery of 5 patients, we identified stenosis in one case due to previously applied polypropilen mesh, in three cases detachment of cruroplasty sutures and in one case sliding hernia. Cruroplasty, Nissen fundoplication and mesh repair were applied to all of these patients. No complications were detected in peroperative and postoperative periods. Four patients had temporary dysphagia symptoms in the early follow-up period for 2 to 6 months.

Conclusion: The prosthetic repair of hiatal hernia has advantages as well as some problems. The patients did not have any problems due to repair with mesh in the follow-up period. We wait for the long term results currently. In our opinion, due to the high risk ratio of recurrence, using mesh in the selected patients would be advantageous to reduce the risk of recurrence in hiatal hernia.