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Related Experiment Videos

The massive hiatal hernia: dealing with the defect.

Eduardo Ma Targarona1, Carmen Balagué, Carmen Martinez

  • 1Service of Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. etargarona@hsp.santpau.es.

Seminars in Laparoscopic Surgery
|October 29, 2004
PubMed
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Laparoscopic repair of paraesophageal hernias (PEHs) is safe, but recurrence can occur. Mesh reinforcement may prevent recurrence, but long-term data and potential severe complications necessitate selective use based on clinical experience.

Area of Science:

  • Gastrointestinal Surgery
  • Minimally Invasive Procedures

Background:

  • Laparoscopic fundoplication success has expanded to complex cases like paraesophageal hernias (PEHs).
  • Laparoscopic repair of PEHs is generally feasible and safe.
  • High recurrence rates (up to 42%) are reported due to challenges in hiatal gap closure.

Purpose of the Study:

  • To review techniques for preventing recurrence after laparoscopic repair of PEHs.
  • To evaluate the efficacy and safety of mesh use in hiatal closure for PEHs.

Main Methods:

  • Systematic review of existing literature on laparoscopic PEH repair techniques.
  • Analysis of studies investigating prosthetic mesh reinforcement for hiatal closure.

Main Results:

Related Experiment Videos

  • Current data suggest mesh use for hiatal repair is safe and effective in preventing PEH recurrence.
  • Limited long-term outcome data are available for mesh use in PEH repair.
  • Infrequent but severe complications associated with mesh use have been reported.

    • Conclusions:

    • Mesh reinforcement appears safe and effective for preventing recurrence in laparoscopic PEH repair.
    • Selective use of mesh is recommended, guided by clinical experience.
    • Further research is needed to establish long-term safety and efficacy.