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Onlay hiatal reinforcement utilizing human acellular dermal matrix: three case series
Jason M Johnson1, Brennan J Carmody, Mohammad K Jamal
1Department of General Surgery, William Beaumont Army Medical Center, El Paso, TX 79920-5001, and Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA. jason.johnson35@us.army.mil
Surgical Innovation
|October 15, 2005
Summary
Human acellular dermal matrix shows promise for reinforcing hiatal defects during complex hernia repairs. This technique offers a potentially effective solution for preventing recurrence in challenging cases.
Area of Science:
- Gastroenterology and Surgical Innovation
Background:
- Recurrence rates are high after primary suture repair for large paraesophageal hernias and redo laparoscopic fundoplication.
- Mesh prostheses are increasingly used for complex hiatal defect repairs.
Observation:
- Three patients with large paraesophageal hernias or recurrent hiatal defects underwent laparoscopic repair using human acellular dermal matrix as onlay reinforcement.
- The matrix was applied after primary suture closure of the hiatal defect.
Findings:
- All three laparoscopic repairs were successful, with no intraoperative or postoperative complications.
- Patients remain symptom-free at 8-10 months follow-up.
Implications:
- Human acellular dermal matrix is a promising prosthetic for hiatus reinforcement in complex hiatal hernia repairs and redo antireflux surgery.
- This approach may reduce recurrence rates in challenging laparoscopic procedures.