[СOMPARISON OF LAPAROSCOPIC CRURORAPHY AND PLASTY, USING LIGHTWEIGHT NET TRANSPLANT IN LARGE HIATAL HERNIAS: REMOTE...

Area of Science:

• Gastroenterology and Surgical Innovation
• Minimally Invasive Surgery Techniques
• Biomaterials in Medical Devices

Background:

• Large hiatal hernias (HH) present significant surgical challenges, often leading to recurrence after primary repair.
• Laparoscopic techniques have advanced HH treatment, but recurrence rates remain a concern.
• The efficacy of mesh augmentation in laparoscopic hiatal hernia repair requires further investigation.

Purpose of the Study:

• To compare the outcomes of two laparoscopic hiatal hernia repair procedures: simple cruroraphy versus a two-layered plasty with lightweight partially absorbable net (LPAN).
• To evaluate the impact of LPAN augmentation on anatomical recurrence rates and functional outcomes in patients with large hiatal hernias.
• To determine the safety and efficacy of LPAN in reducing recurrence without increasing complications.

Main Methods:

• A prospective randomized investigation comparing cruroraphy (Group I) with two-layered plasty using LPAN Ultrapro (Group II) for large hiatal hernias.
• Follow-up assessment of treatment results over an average of 24.4 months.
• Evaluation of symptomatic anatomical recurrences, functional recurrences, and duration of functional dysphagia.

Main Results:

• The rate of symptomatic anatomical recurrences, including those with functional recurrences, was significantly lower in Group II (LPAN plasty).
• The duration of functional dysphagia, excluding cases with stricture, did not show a significant difference between the two groups.
• No significant increase in complication rates was observed in the LPAN group.

Conclusions:

• Two-layered plasty using LPAN is effective in reducing anatomical recurrence rates for large hiatal hernias.
• This technique offers a safe and effective surgical option for large hiatal hernias, potentially becoming the operation of choice.
• LPAN augmentation provides a valuable tool in laparoscopic hiatal hernia repair, improving long-term outcomes.