3D mesh-augmented hiatal hernia repair in patients with GERD: A 3-year single-center experience

There are multiple techniques available to repair hiatal hernias. However, recurrence rates are fairly high. Mesh augmentation of the hiatal repair reduces the rate of recurrence, but is still highly controversial despite its frequent use. The aim of the present study was to evaluate clinical results of the minimally invasive mesh-augmented hiatal reconstruction using a new alloplastic 3D mesh (DynaMesh®-DELTA).

Between January 2019 and December 2022, 320 patients underwent 3D mesh-augmented hiatoplasty at Vivantes Urban Hospital, Berlin, Germany. 133 patients completed follow-up and were subsequently included in this study. Information regarding patient characteristics as well as peri- and postoperative complications were obtained from the electronic patient charts. Patients were followed-up by scheduled visits and questionnaires.

24 (17.1%) out of the 133 patients had complications. One patient had an early recurrence and required redo surgery during the initial stay. Only 3 (2.2%) patients had grade III complications and underwent invasive treatment under general anesthesia. Overall mortality was 0%. During follow-up, 72.7% of the patients reported to be relatively asymptomatic. However, 23 (17.4%) patients had recurrent hiatal hernias and relevant symptoms. 12 (9.1%) of the patients underwent reoperation.

Patients undergoing mesh-augmented hiatal hernia repair showed low postoperative morbidity and recurrence rates. The majority of the patients had significantly improved GERD-associated symptoms. Given the fact that GERD symptom control may be multifactorial, the present technical approach to hiatal hernia repair should be investigated in more detail in the future.