Non-absorbable mesh erosion following hiatal repair: a case series

Despite an absence of recent supportive evidence, mesh is frequently used as an adjunct to suture closure during hiatal hernia repair to increase repair durability. Erosion of non-absorbable mesh is a well-recognized complication of this approach. We present a case series of three patients with asymptomatic erosion of light weight polypropylene mesh (LWPM). From a series of 393 patients undergoing hiatal repair with LWPM, three cases of mesh erosion were identified. One male presented with ongoing reflux symptoms and recurrent hiatal failure who ultimately underwent Roux-en-Y gastric bypass with resolution of reflux symptoms. Two females presented with asymptomatic erosion. One underwent gastroscopy and colonoscopy for investigation of iron deficiency and the other gastroscopy for bleeding gastric ulceration unrelated to mesh erosion. Mesh erosion is a well-recognized and feared complication of mesh-augmented hiatal repair. Erosion of LWPM may be associated with fewer symptomatic implications than previously anticipated.