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01-05-2005 | Original Article

Tension-free repair of hiatal hernia during laparoscopic fundoplication: a ten-year experience

Authors: P. V. Gryska, J. K. Vernon

Published in: Hernia | Issue 2/2005

Abstract

Background: The breakdown of a hiatal hernia repair can lead to clinical failure. The use of prosthetic material at the esophageal hiatus to strengthen the crural repair is relatively new and questions remain. This report examines the safety and efficacy of a tension-free crural repair with mesh.

Patients and methods: Since 1993, 135 consecutive patients (19–86) [9 re-do] completed laparoscopic tension-free hiatal hernia repair prior to Nissen wrap. Esophageal hiatus was patched with a PTFE mesh (first 112 patients) or a PTFE/ePTFE composite (23 patients) secured across the defect with staples to each crura. 130 patients completed a phone questionnaire during 2003/2004 (mean f/u 64 months).

Results: There have been no short-term nor long-term infections related to the PTFE mesh. Symptoms were resolved or improved and resolved with meds in 122/130 (94%). Early re-herniation occurred in one patient after vigorous exercise.

Conclusions: Mesh repair/patch of the esophageal hiatus can be done without infection, with results similar to standard crural repair and consistent with surgical principles of non-tension.

Spechler SJ, VA Study Group (1992) Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. New Engl J Med 326:786–792

Spechler SJ, Lee E, Ahnen D, Goyal R, Hirano I, Ramirez F, Raufman JP, Sampliner R, Schnell T, Sontag S, Vlahcevic Z, Young R, Williford W (2001) Long term outcome of medical and surgical therapies for gastroesophageal reflux disease. J Am Med Assoc 285:2331–2338CrossRef

Filipi CJ (2000) Laparoscopic hiatal hernia repair: why they fail. Hernia 4:219–222

Hunter J, Smith D, Branum G, Waring P, Trus T, Cornwell M, Galloway K (1999) Laparoscopic fundoplication failures: patterns of failure and response to fundoplication revision. Ann Surg 230:595–606CrossRefPubMed

Hashemi M, Peters J, Demeester T, Huprich J, Queck M, Hagen J, Crookes P, Theisen J, Demeester JR, Sillin L, Bremner C (2000) Laparoscopic repair of large type III hiatal hernia: objective follow-up reveals high recurrence rate. J Am Coll Surgeons 190:553–560CrossRef

Carlson MA, Frantzides CT (2001) Complications and results of minimally invasive antireflux procedures: a review of 10,735 reported cases. J Am Coll Surgeons 193:428–439CrossRef

Mittal S, Filipi CJ, Anderson P, Fenton S, Cummings J, Cornet D, Quinn T, Fitzgibbons R (1999) Additional mechanisms of hiatal hernia recurrence and its prevention. Hernia 3:215–220

Kakarlapudi G, Awad Z, Haynatzki G, Sampson T, Stroup G, Filipi CJ (2002) The effect of diaphragmatic stressors on recurrent hiatal hernia. Hernia 6:163–166CrossRefPubMed

Granderath F, Kamolz T, Schweiger M, Pasiut M, Haas C, Wykypiel H, Pointer R (2002) Long-term results of laparoscopic antireflux surgery. Surg Endosc 16:753–757CrossRefPubMed

10.

Watson D, Jamieson G, Devitt P, Mitchell P, Game P (1995) Paraesophageal hiatus hernia: an important complication of laparoscopic Nissen fundoplication. Brit J Surg 82:521–523

11.

Kamolz T, Granderath FA, Bammer T, Pasiut M, Pointner R (2002) Dysphagia and quality of life after laparoscopic Nissen fundoplication in patients with and without prosthetic reinforcement of the hiatal crura. Surg Endosc 16:572–577CrossRefPubMed

12.

Frantzides C, Madan A, Carlson M, Stavropoulos G (2002) A prospective, randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia. Arch Surg 137:649–652CrossRefPubMed

13.

Basso N, DeLeo A, Genco A, Rosato P, Rea S, Spaziani E, Privaera A (2002) 360° laparoscopic fundoplication with tension-free hiatoplasty in the treatment of symptomatic gastroesophageal reflux disease. Surg Endosc 14:164–169CrossRef

14.

Casaccia M, Torelli P, Panaro F, Cavaliere D, Ventura A, Valente U (2002) Laparoscopic physiological hiatoplasty for hiatal hernia: new composite “A”-shaped mesh. Surg Endosc 16:1441–1445CrossRefPubMed

15.

Granderath F, Kamolz T, Schweiger U, Pointer R (2003) Laparoscopic refundoplication with prosthetic hiatal closure after primary failed antireflux surgery. Arch Surg 138:902–907CrossRefPubMed

16.

Gillian K, Geis P, Grover G (2002) Laparoscopic incisional and ventral hernia repair (LIVH): an evolving outpatient technique. J Soc Laparoendesc Surg 6:315–322

17.

Amid P, Shulman A, Lichtenstein I, Hakakha M (1994) Biomaterials for abdominal wall hernia surgery and principles of their applications. Langenbeck Arch Chir 379:168–171CrossRef

18.

Cadiere GB, Bruyns J, Himpens J, Vertruyen M (1996) Intrathoracic migration of the wrap after laparoscopic Nissen fundoplication. Surg Endosc 10:187

19.

Munro W, Brancatisano R, Adams IP, Falk GL (1996) Complication of laparoscopic fundoplication: the first 100 patients. Surg Laparosc Endosc 6:421–423CrossRef

20.

Stein HJ, Feussner H, Siewert JR (1996) Failure of antireflux surgery: causes and management strategies. Am J Surg 171:36–40CrossRefPubMed

21.

Perdikis G, Hinder RA, Filipi CJ, Walenz T, McBride PJ, Smith SL, Kateda N, Klinger PJ (1997) Laparoscopic paraesophageal hernia repair. Arch Surg 132:586–591PubMed

22.

Champion JK, Rock D (2003) Laparoscopic mesh cruroplasty for large paraesophageal hernias. Surg Endosc 17:551–553CrossRefPubMed

23.

Orringer MB, Skinner DB, Belsey RH (1973) Long-term results of the Mark IV operation for hiatal hernia: an analyses of recurrences and their treatment. J Thorac Cardiov Sur 63:25–33

24.

Pitcher DE, Curet MJ, Martin DT, Vogt DM, Mason J, Zucker KA (1995) Successful laparoscopic repair of paraesophageal hernia. Arch Surg 130:6

25.

Schulz HG, Meister V, Bayerl WP, Kahlert M (1996) Totally intrathoracic stomach-laparoscopic reposition of herniated stomach, posterior crural repair. In: Fifth World Polydisciplinary Congress of the International Organization for Statistical Studies on Diseases of the Esophagus (OESO): The Esophagogastric Junction, 4–7 September 1996, Paris 9:2

26.

Paul MG, DeRosa RP, Petrucci PE, Palmer ML, Danovitch SH (1997) Laparoscopic tension-free repair of large paraesophageal hernias. Surg Endosc 11:303–307CrossRefPubMed

27.

Bayerl WP, Schulz HG, Rupp KD (1998) Recurrence of laparoscopic antireflux operations with and without prosthesis with 318 patients. Cong Soc Gastroenterol Westphalia 7

28.

Palanivelu C, Kumar KS, Rajan PS, Parthasarathi R, Shetty AR, Ravichandran R (2002) Role of laparoscopic tension-free cruroplasty in the management of large hiatus. Surg Endosc 16:277

29.

Morales-Conde S, Bellido J, Cadet I, Martin M (2002) Indications and management of prostheses to close the crura during laparoscopic repair of paraesophageal hernias. Surg Endosc 16:284

Title: Tension-free repair of hiatal hernia during laparoscopic fundoplication: a ten-year experience
Authors: P. V. Gryska
J. K. Vernon
Publication date: 01-05-2005
Publisher: Springer-Verlag
Published in: Hernia / Issue 2/2005
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-004-0312-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tension-free repair of hiatal hernia during laparoscopic fundoplication: a ten-year experience

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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