Reinforcement of hiatal defect repair with absorbable mesh fixed with non-permanent devices.

Abstract

AIM:

To report the results of an open label prospective study on a new technique for laparoscopic hiatal hernia (HH) repair with absorbable mesh fixed with absorbable materials Methods: From January 2011 to May 2013, 43 patients were treated; group A, 20 patients submitted to laparoscopic sleeve gastrectomy (LSG); group B, 13 patients submitted to revisional surgery for the diagnosis of HH and symptomatic GERD post-LSG; and group C, ten patients submitted to 360° fundoplication. All patients underwent cruroplasty reinforced with bio-absorbable mesh fixed with absorbable tacks and/or fibrin glue. Conversion rate, intra-operative complications, operative time (tacks vs tacks plus fibrin glue), perioperative complications, perioperative symptoms and radiological control set the criteria for clinical/surgical evaluation.

RESULTS:

Conversion and mortality rate was 0%. The mean time for mesh fixation with the tacks vs tacks plus fibrin glue was 6.2 ± 2 vs 7.3 ± 3 min. The remission of GERD symptoms was observed in 39 patients, and we did not observe any cases of mesh-related complications at a mean follow-up of 17.4 months. Recurrence rate was 2.3% (one asymptomatic patient of group B).

CONCLUSIONS:

Reinforcement with absorbable mesh-cancel bio mesh is a safe and effective option for laparoscopic HH repair in normal weight and obese patients.

• Authors: Gianfranco Silecchia, Angelo Iossa, Giuseppe Cavallaro, Mario Rizzello, Fabio Longo
• Journal: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy (Minim Invasive Ther Allied Technol) Vol. 23 Issue 5 Pg. 302-8 (Oct 2014) ISSN: 1365-2931 [Electronic] England
• PMID: 24773371 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Fibrin Tissue Adhesive

Topics

• Adult
• Female
• Fibrin Tissue Adhesive
• Follow-Up Studies
• Gastrectomy (methods)
• Gastroesophageal Reflux (surgery)
• Hernia, Hiatal (surgery)
• Herniorrhaphy (methods)
• Humans
• Laparoscopy (methods)
• Male
• Middle Aged
• Obesity (complications)
• Operative Time
• Postoperative Complications (epidemiology)
• Prospective Studies
• Recurrence
• Surgical Mesh
• Treatment Outcome