The use of mesh for laparoscopic repair of large
hiatal hernias may decrease recurrence rates in comparison with primary
suture repair. The type of mesh material, as well as its size and shape, is still a matter of debate. The aim of this study was to evaluate a lightweight
polypropylene mesh (TiMesh) repair of
hiatal hernias, with particular reference to symptomatic relief, patient satisfaction and quality of life (QOL). From a prospectively maintained clinical database, 40 consecutive patients were identified who underwent elective laparoscopic
hiatal hernia repair with TiMesh between November 2004 and December 2006. QOL and symptom analysis was carried out using Quality of Life in Reflux and
Dyspepsia (QOLRAD) and
dysphagia questionnaires preoperatively, and postoperatively after 6 weeks, 6 months, and 1 year. The mean age of the patient was 65.2 years (range: 40-93 years). Total complication rate was 7.5%; all complications were treated without residual disability. There was no 30-day mortality. Median
hospital stay was 2.7 days (range 2-13 days). Completed questionnaires were obtained from 37 (92.5%) of 40 patients. After 1 year, more than 90% of patients were satisfied with their symptomatic outcome and regarded their surgery as successful. There was a significant improvement in QOL, measured with QOLRAD at all postoperative time-points (P < 0.001). There was no difference between pre- and postoperative
dysphagia scores. Laparoscopic repair of large
hiatal hernias with TiMesh yields good symptomatic and clinical outcome. Further studies are needed to show whether the use of this lightweight
polypropylene mesh is associated with a reduction in recurrence rates after
hiatal hernia repair in the longer term.