Abstract
Background
Little grade A medical evidence exists to support the use of prosthetic material for hiatal closure. Therefore, the authors compiled and analyzed all the available literature to determine whether the use of prosthetic mesh in hiatoplasty for routine laparoscopic fundoplications (LF) or for the repair of large (>5 cm) paraesophageal hernias (PEH) would decrease recurrence.
Methods
A literature search was performed using an inclusive list of relevant search terms via Medline/PubMed to identify papers (n = 19) describing the use of prosthetic material to repair the crura of patients undergoing laparoscopic PEH reduction, LF, or both.
Results
Case series (n = 5), retrospective reviews (n = 6), and prospective randomized (n = 4) and nonrandomized (n = 4) trials were identified. Laparoscopic procedures (n = 1,368) were performed for PEH, gastroesophageal reflux disease (GERD), hiatal hernia, or a combination of the three. Group A (n = 729) had primary suture repair of the crura, and group B (n = 639) had repair with either interposition of mesh to close the hiatus or onlay of prosthetic material after hiatal or crural closure. The use of mesh was associated with fewer recurrences than primary suture repair in both the LF and PEH groups. The mean follow-up period did not differ between the groups (20.7 months for group A vs. 19.2 months for group B). None of the papers cited any instance of prosthetic erosion into the gastrointestinal tract.
Conclusions
The current data tend to support the use of prosthetic materials for hiatal repair in both routine LF and the repair of large PEHs. Longer and more stringent follow-up evaluation is necessary to delineate better the safety profile of mesh hiatoplasty. Future randomized trials are needed to confirm that mesh repair is superior to simple crural closure.
Similar content being viewed by others
References
Arendt T, Stuber E, Monig H, Folsch UR, Katsoulis S (2000) Dysphagia due to transmural migration of surgical material into the esophagus nine years after Nissen fundoplication. Gastrointest Endosc 51: 607–610
Arnaud JP, Pessaux P, Ghavami B, Flament JB, Trebuchet G, Meyer C, Huten N, Champault G (2000) Laparoscopic fundoplication for gastroesophageal reflux: multicenter study of 1,470 cases. Surg Endosc 14: 1024–1027
Athanasakis H, Tzortzinis A, Tsiaoussis J (2001) Laparoscopic repair of paraesophageal hernia. Endoscopy 33: 590–594
Baladas HG, Smith GS, Richardson MA, Dempsey MB, Falk GL (2000) Esophagogastric fistula secondary to teflon pledget: a rare complication following laparoscopic fundoplication. Dis Esophagus 13: 72–74
Basso N, De Leo A, Genco A, Rosato P, Rea S, Spaziani E, Primavera A (2000) 360° laparoscopic fundoplication with tension-free hiatoplasty in the treatment of symptomatic gastroesophageal reflux disease. Surg Endosc 14: 164–169
Basso N, Rosato P, De Leo A, Genco A, Rea S, Neri T (1999) “Tension-free” hiatoplasty, gastrophrenic anchorage, and 360° fundoplication in the laparoscopic treatment of paraesophageal hernia. Surg Laparosc Endosc 9: 257–262
Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240: 578–585
Carlson MA, Condon RE, Ludwig KA (1998) Management of intrathoracic stomach with polypropylene mesh prosthesis reinforced transabdominal hiatus hernia repair. J Am Coll Surg 187: 227–230
Carlson MA, Richards CG, Frantzides CT (1999) Laparoscopic reinforcement of hiatal herniorrhaphy. Diag Surg 16: 407–410
Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL, Grassi GB (2004) Evidence-based appraisal of antireflux fundoplication. Ann Surg 239: 325–337
Champion JK, Rock D (2003) Laparoscopic mesh cruroplasty for large paraesophageal hernias. Surg Endosc 17: 551–553
Cozacov C, Ben-Shlomo II (1991) Erosion of marlex mesh collar after vertical banded gastroplasty. Obes Surg 1: 443–444
Dally E, Falk GL (2004) Teflon pledget reinforced fundoplication causes symptomatic gastric and esophageal luminal penetration. Am J Surg 187: 226–229
Fernandez LR, Martinez SC, Ortega DP, Fradejas LJ, Marin LF, Moreno AM (2001) Colocutaneous fistula due to polypropylene mesh. Hernia 5: 107–109
Frantzides CT, Carlson MA (1997) Prosthetic reinforcement of posterior cruroplasty during laparoscopic hiatal herniorrhaphy. Surg Endosc 11: 769–771
Frantzides CT, Madan AK, Carlson MA (2002) A prospective randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia. Arch Surg 137: 649–652
Frantzides CT, Richards CG, Carlson MA (1999) Laparoscopic repair of large hiatal hernia with polytetrafluroethylene. Surg Endosc 13: 906–908
Granderath FA, Kamolz T, Schweiger UM (2003) Laparoscopic refundoplication with prosthetic hiatal closure for recurrent hiatal hernia after primary failed antireflux surgery. Arch Surg 138: 902–907
Granderath FA, Schweiger UM, Kamolz T (2002) Laparoscopic antireflux surgery with routine mesh-hiatoplasty in the treatment of gastroesophageal reflux disease. J Gastrointest Surg 6: 347–353
Granderath FA, Schweiger UM, Kamolz T, Asche KU, Pointner R (2005) Laparoscopic Nissen fundoplication with prosthetic hiatal closure reduces postoperative intrathoracic wrap herniation. Arch Surg 140: 40–48
Hashemi M, Peters JH, Deemeester TR, Huprich JE, Quek M, Hagen JA, Crookes PF, Theisen J, DeMeester SR, Sillin LF, Bremner CG (2000) Laparoscopic repair of large type III hiatal hernia: objective follow up reveals high recurrence rate. J Am Coll Surg 190: 553–561
Hawasli A, Zonca S (1998) Laparoscopic repair of paraesophageal hiatal hernia. Am Surg 64: 703–710
Horstmann R, Klotz A, Classen C, Palmes D (2004) Feasibility of surgical technique and evaluation of postoperative quality of life after laparoscopic treatment of intrathoracic stomach. Langenbecks Arch Surg 389: 23–31
Hui TT, Thoman DS, Spyrou M, Philips EH (2001) Mesh crural repair of large paraesophageal hiatal hernias. Am Surg 67: 1170–1174
Huntington TR (1997) Short-term outcomes of laparoscopic paraesophageal hernia repair: a case series of 58 consecutive patients. Surg Endosc 11: 894–898
Jakaite D, Gourley GR, Pellett JR (1991) Erosions of the Angelchik prosthesis in pediatric-sized developmentally disabled patients. J Pediaty Gastroenterol Nutr 13: 186–191
Kamolz T, Granderath FA, Bammer T (2002) Dysphagia and quality of life after laparoscopic Nissen fundoplication in patients with and without prosthetic reinforcement of the hiatal crura. Surg Endosc 16: 572–577
Keidar A, Szold A (2003) Laparoscopic repair of paraesophageal hernia with selective use of mesh. Surg Laparosc Endosc Percutan Tech 13: 149–154
Leeder PC, Smith G, Dehn TC (2003) Laparoscopic management of large paraesophageal hiatal hernia. Surg Endosc 17: 1372–1375
Lichtenstein IL (1987) Herniorrhaphy a personal experience with 6,321 cases. Am J Surg 153: 553–559
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157: 188–193
Losanoff JE, Richman BW, Jones JW (2002) Entero-colocutaneous fistula: a late consequence of polypropylene mesh abdominal wall repair: case report and review of the literature. Hernia 6: 144–147
Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh for incisional hernia. N Engl J Med 343: 392–398
Miller K, Junger W (1997) Ileocutaneous fistula formation following laparoscopic polypropylene mesh hernia repair. Surg Endosc 11: 772–773
Moreno P, Alastrue A, Rull M, Formiguera X, Casas D, Boix J, Fernandez-Llamazares J, Broggi MA (1998) Band erosion in patients who have undergone vertical banded gastroplasty: incidence and technical solutions. Arch Surg 133: 189–193
Morino F, Toppino M, Fronda G, Tapparo A, Avagnina S (1992) Weight loss and complications after vertical banded gastroplasty. Obes Surg 2: 69–73
Oelschlager BK, Barreca M, Chang L, Pellegrini CA (2003) The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique. Am J Surg 186: 4–8
Paul MG, DeRosa RP, Petrucci PE, Palmer ML, Danovitch SH (1997) Laparoscopic tension-free repair of large paraesophageal hernias. Surg Endosc 11: 303–307
Purkiss SF, Argano VA, Kuo J, Lewis CT (1992) Oesophageal erosion of an Angelchik prosthesis: surgical management using fundoplication. Eur J Cardiothorac Surg 6: 517–518
Schauer PR, Ikramuddin S, McLaughlin RH, Graham TO, Slivka A, Lee KK, Schraut WH, Luketich JD (1998) Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg 176: 659–665
Soper NJ, Dunnegan D (1999) Anatomic fundoplication failure after laparoscopic antireflux surgery. Ann Surg 229: 669–677
Subramanyam K, Robbins HT (1989) Erosion of marlex bank and silastic ring into the stomach after gastroplasty: endoscopic recognition and management. Am J Gastroenterol 84: 1319–1321
Targarona EM, Bendahan G, Balague C, Garriga J, Trias M (2004) Mesh in the hiatus. Arch Surg 139: 1286–1296
Vrijland WW, van den Tol MP, Luijendijk RW, Hop WC, Busschback JJ, de Lange DC, van Geldere D, Rottier AB, Vegt PA, IJzermans JN, Jeekel J (2002) Randomized clinical trial of nonmesh versus mesh repair of primary inguinal hernia. Br J Surg 89: 293–297
Wichterman K, Geha AS, Cahow CE, Baue AE (1979) Giant paraesophageal hiatus hernia with intrathoracic stomach and colon: the case for early repair. Surgery 86: 497–506
Wiechmann RJ, Ferguson MK, Naunheim KS, McKesey P, Hazelrigg SJ, Santucci TS, Macherey RS, Landreneau RJ (2001) Laparoscopic management of giant paraesophageal herniation. Ann Thoracic Surg 71: 1080–1087
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Johnson, J.M., Carbonell, A.M., Carmody, B.J. et al. Laparoscopic mesh hiatoplasty for paraesophageal hernias and fundoplications. Surg Endosc 20, 362–366 (2006). https://doi.org/10.1007/s00464-005-0357-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-005-0357-5