Retrospective Review and Prospective Follow-up of 85 Consecutive Patients Treated With a Novel Hepatic-derived Surgical Mesh for Hiatal Hernia Repair: Outcomes, Surgical Complications, and Revisions

This study examined outcomes, surgical complications, and revisions in patients treated with laparoscopic Nissen fundoplication for hiatal hernia and substantial gastroesophageal reflux disease. In total, 85 consecutive patients who underwent hernia repair with MIROMESH Biologic Matrix, a novel hepatic-derived surgical mesh served as subjects. Subjects were contacted by phone, consented, and participated in an Institutional Review Board-approved structured phone interview. Responses were acquired from 73 of the 85 patients. The gastroesophageal reflux disease health–related quality of life showed significant improvement postoperatively. Subjects reported high satisfaction with the procedure. The use of proton pump inhibitors was significantly reduced. Three minor complications were reported; these were quickly resolved without further sequelae. There were no mesh-related complications. No subjects reported further surgery. Placement of the surgical mesh, during surgery, to reinforce the hiatal repair was easy and safe. Excellent outcomes and no revisions a mean of 1.3 years after surgery suggest that a durable repair had been achieved.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research

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To verify the results of the treatment of post-operative giant hiatal hernia (POGH). The POGH becomes each time more frequent after surgical treatment of the gastroesophageal reflux. Fifteen patients (6 females and 9 males; 43.66 ± 5.05 years old; BMI 22.13 ± 1.92) were referred to our Service, for surgical treatment of a type III POGH 30.4 ± 1.76 months after treatment of gastroesophageal reflux disease. The need for a reoperation was determined mainly by dysphagia. Reoperation was completed laparoscopically in all patients and the mean postoperative hospital stay was 3.2 ± 1...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
ConclusionThe majority of patients undergoing ARS do not require additional care within 90  days of surgery. Patients who are readmitted accrue costs that almost double the overall cost of care compared to the initial hospitalization. Measures to attenuate potentially preventable readmissions after ARS may reduce healthcare utilization in this patient population.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusion: In this series of 32 cases, laparoscopic cruroplasty with UBM graft reinforcement has been effective and durable at 12 months of followup. This technique may offer one satisfactory solution for large hiatal hernia repair concomitant with laparoscopic sleeve gastrectomy that may achieve a durable repair with low GERD symptoms. PMID: 30880900 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
ConclusionLHR shows excellent long-term durability and quality of life similar to the open Hill repair, with 85% good to excellent results at a median follow-up of 19  years and a reoperation rate under 10%. It is surmised that Hill suture fixation of the gastroesophageal junction to the preaortic fascia may confer unique structural integrity compared to other repairs.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Endoluminal functional lumen imaging probe (EndoFLIP) can provide real time information about characteristics of the gastroesophageal junction. We performed retrospective analysis of prospectively collected data on use of EndoFLIP during minimally invasive hiatal hernia repair to tailor the size of the crural closure and size of the fundoplication. We then determined whether it provides good reflux control without significant dysphagia. Forty patients underwent minimally invasive hiatal hernia repair with fundoplication. After fundoplication, the average minimal diameter (Dmin) decreased to 5.97±0.6 from 8.92±...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
Majority of severe gastroesophageal reflux disease (GERD) patients have a hiatal hernia over 2 cm, a Hill Grade 2 or higher. Transoral incisionless fundoplication (TIF) procedure has been shown to improve GERD symptomatology for patients with a hiatal hernia of 2 cm or less. However, data is limited on efficacy of a hybrid procedure, combining both intraoperative endoscopic TIF and laparoscopic hernia repair for non-TIF candidates. The hybrid procedure allows for less extensive surgical dissection minimizing operative risks while TIF is associated with lower rates of post-fundoplication dysphagia and gas-bloating.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Saturday abstract Source Type: research
ConclusionsUse of non-absorbable mesh to reinforce primary hiatal hernia repair results in equal hiatal hernia recurrence and symptomatic outcome compared to repair using sutures alone. During 1-year follow-up, there were no mesh-related complications. Follow-up beyond 1  year needs to demonstrate whether these findings are sustained.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
This study was performed on 98 gastroesophageal reflux disease patients who underwent Nissen fundoplication with mesh-augmented crura repair and fundoplication with standard crura repair. We used non-absorbable laparoscopic self-fixating mesh by ProGrip ™. All patients were separated into the mesh group (n = 50) and non-mesh group (n = 48). The groups were evaluated according to the following criteria: dysphagia, patients’ symptomatic outcome judgment according to The Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire and patients’ satisfac...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ABSTRACT Background: To determine the correlation between asthma and hiatal hernia (HH) in patients with gastroesophageal reflux disease (GERD)‐related asthma requiring laparoscopic anti‐reflux surgery. Methods: One hundred thirty‐six GERD patients with medically refractory asthma with (80 patients) or without HH (56 patients) were enrolled. GERD was assessed by endoscopy, esophageal manometry, reflux monitoring, and symptom questionnaires, and treated with laparoscopic Nissen fundoplication (LNF) or LNF with concomitant hiatal hernia repair (LNF‐HHR). The outcome measures included patient satisfaction and drug ind...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
AbstractBackgroundHiatus hernia (HH) contributes to the pathophysiology of gastroesophageal reflux disease (GERD). Mesh-augmentation of surgical repair might be associated with a reduced risk of recurrence and GERD. However, recurrence rates, mesh-associated complications and quality of life (QOL) after mesh versus suture repair are debated. The aim of this meta-analysis was to determine HH recurrence following mesh-augmentation versus suture repair. Secondary aims were to compare complications, mortality, QOL and GERD symptoms following different repair techniques.MethodsA systematic literature search of the PubMed, Medli...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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