532 OUTCOME OF QUILICI’S HEPATIC SHOULDER PROCEDURE TO AUGMENT LAPAROSCOPIC HIATOPLASTY IN LARGE OR RECURRENT HIATAL HERNIA

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Johannes Zacherl ◽  
Viktoria Kertesz ◽  
Cordula Höfle ◽  
Lisa Gensthaler ◽  
Bernhard Eltschka ◽  
...  
Keyword(s):  
High Risk ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Hernia Repair ◽  
Perioperative Complications ◽  
Recurrent Hernia ◽  
Hernia Recurrence ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

Abstract   Laparoscopic hiatoplasty and fundoplication is the gold standard of surgical treatment of GERD and hiatal hernia. However, the main drawback of laparoscopic hiatal hernia repair is a substantial recurrence rate. Hence, prosthetic meshs have been used to reduce the risk for recurrence. But meshs may cause major complications. As a consequence we adopted the hepatic shoulder plasty described by Quilici to augment the hiatal hernia repair in patients with a high risk for hernia recurrence. Methods Patients with large (>4 cm) axial hiatal hernia, giant paraesophageal or with recurrent hernia consecutively underwent laparoscopic hernia repair with crural sutures and hepatic shoulder plasty. A Toupet or a floppy Nissen fundoplication was added. In patients with giant paraesophageal hernia the hernia sack was resected. Perioperative complications were recorded. Follow-up comprised endoscopy and/or radiography and QoL-evaluation with the Eypasch score (GIQLI). Results Between 2012 and 2018 51 patients (mean age 71 years, 65% female) underwent Quilici’s procedure. Among them 33,3% had one or more previous hiatal hernia repair. There were no conversions. Postoperative complication rate was 7.8%. At follow-up after 2 years 6 recurrences (12%) were encountered, 4 of them were symptomatic (8%). One patient underwent reoperation due to hernia recurrence. In 84% QoL was significantly improved at follow-up. Conclusion In patients with high risk of recurrence, biological augmentation of the hiatal closure with the left lobe of the liver may be a valuable alternative to prosthetic reinforcement. We observed no complication attributable to liver lobe transposition.

Resorbable Biosynthetic Mesh for Crural Reinforcement during Hiatal Hernia Repair

2014 ◽  
Vol 80 (10) ◽  
pp. 1030-1033 ◽  
Author(s):  
Evan T. Alicuben ◽  
Stephanie G. Worrell ◽  
Steven R. DeMeester
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Recurrent Hernia ◽  
Synthetic Mesh ◽  
Hiatal Hernia Repair ◽  
Perioperative Morbidity ◽  
Collis Gastroplasty ◽  
Reduction Techniques ◽  
Crural Closure

The use of mesh to reinforce crural closure during hiatal hernia repair is controversial. Although some studies suggest that using synthetic mesh can reduce recurrence, synthetic mesh can erode into the esophagus and in our opinion should be avoided. Studies with absorbable or biologic mesh have not proven to be of benefit for recurrence. The aim of this study was to evaluate the outcome of hiatal hernia repair with modern resorbable biosynthetic mesh in combination with adjunct tension reduction techniques. We retrospectively analyzed all patients who had crural reinforcement during repair of a sliding or paraesophageal hiatal hernia with Gore BioA resorbable mesh. Objective follow-up was by videoesophagram and/or esophagogastroduodenoscopy. There were 114 patients. The majority of operations (72%) were laparoscopic primary repairs with all patients receiving a fundoplication. The crura were closed primarily in all patients and reinforced with a BioA mesh patch. Excessive tension prompted a crural relaxing incision in four per cent and a Collis gastroplasty in 39 per cent of patients. Perioperative morbidity was minor and unrelated to the mesh. Median objective follow-up was one year, but 18 patients have objective follow-up at two or more years. A recurrent hernia was found in one patient (0.9%) three years after repair. The use of crural relaxing incisions and Collis gastroplasty in combination with crural reinforcement with resorbable biosynthetic mesh is associated with a low early hernia recurrence rate and no mesh-related complications. Long-term follow-up will define the role of these techniques for hiatal hernia repair.

Initial Outcomes of Laparoscopic Paraesophageal Hiatal Hernia Repair with Mesh

2013 ◽  
Vol 79 (10) ◽  
pp. 1017-1021 ◽  
Author(s):  
Alana Gebhart ◽  
Steven Vu ◽  
Chris Armstrong ◽  
Brian R. Smith ◽  
Ninh T. Nguyen
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Recurrence Rate ◽  
Intraoperative Complications ◽  
Hernia Recurrence ◽  
Surgical Approaches ◽  
Hiatal Hernia Repair ◽  
Perioperative Morbidity ◽  
Paraesophageal Hiatal Hernia

The use of mesh in laparoscopic paraesophageal hiatal hernia repair (LHR) may reduce the risk of late hernia recurrence. The aim of this study was to evaluate initial outcomes and recurrence rate of 92 patients who underwent LHR reinforced with a synthetic bioabsorbable mesh. Surgical approaches included LHR and Nissen fundoplication (n = 64), LHR without fundoplication (n = 10), reoperative LHR (n = 9), LHR with a bariatric operation (n = 6), and emergent LHR (n = 3). The mean length of hospital stay was 2 ± 3 days (range, 1 to 30 days). There were no conversions to open laparotomy and no intraoperative complications. One of 92 patients (1.1%) required intensive care unit stay. The 90-day mortality was zero. Minor complications occurred in 3.3 per cent, major complications in 2.2 per cent, and late complications in 5.5 per cent of patients. There were no perforations or early hernia recurrence. The 30-day reoperation rate was 1.1 per cent. For patients with available 1-year follow-up, the overall recurrence rate was 18.5 per cent with a mean follow-up of 30 months (range, 12 to 51 months). LHR repair with mesh is associated with low perioperative morbidity and no mortality. The use of bioabsorbable mesh appears to be safe with no early hiatal hernia recurrence or late mesh erosion. Longer follow-up is needed to determine the long-term rate of hernia recurrence associated with LHR with mesh.

scholarly journals P-BN11 Patient Reported Outcomes of Phasix™ ST Mesh for Laparoscopic Hiatal Hernia Repair

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Yan Yu Tan ◽  
Sri Vishnu Thulasiraman ◽  
Phanibhushana Munipalle ◽  
Yirupaiahgari Viswanath
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Patient Reported Outcomes ◽  
Hiatal Hernia Repair ◽  
Complication Rates ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Patient Reported

Abstract Background Laparoscopic hiatal hernia repair continues to suffer from high recurrence rates, which has prompted the use of mesh reinforcement by some surgeons. Use of mesh however remains controversial due to its association with complications such as erosion, fibrosis and oesophageal stenosis. Biosynthetic Poly-4-Hydroxybutyrate Phasix™ ST mesh is an emerging technology which combines the durability of synthetic mesh with the remodelling characteristics of biologic mesh and includes an anti-adhesion hydrogel barrier. There is a paucity of patient reported outcome data for Phasix™ ST mesh. This study evaluates early patient reported outcomes following laparoscopic hiatal hernia repair with Phasix™ ST mesh. Methods Adult patients undergoing laparoscopic hiatal hernia repair with Phasix™ ST mesh between July 2020 to June 2021 at our institution were identified. Prospective data, including demographic data and complication rates, was collected from electronic and paper medical records. The 12-Item Short Form Survey (SF-12) was administered to assess quality of life pre-operatively and post-operatively with a minimum 30-day follow-up. Results Fourteen patients (12 female, one male) were included with a median age of 66 years (range 52-79). There were no intraoperative complications, mesh-related complications, re-operation, re-admission, or recurrence at a median follow-up of 4 months (IQR 4.0). Median physical health component (PHC) score was 32.7 (IQR 6.2) at baseline and increased to 41.6 (IQR 13.7) post-operatively. Median difference in PHC score was +11.4 (IQR 10.7). Median mental health component (MHC) score was 39.8 (IQR 12.5) at baseline and increased to 57.4 (IQR 8.2) post-operatively. Mean difference in MHC score was +17.7 (IQR 15.9). Conclusions To our knowledge, this is the first report of outcomes on the use of Phasix™ ST mesh for laparoscopic hiatal hernia repair in the United Kingdom. Our study found that it is associated with improvements in both physical and mental quality of life in the short-term post-operative follow-up, although there is some variation in the degree of improvement reported.

Laparoscopic hiatal hernia repair: why they fail

Hernia ◽  
2000 ◽  
Vol 4 (4) ◽  
pp. 219-222 ◽  
Author(s):  
C. J. Filipi
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

scholarly journals Iatrogenic cardiac tamponade after laparoscopic hiatal hernia repair requiring emergency sternotomy

2018 ◽  
Vol 56 (1) ◽  
pp. 215-215 ◽  
Author(s):  
Samuel Heuts ◽  
Walther N K A van Mook ◽  
Eric J Belgers ◽  
Roberto Lorusso
Keyword(s):  
Hernia Repair ◽  
Cardiac Tamponade ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

A646 Laparoscopic Hiatal Hernia Repair With A Fundopexy In a Post Sleeve Gastrectomy Patient

2019 ◽  
Vol 15 (10) ◽  
pp. S263
Author(s):  
Vicente Cogollo ◽  
Juliana Henrique ◽  
Luis Felipe Okida ◽  
Maria Fonseca ◽  
Emanuele Lo Menzo ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

scholarly journals Intrathoracic sleeve gastrectomy migration with gastric volvulus treated with laparoscopic repair and conversion to gastric bypass

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Yahya Alwatari ◽  
Renato Roriz-Silva ◽  
Roel Bolckmans ◽  
Guilherme M Campos
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Gastric Volvulus ◽  
Hiatal Hernia Repair ◽  
Upper Endoscopy ◽  
Technical Standards ◽  
Upper Gastrointestinal

Abstract A 43 years old female with laparoscopic sleeve gastrectomy (SG) and an ‘anterior’ hiatal hernia repair 11 years ago, presented with 3 years history dysphagia and heartburn. Upper gastrointestinal barium showed an almost complete intrathoracic migration of the SG with a partial organoaxial volvulus. Upper endoscopy revealed a 10 cm hiatal hernia with grade B esophagitis. Laparoscopic revision surgery with reduction of the gastric sleeve, standard posterior hiatal hernia repair, resection of the narrowed remnant of the SG and conversion to a gastric bypass was performed. No postoperative complications occurred. The patient is asymptomatic at 2 years of follow-up. We present the technical standards for the management and discuss the suspected pathophysiology of this rare but challenging condition.

Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

2019 ◽  
Vol 34 (7) ◽  
pp. 3072-3078 ◽  
Author(s):  
Alex Addo ◽  
Andrew Broda ◽  
H. Reza Zahiri ◽  
Ian M. Brooks ◽  
Adrian Park
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair
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