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Transthoracic repair of an incarcerated diaphragmatic hernia using hexamethylene diisocyanate cross-linked porcine dermal collagen (Permacol)

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Abstract

It is the general surgeon who commonly repairs paraesophageal hernias nowadays, and they are repaired laparoscopically, making the performance of thoracotomy relatively rare. Whether to use prosthetic materials to repair the hiatus is still under debate, as is the question of which material to use, if any. We report a case of a 38-year-old man who had a large, incarcerated paraesophageal hernia. He had a past history of extensive abdominal surgery for exomphalos, which rendered any abdominal surgical approach a high-risk procedure. We therefore decided to proceed with thoracotomy and repair of the hiatus with hexamethylene diisocyanate (HMDI) cross-linked porcine dermal collagen. He made a good recovery with no complications.

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References

  1. Davis SS Jr. Current controversies in paraesophageal hernia repair. Surg Clin North Am 2008;88:959–978.

    Article  PubMed  Google Scholar 

  2. Akerlund A, Ohnell A, Key E. Hernia diaphragmatica hiatus oesophagei vom anatomischen und rontgenologischen gesichtspunkt. Acta Radiol 1926;6:3.

    Article  Google Scholar 

  3. Rogers ML, Duffy JP, Beggs FD, Salama FD, Knowles KR, Morgan WE. Surgical treatment of para-oesophageal hiatal hernia. Ann R Coll Surg Engl. 2001;83:394–398.

    PubMed  CAS  Google Scholar 

  4. Cuschieri A, Shimi S, Nathanso LK. Laparoscopic reduction, crural repair, and fundoplication of large hiatal hernia. Am J Surg 1992;163:425.

    Article  PubMed  CAS  Google Scholar 

  5. Targarona EM, Bendahan G, Balague C, Garriga J, Trias M. Mesh in the hiatus: a controversial issue. Arch Surg 2004;139:1286–1296.

    Article  PubMed  Google Scholar 

  6. Johnson JM, Carbonell AM, Carmody BJ, Jamal MK, Maher JW, Kellum JM, et al. Laparoscopic mesh hiatoplasty for paraesophageal hernias and fundoplications: a critical analysis of the available literature. Surg Endosc 2006;20:362–366.

    Article  PubMed  CAS  Google Scholar 

  7. Ringley CD, Bochkarev V, Ahmed SI, Vitamvas ML, Oleynikov D. Laparoscopic hiatal hernia repair with human acellular dermal matrix patch: our initial experience. Am J Surg 2006;192:767–772.

    Article  PubMed  Google Scholar 

  8. Oelschlager BK, Pellegrini CA, Hunter J, Soper N, Brunt M, Sheppard B, et al. Biologic prosthesis reduces recurrence after laparoscopic paraesophageal hernia repair: a multicenter, prospective, randomized trial. Ann Surg 2006;244:481–490.

    PubMed  Google Scholar 

  9. Fumagalli U, Bona S, Caputo M, Elmore U, Battafarano F, Pestalozza A, et al. Are Surgisis biomeshes effective in reducing recurrences after laparoscopic repair of large hiatal hernias? Surg Laparosc Endosc Percutan Tech 2008;18:433–436.

    Article  PubMed  Google Scholar 

  10. Gaertner WB, Bonsack ME, Delaney JP. Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 2007;11:1275–1285.

    Article  PubMed  Google Scholar 

  11. Petter-Puchner AH, Fortelny RH, Mittermayr R, Walder N, Ohlinger W, Redl H. Adverse effects of porcine small intestine submucosa implants in experimental ventral hernia repair. Surg Endosc 2006;20:942–946.

    Article  PubMed  CAS  Google Scholar 

  12. Lee EI, Chike-Obi CJ, Gonzalez P, Garza R, Leong M, Subramanian A, et al. Abdominal wall repair using human acellular dermal matrix: a follow-up study. Am J Surg 2009;198:650–657.

    Article  PubMed  Google Scholar 

  13. Gupta A, Zahriya K, Mullens PL, Salmassi S, Keshishian A. Ventral herniorrhaphy: experience with two different biosynthetic mesh materials, Surgisis and Alloderm. Hernia 2006;10:419–425.

    Article  PubMed  CAS  Google Scholar 

  14. Miserez M, Grass G, Weiss C, Stützer H, Sauerland S, Neugebauer EA et al. Closure of the LAPSIS trial. Br J Surg 2010;97:1598.

    Article  PubMed  CAS  Google Scholar 

  15. Mitchell IC, Garcia NM, Barber R, Ahmad N, Hicks BA, Fischer AC. Permacol: a potential biologic patch alternative in congenital diaphragmatic hernia repair. J Pediatr Surg 2008;43:2161–2164.

    Article  PubMed  Google Scholar 

  16. Hiles M, Record Ritchie RD, Altizer AM. Are biologic grafts effective for hernia repair? A systematic review of the literature. Surg Innov 2009;16:26–37.

    Article  PubMed  Google Scholar 

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Correspondence to Neil Smart.

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Gooch, B., Smart, N. & Wajed, S. Transthoracic repair of an incarcerated diaphragmatic hernia using hexamethylene diisocyanate cross-linked porcine dermal collagen (Permacol). Gen Thorac Cardiovasc Surg 60, 145–148 (2012). https://doi.org/10.1007/s11748-011-0786-0

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  • DOI: https://doi.org/10.1007/s11748-011-0786-0

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