Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic mesh hiatoplasty for paraesophageal hernias and fundoplications

A critical analysis of the available literature

  • Original articles
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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

    Article  CAS  PubMed  Google Scholar 

  2. 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

    PubMed  Google Scholar 

  3. Athanasakis H, Tzortzinis A, Tsiaoussis J (2001) Laparoscopic repair of paraesophageal hernia. Endoscopy 33: 590–594

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  CAS  PubMed  Google Scholar 

  5. 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

    CAS  PubMed  Google Scholar 

  6. 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

    Article  CAS  Google Scholar 

  7. 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

    PubMed  Google Scholar 

  8. 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

    Article  CAS  PubMed  Google Scholar 

  9. Carlson MA, Richards CG, Frantzides CT (1999) Laparoscopic reinforcement of hiatal herniorrhaphy. Diag Surg 16: 407–410

    CAS  Google Scholar 

  10. 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

    PubMed  Google Scholar 

  11. Champion JK, Rock D (2003) Laparoscopic mesh cruroplasty for large paraesophageal hernias. Surg Endosc 17: 551–553

    CAS  PubMed  Google Scholar 

  12. Cozacov C, Ben-Shlomo II (1991) Erosion of marlex mesh collar after vertical banded gastroplasty. Obes Surg 1: 443–444

    Article  PubMed  Google Scholar 

  13. Dally E, Falk GL (2004) Teflon pledget reinforced fundoplication causes symptomatic gastric and esophageal luminal penetration. Am J Surg 187: 226–229

    Article  PubMed  Google Scholar 

  14. Fernandez LR, Martinez SC, Ortega DP, Fradejas LJ, Marin LF, Moreno AM (2001) Colocutaneous fistula due to polypropylene mesh. Hernia 5: 107–109

    Google Scholar 

  15. Frantzides CT, Carlson MA (1997) Prosthetic reinforcement of posterior cruroplasty during laparoscopic hiatal herniorrhaphy. Surg Endosc 11: 769–771

    Article  CAS  PubMed  Google Scholar 

  16. 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

    PubMed  Google Scholar 

  17. Frantzides CT, Richards CG, Carlson MA (1999) Laparoscopic repair of large hiatal hernia with polytetrafluroethylene. Surg Endosc 13: 906–908

    Article  CAS  PubMed  Google Scholar 

  18. 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

    PubMed  Google Scholar 

  19. 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

    PubMed  Google Scholar 

  20. 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

    PubMed  Google Scholar 

  21. 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

    Article  CAS  PubMed  Google Scholar 

  22. Hawasli A, Zonca S (1998) Laparoscopic repair of paraesophageal hiatal hernia. Am Surg 64: 703–710

    CAS  PubMed  Google Scholar 

  23. 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

    Article  CAS  PubMed  Google Scholar 

  24. Hui TT, Thoman DS, Spyrou M, Philips EH (2001) Mesh crural repair of large paraesophageal hiatal hernias. Am Surg 67: 1170–1174

    CAS  PubMed  Google Scholar 

  25. Huntington TR (1997) Short-term outcomes of laparoscopic paraesophageal hernia repair: a case series of 58 consecutive patients. Surg Endosc 11: 894–898

    Article  CAS  PubMed  Google Scholar 

  26. 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

    CAS  Google Scholar 

  27. 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

    CAS  PubMed  Google Scholar 

  28. Keidar A, Szold A (2003) Laparoscopic repair of paraesophageal hernia with selective use of mesh. Surg Laparosc Endosc Percutan Tech 13: 149–154

    Article  PubMed  Google Scholar 

  29. Leeder PC, Smith G, Dehn TC (2003) Laparoscopic management of large paraesophageal hiatal hernia. Surg Endosc 17: 1372–1375

    Article  CAS  PubMed  Google Scholar 

  30. Lichtenstein IL (1987) Herniorrhaphy a personal experience with 6,321 cases. Am J Surg 153: 553–559

    Article  CAS  PubMed  Google Scholar 

  31. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157: 188–193

    Article  CAS  PubMed  Google Scholar 

  32. 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

    CAS  PubMed  Google Scholar 

  33. 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

    Article  CAS  PubMed  Google Scholar 

  34. Miller K, Junger W (1997) Ileocutaneous fistula formation following laparoscopic polypropylene mesh hernia repair. Surg Endosc 11: 772–773

    Article  CAS  PubMed  Google Scholar 

  35. 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

    CAS  PubMed  Google Scholar 

  36. Morino F, Toppino M, Fronda G, Tapparo A, Avagnina S (1992) Weight loss and complications after vertical banded gastroplasty. Obes Surg 2: 69–73

    Article  PubMed  Google Scholar 

  37. 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

    Article  PubMed  Google Scholar 

  38. Paul MG, DeRosa RP, Petrucci PE, Palmer ML, Danovitch SH (1997) Laparoscopic tension-free repair of large paraesophageal hernias. Surg Endosc 11: 303–307

    CAS  PubMed  Google Scholar 

  39. 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

    Article  CAS  PubMed  Google Scholar 

  40. 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

    Article  CAS  PubMed  Google Scholar 

  41. Soper NJ, Dunnegan D (1999) Anatomic fundoplication failure after laparoscopic antireflux surgery. Ann Surg 229: 669–677

    Article  CAS  PubMed  Google Scholar 

  42. 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

    CAS  PubMed  Google Scholar 

  43. Targarona EM, Bendahan G, Balague C, Garriga J, Trias M (2004) Mesh in the hiatus. Arch Surg 139: 1286–1296

    PubMed  Google Scholar 

  44. 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

    Article  CAS  PubMed  Google Scholar 

  45. 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

    CAS  PubMed  Google Scholar 

  46. 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

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Virginia Commonwealth University, 1200 East Broad Street, Richmond, Post Office Box 980519, VA, 23298-0519, USA

    J. M. Johnson, A. M. Carbonell, B. J. Carmody, M. K. Jamal, J. W. Maher, J. M. Kellum & E. J. DeMaria

Authors
  1. J. M. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. M. Carbonell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. J. Carmody
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. K. Jamal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. W. Maher
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. M. Kellum
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. J. DeMaria
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. M. Johnson.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-005-0357-5

Keywords

Search

Navigation