Laparoscopic mesh hiatoplasty for paraesophageal hernias and fundoplications

Koch

et al. 2011

Langenbecks Arch Surg

Section: Discussionmentioning

confidence: 96%

Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence

Koch

et al. 2011

Langenbecks Arch Surg

Turkish J Thorac Cardiovasc Surg

“…Some authors state that mesh repair should be reserved for cases where primary crural repair is not possible, but others advocate a more liberal approach. [4,5] There are some reports which state that intraoperative measuring of the hiatal surface area may help in the patient selection process and decrease the incidence of recurrence. [6] The overall impression is that mesh closure can be performed with few complications which usually require no secondary surgical intervention, but there are situations resulting in the erosion of prosthetic material which necessitate esophagectomies and gastrectomies.…”

Section: Discussionmentioning

confidence: 99%

Herniation of the stomach and colon into the right hemithorax following a transthoracic Collis-Belsey operation

Batırel¹,

Akgül²,

Bilgi³

2011

Collis gastroplasty and Belsey fundoplication is a good choice for patients with a large hiatal hernia and associated reflux. In this article, we report a patient who presented as post-emetic with herniation of the stomach and colon into the right hemithorax, within two months after the Collis Belsey procedure. The patient was reoperated on, and the hernia was reduced through a left posterolateral thoracotomy. At the 22-month follow-up, the patient was well and was able to tolerate a full diet without any symptoms.

ABCD, arq. bras. cir. dig.

“…Nevertheless, other studies have already demonstrated that the use of mesh lowers the rates of recurrence, it is the possibility of complications what we have do pay attention to 1,4,7,8,9,12 . In our series with a long follow-up period, we found no complications related to the use of a mesh, even in those patients with recurrence.…”

Section: Frantzides and Carlsonmentioning

confidence: 95%

“…A comprehensive review of the literature regarding the use of prosthesis in the hiatus (1,368 patients) was published recently by Johnson et al 12 . One must consider the fact that the authors combine studies with different types of prostheses (PTFE, polypropylene, organic), shapes (rectangular, circular, "U-shaped"), application techniques (onlay or interposed between the pillars) and indication (routine in simple hernias and large paraesophageal hernias).…”

Section: Introductionmentioning

confidence: 99%

Tela de polipropileno no reparo laparoscópico de grandes hérnias hiatais: aspectos técnicos

Brandalise¹,

Aranha²,

Brandalise³

2012

-Background -The minimally invasive surgery has gained rapidly important role in the treatment of gastroesophageal reflux disease. However, the best method to treat large paraesophageal hernias (type III and IV) is still under discussion. The use of prosthetics for enhancing the crural repair has been proposed by several authors in order to reduce the high relapse rates found in these patients. Aim -To demonstrate the technique and surgical results in using an idealized polypropylene mesh for the strengthening of the cruroraphy in large hiatal hernias. Methods -Was applied the polypropylene mesh to reinforce the hiatal closure in large hernias -types II to IV in Hill's classification -with a primary or recurrent hiatal defect greater than 5 cm, in a series of 70 patients. The prosthesis was done cutting a polypropylene mesh in a U-shape, adapted to the dimensions found in the intraoperative field and coating the inner edge (which will have direct contact with the esophagus) with a silicon catheter. This was achieved by removing a small longitudinal segment of the catheter and then inserting the edge of the cut mesh, fixing with running nylon 5-0 suture. Results -From 1999 to 2012, this technique was used in 70 patients. There were 52 females and 18 males, aged 32-83 years (mean 63 years). In 48 (68.6%) patients, paraesophageal hernia was primary and in 22 (31.4%), it was relapse after antireflux surgery. The only case of death in this series (1.4%) occurred on 22nd postoperative day in one patient (74 y) that had a laceration of the sutures on the fundoplication, causing gastropleural fistula and death. There was no relationship with the use of the prosthesis.A follow-up of six months or more was achieved in 60 patients (85.7%), ranging from six to 146 months (mean 49 months). All patients have at least one follow-up endoscopy or esophageal contrast examination, and a clinical interview. In this follow-up period, no cases of complications related to the prosthesis (stenosis or erosion) were observed. Conclusion-The use of this model of polypropylene mesh is safe if the technical aspects of its placement are followed carefully. ABCDDV/874RESUMO -Racional: A cirurgia minimamente invasiva ganhou rapidamente papel fundamental no tratamento da doença do refluxo gastroesofágico. Entretanto, o melhor método para as grandes hérnias paraesofágicas (tipos III e IV) ainda está em discussão. O uso de próteses para reforço da hiatoplastia tem sido proposto por diversos autores, no intuito de diminuir as altas taxas de recidivas encontradas nesses pacientes. Riscos de estenose e erosão da prótese são as complicações mais preocupantes quando se pensa em aplicar uma prótese no hiato esofágico. Objetivo -Demonstrar a técnica cirúrgica e resultados do uso de um modelo de tela idealizado no serviço dos autores para reforçar a hiatoplastia em grandes hérnias de hiato. Métodos -Uma prótese de polipropileno foi aplicada para reforço da hiatoplastia em pacientes com grandes hérnias de hiato (Tipos II a IV de Hill). A prótese ...