The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique

Oelschlager, Brant K.; Barreca, Marco; Chang, Lily; Pellegrini, Carlos A.

doi:10.1016/s0002-9610(03)00114-4

Cited by 140 publications

(83 citation statements)

References 25 publications

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“…Several different types of polytetrafl uroethylene (PTFE) and composite materials have been used including dual mesh (W.L Gore and associates, Inc., Flagstaff, AZ, USA) [14] and a simple PTFE patch [15,16]. Porcine small intestinal mucosa (Surgisis; Cook surgical, Bloomington, IN, USA), which provides scaffolding for natural tissue ingrowth, also is used [17]. In our initial 27 cases we used prolene mesh (Prolene; Ethicon, Inc., Somerville, NJ, USA) because it is readily available, inexpensive, malleable, and easy to handle.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of large hiatus hernia with mesh cruroplasty

Chowbey

Mittal²,

Dey³

et al. 2008

Indian J Surg

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Purpose Laparoscopy has become the standard surgical approach to surgery for gastrooesophageal refl ux disease (GERD) and hiatal hernia repair with excellent long-term results and high patient satisfaction. However several studies have shown that hiatal hernia repair, especially large hiatus are associated with high recurrence rate. Mesh reinforcement has been proposed for repair of large hiatus hernia. The objective of this study was to evaluate the role of mesh cruroplasty in management of large hiatus hernia (> 5 cm).Methods Between February 2002 to December 2007, 73 patients (28 men and 45 women) who underwent laparoscopic hiatal hernia repair with mesh cruroplasty were included in our study. Mesh reinforcement (cruroplasty) was used for repair of large hiatus hernia (>5 cms hernial defect). Mean age was 50.4 years (range 30-72 years). Follow up included barium swallow of patients at 3 months and yearly thereafter.Results Seventy-three patients underwent mesh cruroplasty for large hiatus hernia. We were able to adequately mobilise the oesophagus to achieve an intra-abdominal length of at least 3 cm in all patients. Intraoperative complication rate was 8.21% (6/73), intraoperative complications included pleural tear, bleeding from splenic capsule laceration and short gastric vessels. Postoperative complication rate was 4.1% (3/73), which included complete dyspahgia, atelactasis and pneumonia. Mean duration of hospitalisation was 3.5 days (range 3-9 days). Five patients (5/73) were lost to follow up. Four patients (5.8%) developed recurrence on routine follow up. No mesh related complications were noted on long-term follow up period. Mean follow up period was 3.2 years (range 5 months-6 years). ConclusionOur data supports the use of mesh in hiatal hernia repair, especially in large hiatus hernia as it leads to low recurrence rates. Longer follow up and more randomised controlled trials are needed to establish laparoscopic mesh cruroplasty as standard technique for large hiatal hernia repair.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic management of large hiatus hernia with mesh cruroplasty

Chowbey

Mittal²,

Dey³

et al. 2008

Indian J Surg

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“…As such it has been applied to a host of potential indications. These include reinforcement of soft tissue for incisional and inguinal herniorraphy; urethral sling placement in urogynaecology; staple line reinforcement; paraesophageal hernia repair and in the treatment of anal fistula [3][4][5][6][7][8][9][10][11][12][13]. The fact that it has been demonstrably useful as a bioprosthetic material in infected fields makes its application in fistula surgery quite reasonable.…”

Section: Plug Material Mechanism and Applicationsmentioning

confidence: 99%

The surgisis^® AFP^™ anal fistula plug: report of a consensus conference*

et al. 2007

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“…Hence there has been an increasing vogue for using prosthetic material to reinforce the repair in large hiatus hernia, particularly since the recurrence rate following this type of surgery is high, and recurrent hiatal herniation accounts for up to 70% of re-operations for failed anti-reflux surgery [3,5,7]. The use of biological mesh during hiatal hernia repair has been shown to decrease the recurrence rate of hernia lower than that obtained historically without the mesh [8]. The use of synthetic mesh is associated with complications such as oesophageal stricture, erosion, perforation, migration of mesh into oesophagus or stomach, and infections [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…This has led to debate regarding the type of mesh material, size, shape, and fixation techniques. The biological porcine collagen mesh has been shown to reduce complications and recurrence [8].…”

Section: Introductionmentioning

confidence: 99%