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Complications of laparoscopic hiatus hernia repair

L M Almond, V Charalampakis, P Mistry, J Hodson, J Matthews, R Singhal, P Super
INTRODUCTION: Laparoscopic anti-reflux surgery is conventionally performed using two 10/12 mm ports. While laparoscopic procedures reduce post-operative pain, the use of larger ports invariably increases discomfort and affects cosmesis. We describe a new all 5 mm ports technique for laparoscopic anti-reflux surgery and present a review of our initial experience with this approach. METHODS: All patients undergoing laparoscopic fundoplication over a 35 month period from February 2013 under the care of a single surgeon were included...
September 30, 2016: International Journal of Surgery
Bruna do Nascimento Santos, Marcos Belotto de Oliveira, Renata D'Alpino Peixoto
INTRODUCTION: According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy...
January 2016: Case Reports in Oncology
Jeremy R Huddy, Sheraz R Markar, Melody Z Ni, Mario Morino, Edoardo M Targarona, Giovanni Zaninotto, George B Hanna
BACKGROUND: Synthetic mesh (SM) has been used in the laparoscopic repair of hiatus hernia but remains controversial due to reports of complications, most notably esophageal erosion. Biological mesh (BM) has been proposed as an alternative to mitigate this risk. The aim of this study is to establish the incidence of complications, recurrence and revision surgery in patients following suture (SR), SM or BM repair and undertake a survey of surgeons to establish a perspective of current practice...
April 29, 2016: Surgical Endoscopy
Emanuele Asti, Andrea Lovece, Luigi Bonavina, Pamela Milito, Andrea Sironi, Gianluca Bonitta, Stefano Siboni
OBJECTIVES: To evaluate objective and subjective outcomes of patients undergoing laparoscopic repair of large hiatal hernia, either with or without resorbable mesh augmentation. The primary outcome of the study was anatomical recurrence rate as measured by endoscopy. Secondary outcomes were safety, efficacy, and long-term quality of life. METHODS: This was an observational cohort study. Patients who underwent laparoscopic repair of large (≥5 cm) type III hiatal hernia were included...
April 29, 2016: Surgical Endoscopy
P Priego, J Perez de Oteyza, J Galindo, P Carda, F García-Moreno, G Rodríguez Velasco, E Lobo
PURPOSE: The application of mesh-reinforced hiatal closure has resulted in a significant reduction in recurrence rates in comparison with primary suture repair. However, the use of meshes has not completely extended in all the cases of large paraesophageal hiatal hernias (LPHH) due to the complications related to them. The aim of this study is to present our long-term results and complications related to Crurasoft(®) mesh (Bard) for the treatment of LPHH. METHODS: From January 2004 to December 2014, 536 consecutive patients underwent open or laparoscopic fundoplication for gastroesophageal reflux disease or LPHH at Ramón y Cajal University Hospital...
March 29, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Leopoldo Herrera Chabert, Jacob Joffe Fraind, Narcizo Leon Quintero
INTRODUCTION: The purpose of this report is to describe a tension-free repair we have used successfully in 12 patients with large hiatal defects. It is based on the creation of a web-shoelace pattern of polypropylene (Prolene®; Ethicon, Somerville, NJ) suture of the crura that functions as a barrier, with the advantages of being stronger and more economical than a mesh without the potential complications that may follow mesh repair or suture repair of a large hiatus hernia without mesh...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Oscar M Crespin, Robert B Yates, Ana V Martin, Carlos A Pellegrini, Brant K Oelschlager
INTRODUCTION: Laparoscopic hiatal hernia repair has a better chance of success if the hiatus is closed without tension. This study attempts to answer the following questions: (1) What is the rate of hiatal hernia recurrence in patients who undergo hiatal closure with diaphragmatic relaxing incisions? (2) Can biologic mesh be safely substituted for synthetic mesh as coverage of the relaxing incisions? METHODS: We identified all patients who underwent laparoscopic hiatal hernia repair at our institution between 2007 and 2013 and reviewed their clinical records...
June 2016: Surgical Endoscopy
P A Le Page, R Furtado, M Hayward, S Law, A Tan, S J Vivian, H Van der Wall, G L Falk
INTRODUCTION: The surgical management of symptomatic giant hiatus hernia (GHH) aims to improve quality of life (QoL) and reduce the risk of life threatening complications. Previous reports are predominantly those with small sample sizes and short follow-up periods. The present study sought to assess a large cohort of patients for recurrence and QoL over a longer time period. METHODS: This was a follow-up study of a prospectively collected database of 455 consecutive patients...
April 2015: Annals of the Royal College of Surgeons of England
Maher El Chaar, George Ezeji, Leonardo Claros, Maureen Miletics, Jill Stoltzfus
BACKGROUND: Laparoscopic sleeve gastrectomy (SG), while generally safe and efficacious, may be complicated by gastroesophageal reflux disease (GERD) symptoms as well as the need for hiatus hernia (HH) repair. Identification and management of HH during SG and the effect of HH repair on GERD-related symptoms following SG are controversial. OBJECTIVE: This study aimed to evaluate HH repair during SG in morbidly obese patients and its short-term effect on GERD-related symptoms and other clinical outcomes...
January 2016: Obesity Surgery
Stavros A Antoniou, Beat P Müller-Stich, George A Antoniou, Gernot Köhler, Ruzica-Rosalia Luketina, Oliver O Koch, Rudolph Pointner, Frank-Alexander Granderath
PURPOSE: Laparoscopic repair of large hiatal hernias is associated with high recurrence rates. Erosion and mesh migration are rare but devastating complications of synthetic mesh repair, whereas reoperation is accompanied by significant operative morbidity. The aim of this study was to estimate the comparative risk of hernia recurrence following primary suture or biologic mesh repair. METHODS: A systematic literature search of the MEDLINE database was performed and comparative data of relevant studies were combined using the Mantel-Haenszel meta-analysis model...
July 2015: Langenbeck's Archives of Surgery
Philip A Le Page, David Martin
BACKGROUND: A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists for this problem. METHODS: A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data...
June 2015: World Journal of Surgery
Jan H Koetje, Tanya Irvine, Sarah K Thompson, Peter G Devitt, Simon D Woods, Ahmad Aly, Glyn G Jamieson, David I Watson
INTRODUCTION: Laparoscopic surgery is the treatment of choice for repair of large hiatus hernia, but can be followed by recurrence. Repair with prosthetic mesh has been recommended to prevent recurrence, although complications following mesh repair have generated disagreement about whether or not mesh should be used. The early objective and clinical results of a randomized trial of repair with mesh versus sutures have been reported, and revealed few differences. In the current study, we evaluated quality of life outcomes within this trial at follow-up to 2 years...
June 2015: World Journal of Surgery
Kyle C Ward, Kevin P Costello, Sara Baalman, Richard A Pierce, Corey R Deeken, Margaret M Frisella, L Michael Brunt, Brent D Matthews
PURPOSE: The objective of this study was to evaluate the performance of acellular human dermis reinforcement during laparoscopic hiatal hernia repair. METHODS: A prospective non-randomized, single institution study enrolled patients undergoing laparoscopic hiatal hernia repair. Acellular human dermis, FlexHD (Musculoskeletal Transplant Foundation, Edison, NJ) or AlloDerm (LifeCell Inc., Branchburg, NJ) were used to buttress the repair after primary closure. A protocol barium swallow (BAS) was performed at 6 months and then as needed due to clinical indications...
August 2015: Surgical Endoscopy
Evan T Alicuben, Stephanie G Worrell, Steven R DeMeester
BACKGROUND: Hernia recurrence is the leading form of failure after antireflux surgery and may be secondary to unrecognized tension on the crural repair or from a foreshortened esophagus. Mesh reinforcement has proven beneficial for repair of hernias at other sites, but the use of mesh at the hiatus remains controversial. The aim of this study was to evaluate the outcomes of hiatal hernia repair with human dermal mesh reinforcement of the crural closure in combination with tension reduction techniques when necessary...
November 2014: Journal of the American College of Surgeons
D Acin-Gandara, C Miliani-Molina, Ja Carneros-Martin, J Martinez-Pineiro, M De Vega, F Pereira-Perez
Several series have shown that laparoscopic fundoplication is feasible and safe for the treatment of hiatal hernia, although a high recurrence rate of 42% has been published. The use of mesh repair in these hernias has shown fewer recurrences than primary suture with small number of complications reported.Some of these are severe fibrosis within the hiatus, mesh erosion of the intestinal wall, esophageal strictures, mesh migration into the upper gastrointestinal tract and esophageal perforations. We present a case with late erosion and complete transmural gastric migration of the mesh after surgery...
July 2014: Chirurgia
Daniela Molena, Benedetto Mungo, Miloslawa Stem, Anne O Lidor
BACKGROUND: The laparoscopic approach for repair of giant and/or recurrent paraesophageal hernias (PEH) is challenging, due to limited access to the dissection of the hernia sac into the proximal mediastinum and esophageal mobilization through the diaphragmatic hiatus. An esophageal lengthening procedure is often necessary, due to the difficulty in obtaining adequate intra-abdominal esophageal length. We, therefore, developed a VATS and laparoscopic technique, which allows for safe and extensive thoracic dissection and intra-abdominal gastric fixation and cruroplasty, yet preserving the benefits of minimally invasive surgery...
January 2015: Surgical Endoscopy
Z A Bataineh, L A Rousan, A Abu Baker, H Wahdow, R N Kiwan, M M Saleem
Congenital massive hiatus hernia (CMHH) is an uncommon disorder during childhood. It can be associated with grave complications especially if presented in the highest grade; type IV, when the hernia contains other intra-peritoneal organ beside the stomach through a large hiatus defect. The insidious form of clinical presentation can be deceptive in diagnosis and may mimic congenital diaphragmatic hernia or other chest pathologies. The basic principle of surgical repair is to reduce the herniated organs, excise the hernia sac, and repair the crural defect and to add anti-reflux procedure with or without gastropexy...
June 2014: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Benjamin Clapp
BACKGROUND AND OBJECTIVES: Laparoscopic sleeve gastrectomy has become a valuable primary bariatric operation. It has an acceptable complication profile and amount of weight loss. However, one of the most distressing complications to the patient is reflux postoperatively. There is thought to be a relationship between a hiatal hernia and postoperative reflux. There is disagreement on how to address a hiatal hernia intraoperatively, and the use of mesh is controversial. Our objectives were to examine the use of a prosthetic bioabsorbable mesh for repair of a large hiatal hernia during a sleeve gastrectomy and to examine the incidence of reflux and mesh-related complications in the near term...
October 2013: JSLS: Journal of the Society of Laparoendoscopic Surgeons
D Collet, G Luc, L Chiche
Para-esophageal hernias are relatively rare and typically occur in elderly patients. The various presenting symptoms are non-specific and often occur in combination. These include symptoms of gastro-esophageal reflux (GERD) in 26 to 70% of cases, microcytic anemia in 17 to 47%, and respiratory symptoms in 9 to 59%. Respiratory symptoms are not completely resolved by surgical intervention. Acute complications such as gastric volvulus with incarceration or strangulation are rare (estimated incidence of 1.2% per patient per year) but gastric ischemia leading to perforation is the main cause of mortality...
December 2013: Journal of Visceral Surgery
Christina L Greene, Steven R DeMeester, Joerg Zehetner, Stephanie G Worrell, Daniel S Oh, Jeffrey A Hagen
BACKGROUND: Laparoscopic paraesophageal hernia (PEH) repair is associated with an objective recurrence rate exceeding 50% at 5 years. Minimizing tension is a critical factor in preventing hernia recurrence. This study aimed to evaluate the outcomes of crural relaxing incisions in patients undergoing PEH repair. METHODS: Records were reviewed to identify patients who received a relaxing incision during laparoscopic PEH repair. The patients were followed by chest X-ray and videoesophagram at 3 months and then annually...
December 2013: Surgical Endoscopy
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