Laparoscopic mesh-suture hiatal hernia repair

Abstract

BACKGROUND: A new original laparoscopic operative technique was used to suture paraesophageal hernia (PEH) with the strips of mesh. METHODS: The Mercilen (MercilenTM) mesh suture was used to close large hiatal hernia. The strips of mesh, instead of normal thread, were applied to close the gap between diaphragm's crura in four patients with hernia defect more than 5 cm. Mesh suture were tighten as a simple laparoscopic intracorporeal knot. The surgical technique and surgical outcomes are presented. RESULTS: Four patients underwent a laparoscopic PEH suturing with Mercilen strips of mesh. We recorded no recurrence or dysphagia at 6 and 12 months follow-up. CONCLUSIONS: Mesh-sutured repairs of diaphragm's hernia support the concepts of force distribution and resistance to suture pull through. The new original technique avoids using the sheet of mesh and enables to reduce the amount of dangerous complications connected with mesh and its fixation. Mesh-sutured closures of hiatal hernias seem to be safe and effective in tension closure of large hiatal defects. Further investigations are needed to evaluate the results.

Keywords

• cruroplasty
• diaphragmatic hernia
• hiatal hernia
• mesh strips
• mesh suture
• paraesophageal hernia