Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.

Agrusa, A., Romano, G., Frazzetta, G., De Vita, G., Di Giovanni, S., Chianetta, D., et al. (2014). Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience. CASE REPORTS IN SURGERY, 2014 [10.1155/2014/851278.].

Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

AGRUSA, Antonino;ROMANO, Giorgio;FRAZZETTA, Giuseppe;DE VITA, Giovanni;DI GIOVANNI, Silvia;CHIANETTA, Daniela;DI BUONO, Giuseppe;SORCE, Vincenzo;GULOTTA, Gaspare
2014

Abstract

Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.
Settore MED/18 - Chirurgia Generale
Agrusa, A., Romano, G., Frazzetta, G., De Vita, G., Di Giovanni, S., Chianetta, D., et al. (2014). Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience. CASE REPORTS IN SURGERY, 2014 [10.1155/2014/851278.].
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10447/97634
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