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Mesh in laparoscopic large hiatal hernia repair
General Surgery / Jun 21st, 2016 8:29 am     A+ | a-
 
The use of mesh is becoming more popular for large hiatal hernia (type ii-iv) repair toreduce the recurrence rate. The aim of this study was to outline the currently available literature on the use of  meshin laparoscopic large hiatal hernia repair,emphasing objective outcome.
 
The  use of mesh in the repair of large hiatal hernias is promising with respect to the reduction of anatomical recurrences. However, many different kinds and configurations of mesh are available. This systematic review of the literature is a basis for high-quality randomized controlled trials to obtain the most effective and safe mesh in the long term.
 
Hiatal hernias can be subdivided  into sliding, tupe Iand large, types II-IV hiatal hernias. Sliding hiatal hernias typically are associated with gastroesophageal reflux disease and often are managed medically with antisecretory drugs. In patients with a large hiatal hernia.however,surgery is the only  available curative treatment option. Large hiatal hernias may be associated with severe complication such as organoaxial rotation leading to strangulation of the stomach. The risk of  developing this complication in the presence of a large hiatal .hernia, however, is very limited. Therefore,a wait-and-see stance has now been the standard of care in minimally or asymptomatic patients.

However, symptomatic patients with a large hiatal hernia should be offered surgical repair. This consists of dissection of the hernia sac from the posterior mediastinum,reduction of the herniated intraabdominal organs with a tension-free intra-abdominal position of the distal esophagus, posterior cruroplasty, and the addition of an antireflux procedure .
Laparoscopic repair of large hiatal hernias has good symptomatic outcomes, with a  success rate of 90% after 4 tears of follow up. There are many types of mesh available, including heavy-and light-weight polypropylene, polytetrafluoroethylene (ePTFE, and biologic meshes.additionlly, multiple configurations of these meshed are used,i.e., oval, square,or an a,u or v shape .several randomized controlled trials and observational studifs have reported the results of these different meshes usd in large hiatal hernia repair.

Some overviews describing the available techniques in the use of mesh in large hiatal hernia with a summary of the literature have been published a few  years ago.nevertheless, a systematic review of the literature regarding mesh in laparoscopic large hiatal hernia repair is lacking. In addition, numerous studies with a longer follow-up after large hiatal hernia repair with the use of mesh have been published since then.
 
7 COMMENTS
Dr. Akram Ahmed
#1
Apr 26th, 2020 2:25 pm
The content is extremely interesting and useful. The professor is excellent in conveying knowledge and inducing thought. Thanks for uploading Mesh in laparoscopic large hiatal hernia repair video.
Dr. Naveen Chandra
#2
May 18th, 2020 10:27 am
Great explanation! It was really interesting and useful. Wow!! Sir you are such a good teacher. this was awesome video of Mesh in laparoscopic large hiatal hernia repair video. Very clear explanation and perfect images. Just makes it all look so much easier.

Dr. Naveen Chandra
#3
May 18th, 2020 10:27 am
Great explanation! It was really interesting and useful. Wow!! Sir you are such a good teacher. this was awesome video of Mesh in laparoscopic large hiatal hernia repair video. Very clear explanation and perfect images. Just makes it all look so much easier.

Dr. Nilesh
#4
May 22nd, 2020 3:17 pm
Impressive video of Mesh in laparoscopic large hiatal hernia repair. Dr. Mishra, your demonstration of each technique was very well presented. This the best training institute to learn Laparoscopy surgery.
Dr. Dhananjay Shahu
#5
Jun 12th, 2020 8:02 am
Fantastic video full of inspiration! Thank you for sharing this video of Mesh in laparoscopic large hiatal hernia repair. Thank you Dr. Mishra for providing this wonderful video!!! I love this video too much.
Dr. Mammai Kutti
#6
Jun 17th, 2020 5:17 pm
I want to thank you sir from the corr of my heart really you are so amazing. I wish i have a teacher like you. And I also want to become a tutor like you sir. Thank you so much sir for this amazing lecture on Mesh in laparoscopic large hiatal hernia repair video. Very clear explanation and perfect. God bless you sir.
Dr. Rudra
#7
Jun 17th, 2020 5:25 pm
Impressive explanation I found, after searching far for better. Thank you Dr. Mishra sir for the simplify explanation of the Mesh in laparoscopic large hiatal hernia repair. Thanks alot sir.....was searching for it.....thanks once again sir....you are a Great Teacher.....

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