Our Summary

This study is about a surgical procedure called laparoscopic paraesophageal hernia repair (LPEHR), which is a minimally invasive operation to repair a specific type of hernia. The researchers wanted to know whether using a mesh reinforcement during the surgery improved patient outcomes compared to just using sutures.

They looked at the results of seven different studies that compared the two methods. They looked at how often the hernia came back within six months and after six months, and also looked at complications during surgery, overall sickness, and how often more surgery was needed.

They found that whether or not mesh was used didn’t really make a difference in terms of how often the hernia came back, even when they looked at different types of mesh. The rate of complications during surgery and the rate of needing more surgery was also the same for both methods.

However, they did find that patients who had surgery with a type of mesh that doesn’t get absorbed by the body had more overall sickness than those who had surgery without mesh or with a type of mesh that the body can absorb.

FAQs

  1. What is laparoscopic paraesophageal hernia repair (LPEHR)?
  2. Does the use of mesh reinforcement during LPEHR improve patient outcomes compared to just using sutures?
  3. Were there any difference in the rates of complications during surgery and the need for additional surgery between using mesh reinforcement and sutures in LPEHR?

Doctor’s Tip

Based on this study, a doctor may advise a patient undergoing hernia repair surgery to discuss with their surgeon the type of mesh being used and whether it is absorbable or non-absorbable. They may also recommend discussing the potential risks and benefits of using mesh during the procedure. Additionally, the doctor may emphasize the importance of following post-operative care instructions to ensure a successful recovery and reduce the risk of complications.

Suitable For

Overall, patients who are typically recommended for hernia repair are those who are experiencing symptoms such as pain, discomfort, or digestive issues due to the hernia. The decision to undergo surgery is usually made based on the severity of the symptoms and the risk of complications if the hernia is left untreated. In the case of laparoscopic paraesophageal hernia repair, patients with a paraesophageal hernia that is causing symptoms such as gastroesophageal reflux disease (GERD) or difficulty swallowing may be recommended for surgery.

Timeline

Before hernia repair:

  1. Patient experiences symptoms such as pain, discomfort, and bulging at the site of the hernia.
  2. Patient consults with a doctor who diagnoses the hernia and recommends surgery.
  3. Patient undergoes pre-operative tests and consultations to prepare for the surgery.

After hernia repair:

  1. Patient undergoes laparoscopic paraesophageal hernia repair (LPEHR) surgery, either with mesh reinforcement or just sutures.
  2. Recovery period in the hospital or at home, with follow-up appointments with the surgeon.
  3. Patient may experience pain, discomfort, and limited activity during the recovery period.
  4. Patient gradually resumes normal activities as directed by the surgeon.
  5. Long-term follow-up to monitor for any complications or recurrence of the hernia.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hernia repair include:

  1. What type of hernia do I have and what are my treatment options?
  2. What are the potential risks and benefits of laparoscopic paraesophageal hernia repair (LPEHR) compared to other types of hernia repair?
  3. Will mesh reinforcement be used during my surgery? What are the advantages and disadvantages of using mesh?
  4. How experienced are you in performing laparoscopic hernia repairs, specifically LPEHR?
  5. What is the expected recovery time and what kind of post-operative care will I need?
  6. What are the potential complications of the surgery and how will they be managed?
  7. How likely is it that the hernia will come back after surgery?
  8. Are there any dietary or lifestyle changes I should make before or after the surgery?
  9. How long will I need to be off work or limit my physical activity after the surgery?
  10. Are there any long-term effects or considerations I should be aware of after hernia repair surgery?

Reference

Authors: Angeramo CA, Schlottmann F. Journal: Ann Surg. 2022 Jan 1;275(1):67-72. doi: 10.1097/SLA.0000000000004913. PMID: 33843796