Our Summary

This research paper is about a study that compares two different methods of fixing hiatal hernias (a condition where part of your stomach pushes up into your chest) using a special type of material called a biological mesh. The two methods are called the “keyhole” configuration and the “starburst” configuration.

The keyhole method was used in 51 surgeries between July 2017 and August 2019. After these surgeries, 31% of patients had complications within the first month, 16% had their hernia come back, and 14% needed another surgery.

The starburst method was used in 58 surgeries between October 2020 and August 2021. After these surgeries, 16% of patients had complications within the first month, 19% had their hernia come back, and only 3% needed another surgery.

So, the starburst method seemed to do better than the keyhole method in terms of fewer complications after surgery, less need for another surgery, and similar rates of the hernia coming back. However, the researchers plan to continue refining the starburst technique and studying its long-term results.

FAQs

  1. What are the “keyhole” and “starburst” methods of hiatal hernia repair?
  2. According to the study, which method of hiatal hernia repair resulted in fewer complications and less need for additional surgery?
  3. Are there plans to continue studying and refining the “starburst” method of hiatal hernia repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to discuss with your surgeon the different techniques available, such as the keyhole and starburst methods, to determine which may be the best option for you based on your individual medical history and needs. It’s important to ask questions and understand the potential risks and benefits of each technique before making a decision on how to proceed with surgery. Additionally, following your surgeon’s post-operative instructions, attending follow-up appointments, and maintaining a healthy lifestyle can help support successful healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those with severe symptoms such as heartburn, acid reflux, chest pain, difficulty swallowing, regurgitation, and shortness of breath. Additionally, patients with hiatal hernias that are causing complications such as bleeding, ulcers, or strictures may also be recommended for surgery. Other factors that may influence the decision to recommend hiatal hernia repair include the size of the hernia, the presence of other medical conditions, the patient’s overall health and age, and the severity of symptoms.

Timeline

Before the hiatal hernia repair surgery, a patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation of food, and feeling full quickly after eating. These symptoms can affect a patient’s quality of life and may require lifestyle changes and medication to manage.

After the surgery, the patient will typically stay in the hospital for a few days to recover. They may experience some pain and discomfort in the chest and abdomen, which can be managed with pain medication. The patient will be advised to follow a special diet and avoid strenuous activities for a few weeks to allow the surgical site to heal properly.

In the weeks and months following the surgery, the patient will have follow-up appointments with their surgeon to monitor their progress and address any concerns. It may take some time for the patient to fully recover and adjust to any dietary or lifestyle changes recommended by their healthcare provider.

Overall, hiatal hernia repair surgery can provide relief from symptoms and improve the patient’s quality of life, but it is important for patients to follow their healthcare provider’s instructions for a successful recovery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hiatal hernia repair surgery using a biological mesh?

  2. How does the keyhole method differ from the starburst method in terms of surgical technique and outcomes?

  3. What factors should I consider when deciding between the keyhole and starburst methods for hiatal hernia repair?

  4. What is the expected recovery time and post-operative care for each method?

  5. Are there any long-term implications or considerations to take into account with either method?

  6. How experienced are you in performing hiatal hernia repair surgeries using the starburst method?

  7. What is the success rate of the starburst method compared to the keyhole method in terms of preventing hernia recurrence?

  8. Are there any specific lifestyle changes or precautions I should take after undergoing hiatal hernia repair surgery with a biological mesh?

  9. How frequently will I need follow-up appointments and monitoring after the surgery?

  10. Are there any alternative treatment options or approaches to consider for hiatal hernia repair in my case?

Reference

Authors: Grimsley E, Capati A, Saad AR, DuCoin C, Velanovich V. Journal: Surg Endosc. 2023 Mar;37(3):2239-2246. doi: 10.1007/s00464-022-09447-9. Epub 2022 Jul 28. PMID: 35902405