Our Summary

This research paper is about a study conducted to examine the effectiveness and safety of a surgical procedure called laparoscopic hiatal hernia repair (LHHR) with biologic mesh. This procedure is used to treat hiatal hernia, a common condition often associated with gastroesophageal reflux disease (GERD), a chronic disease where stomach acid frequently flows back into the esophagus.

The study looked at patients who underwent this surgery from July 2009 to October 2014. The main measures of the study were the relief from GERD symptoms and recurrence of hiatal hernia.

The results showed that out of 221 patients who underwent this procedure, the GERD symptoms significantly reduced. The average GERD-health-related quality-of-life (GERD-HRQL) score went down from 18.5 to 4.4. This score measures the severity of GERD symptoms, so a lower score means that the symptoms have improved.

Furthermore, only 8 patients out of the 221 had a recurrence of their hiatal hernia, and only one of them needed a second surgery. The complications from the surgery were generally minor, like difficulty swallowing, nausea and vomiting. However, one patient died from a hemorrhage that happened one week after surgery.

In conclusion, this study suggests that the laparoscopic hiatal hernia repair with biologic mesh is an effective and safe treatment for managing hiatal hernia and reducing GERD symptoms.

FAQs

  1. What is the laparoscopic hiatal hernia repair with biologic mesh procedure and what conditions does it treat?
  2. What were the main measures and results of the study on the effectiveness and safety of the laparoscopic hiatal hernia repair procedure?
  3. What are some potential complications from the laparoscopic hiatal hernia repair surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative instructions carefully, including taking prescribed medications, avoiding heavy lifting or strenuous activities, and following a specialized diet to prevent complications and promote healing. It is also important to attend follow-up appointments with your healthcare provider to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for hiatal hernia repair are those who have symptomatic hiatal hernias that are causing discomfort or complications such as GERD. These patients may experience symptoms such as heartburn, regurgitation, chest pain, difficulty swallowing, or chronic cough.

Additionally, patients who have not responded well to conservative treatments such as lifestyle modifications, medications, or dietary changes may also be recommended for hiatal hernia repair. Patients who have a large hiatal hernia that is causing significant discomfort or complications may also benefit from surgical intervention.

Overall, the decision to recommend hiatal hernia repair will depend on the individual patient’s symptoms, medical history, and overall health status. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine the best course of action for managing their hiatal hernia.

Timeline

Before the hiatal hernia repair:

  • Patient experiences symptoms of GERD such as heartburn, chest pain, difficulty swallowing, and regurgitation.
  • Patient may undergo tests such as endoscopy, barium swallow, and pH monitoring to diagnose hiatal hernia and GERD.
  • Patient may try lifestyle changes, medications, and other non-surgical treatments to manage symptoms.

After the hiatal hernia repair:

  • Patient undergoes laparoscopic hiatal hernia repair with biologic mesh.
  • Patient experiences relief from GERD symptoms, as shown by a significant reduction in GERD-HRQL score.
  • Only a small percentage of patients experience a recurrence of hiatal hernia, and most do not require a second surgery.
  • Complications from the surgery are generally minor, with one patient experiencing a fatal hemorrhage.

Overall, the surgery is found to be effective in reducing GERD symptoms and managing hiatal hernia, with a low rate of complications and recurrence.

What to Ask Your Doctor

When discussing hiatal hernia repair with a doctor, a patient may want to ask the following questions:

  1. What are the potential risks and complications associated with laparoscopic hiatal hernia repair with biologic mesh?
  2. How long is the recovery process after this surgery, and what can I expect in terms of pain and discomfort?
  3. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  4. How likely is it that my hiatal hernia will recur after this procedure, and what are the signs to watch out for?
  5. Are there any alternative treatment options for hiatal hernia that I should consider?
  6. How experienced are you in performing laparoscopic hiatal hernia repair with biologic mesh, and what is your success rate with this procedure?
  7. Will I need to undergo any additional tests or evaluations before the surgery to ensure that I am a good candidate for this procedure?
  8. How soon after the surgery will I be able to resume normal activities, such as work and exercise?
  9. Are there any long-term effects or potential complications that I should be aware of after undergoing this surgery?
  10. What steps can I take to prevent the recurrence of hiatal hernia or manage GERD symptoms in the future?

Reference

Authors: Chang CG, Thackeray L. Journal: JSLS. 2016 Jan-Mar;20(1):e2015.00104. doi: 10.4293/JSLS.2015.00104. PMID: 26884676