Our Summary

This study looked at the effectiveness of using a special material called biosynthetic mesh in the surgery to repair a type of hernia that occurs in the stomach area, specifically hiatal and paraesophageal hernias. This type of hernia often comes back after surgery, which can be a big problem.

The researchers compared two types of surgery: one that used the biosynthetic mesh and one that just used stitches. They looked at how well the surgeries worked in the short term (3 months to a year after surgery) and in the long term (a year or more after surgery). They also looked at whether the hernia came back and caused symptoms again.

The study found that in both the short and long term, the surgery with the mesh didn’t improve symptoms more than the surgery with just stitches. However, in the long term, the surgery with the mesh did reduce the chance of the hernia coming back and causing symptoms again. This was especially true for medium and large size hernias.

The researchers concluded that using this biosynthetic mesh in surgery for these types of hernias can reduce the chance of the hernia coming back, especially for larger hernias. However, more studies are needed to confirm these results.

FAQs

  1. What is the purpose of using biosynthetic mesh in hiatal hernia repair?
  2. Did the study find that surgery with the mesh improved symptoms more than the surgery with just stitches?
  3. Does using biosynthetic mesh in surgery reduce the chance of the hernia coming back?

Doctor’s Tip

A helpful tip a doctor might give a patient about hiatal hernia repair using biosynthetic mesh is to follow post-operative instructions carefully to ensure proper healing and reduce the risk of complications. This may include avoiding heavy lifting, sticking to a soft diet for a period of time, and taking prescribed medications as directed. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help prevent the hernia from recurring in the future. It’s important to follow up with your doctor for regular check-ups to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those with:

  1. Severe symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and vomiting that do not improve with medications or lifestyle changes.
  2. Complications of hiatal hernia such as Barrett’s esophagus, esophagitis, or strictures.
  3. Large hiatal hernias that are causing significant symptoms or complications.
  4. Hiatal hernias that have recurred after previous surgical repair.
  5. Hiatal hernias that are causing respiratory symptoms such as coughing, wheezing, or shortness of breath.
  6. Patients who are at risk for complications such as strangulation or obstruction of the stomach or esophagus.

It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if hiatal hernia repair is the best treatment option for them.

Timeline

Before hiatal hernia repair:

  • Patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation of food, and stomach acid reflux
  • Patient may undergo diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the diagnosis of hiatal hernia
  • Patient may be prescribed medications to manage symptoms, such as proton pump inhibitors and antacids

After hiatal hernia repair:

  • Patient undergoes surgery to repair the hiatal hernia, which may involve either using stitches or biosynthetic mesh
  • Recovery period post-surgery typically involves pain management, dietary restrictions, and gradually resuming normal activities
  • In the short term (3 months to a year after surgery), patient may experience improvement in symptoms but may not see a significant difference between surgeries with mesh or just stitches
  • In the long term (a year or more after surgery), patient may experience reduced chances of hiatal hernia recurrence and symptom improvement, especially for medium and large size hernias
  • Patient may be advised to follow up with their healthcare provider for regular check-ups and monitoring of symptoms to ensure the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair using biosynthetic mesh include:

  1. What are the potential benefits of using biosynthetic mesh in my hiatal hernia repair surgery?
  2. What are the potential risks or complications associated with using biosynthetic mesh in this type of surgery?
  3. Are there any specific factors that would make me a good candidate for using biosynthetic mesh in my surgery?
  4. How does the use of biosynthetic mesh compare to traditional hernia repair surgery using just stitches?
  5. What is the success rate of hiatal hernia repair surgery using biosynthetic mesh in preventing the hernia from recurring in the long term?
  6. How long is the recovery process expected to be for surgery using biosynthetic mesh compared to traditional surgery?
  7. Are there any specific follow-up care or monitoring required after surgery with biosynthetic mesh?
  8. Are there any alternative treatment options for hiatal hernia repair that I should consider?
  9. How experienced are you in performing hiatal hernia repair surgeries using biosynthetic mesh?
  10. Can you provide me with any additional information or resources to help me better understand the use of biosynthetic mesh in hiatal hernia repair surgery?

Reference

Authors: Salehi N, Marshall T, Christianson B, Al Asadi H, Najah H, Lee-Saxton YJ, Tumati A, Safe P, Gavlin A, Chatterji M, Finnerty BM, Fahey TJ 3rd, Zarnegar R. Journal: Surg Endosc. 2024 Nov;38(11):6476-6484. doi: 10.1007/s00464-024-11257-0. Epub 2024 Sep 13. PMID: 39271508