Our Summary

This study looked at a surgical procedure called paraesophageal hiatal hernia repair, which can be done with or without a type of reinforcement called mesh. The purpose of the study was to investigate whether using a certain type of mesh, made from the urinary bladder of a pig (UBM), had any advantages or disadvantages compared to not using it.

The researchers examined the medical records of 121 patients who underwent this type of surgery between 2012 and 2017, excluding those who also had weight loss surgery at the same time. They found that the operation took a bit longer when the UBM mesh was used, but there was no significant difference in how long patients stayed in the hospital or in the rate of patients being readmitted to the hospital within 30 days of the surgery. There was also no significant difference in the rate of complications after the surgery.

In conclusion, the study found that using UBM mesh to reinforce hiatal hernia repairs can be done safely and does not increase the risk of complications after surgery. This suggests that it could be a viable option for this type of procedure.

FAQs

  1. What is paraesophageal hiatal hernia repair surgery and how does the use of UBM mesh affect it?
  2. What were the findings of the study regarding the use of UBM mesh in hiatal hernia repair surgery?
  3. Does the use of UBM mesh in hiatal hernia repair surgery increase the risk of post-surgery complications?

Doctor’s Tip

A doctor may advise a patient undergoing hiatal hernia repair to discuss with their surgeon the option of using UBM mesh for reinforcement during the surgery. They may explain that this type of mesh has been shown to be safe and does not increase the risk of complications, providing potential benefits during the procedure. It is important for the patient to have an open and informed discussion with their healthcare provider to determine the best course of action for their individual case.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those who experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and belching. These symptoms can often be caused by the stomach pushing through the diaphragm into the chest cavity, leading to a hiatal hernia. Surgery may be recommended for patients who do not respond to medication or lifestyle changes, have severe symptoms, or have complications such as Barrett’s esophagus or esophagitis. A healthcare provider will evaluate each patient individually to determine if they are a good candidate for hiatal hernia repair.

Timeline

Before the hiatal hernia repair:

  • Patient experiences symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and nausea
  • Patient undergoes diagnostic tests such as upper endoscopy, barium swallow, and pH monitoring to confirm the diagnosis of a hiatal hernia
  • Patient may be advised to make lifestyle changes such as losing weight, avoiding trigger foods, and elevating the head of their bed to manage symptoms

After the hiatal hernia repair:

  • Patient undergoes the surgical procedure to repair the hiatal hernia, which may involve using mesh reinforcement
  • Recovery period after surgery, which may include pain management, dietary restrictions, and gradually increasing physical activity
  • Follow-up appointments with the surgeon to monitor the healing process and address any concerns or complications
  • Patient may experience improvements in symptoms such as reduced heartburn, improved swallowing, and decreased chest pain

Overall, the timeline of a patient before and after hiatal hernia repair involves diagnosis of the condition, undergoing surgery to repair the hernia, and recovery and follow-up care to ensure successful healing and symptom relief.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair with UBM mesh include:

  1. What are the potential benefits of using UBM mesh in my hiatal hernia repair surgery?
  2. Are there any potential risks or complications associated with using UBM mesh in this procedure?
  3. How does the use of UBM mesh affect the length of the surgery and my recovery time?
  4. Will the use of UBM mesh increase the likelihood of needing additional surgeries in the future?
  5. Are there any alternative options to using UBM mesh in my hiatal hernia repair surgery?
  6. How experienced are you in performing hiatal hernia repair surgeries with UBM mesh?
  7. What is the success rate of hiatal hernia repair surgeries with UBM mesh compared to those without it?
  8. Will I need any additional follow-up care or monitoring after the surgery if UBM mesh is used?
  9. How will the use of UBM mesh affect the cost of the surgery and my insurance coverage?
  10. Are there any specific lifestyle changes or precautions I should take after the surgery if UBM mesh is used?

Reference

Authors: Howell RS, Fazzari M, Petrone P, Barkan A, Hall K, Servide MJ, Anduaga MF, Brathwaite CEM. Journal: JSLS. 2018 Apr-Jun;22(2):e2017.00100. doi: 10.4293/JSLS.2017.00100. PMID: 29950797