Our Summary

This research paper is about a study conducted at the Vivantes Urban Hospital in Berlin, Germany, where a new method was used to repair hiatal hernias. This condition is a type of hernia where part of the stomach pushes up through the diaphragm muscle. The new method used a 3D mesh product called DynaMesh-DELTA.

The study tracked 320 patients who had this surgery between 2019 and 2022. Of these, 133 completed their follow-up visits and were included in the study. The researchers then looked at their medical records to see how they did after the surgery.

The results show that 24 of the 133 patients (17.1%) had complications from the surgery. One patient had to have a second surgery right away. Only 3 patients (2.2%) had serious complications that required more surgery under general anesthesia. None of the patients died from the surgery.

During their follow-up visits, almost 73% of the patients said they had few or no symptoms. However, 23 patients (17.4%) had the hernia come back and had noticeable symptoms. 12 patients (9.1%) had to have another surgery.

The study concludes that this new method of repairing hiatal hernias with a 3D mesh product shows promise. It resulted in low rates of complications and recurrences. Most patients reported a significant improvement in symptoms related to gastroesophageal reflux disease (GERD), a common problem for people with hiatal hernias. The researchers suggest that more detailed studies should be done in the future to further evaluate this method.

FAQs

  1. What techniques are available to repair hiatal hernias?
  2. What are the recurrence rates after hiatal hernia repair surgery?
  3. How effective is the minimally invasive mesh-augmented hiatal reconstruction using a new alloplastic 3D mesh?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair using mesh augmentation is to follow postoperative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow for proper healing of the surgical site. It is also important to maintain a healthy diet and lifestyle to reduce the risk of recurrence and improve overall outcomes. Regular follow-up appointments with your healthcare provider are essential to monitor your recovery and address any concerns or symptoms that may arise.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those with symptomatic gastroesophageal reflux disease (GERD), severe or recurrent hiatal hernias, and those who have failed conservative management such as medication or lifestyle changes. Additionally, patients with complications from their hiatal hernia such as severe esophagitis, Barrett’s esophagus, or respiratory symptoms may also be candidates for repair. In this study, patients who underwent mesh-augmented hiatal hernia repair showed low postoperative morbidity and recurrence rates, with the majority experiencing improved GERD-associated symptoms.

Timeline

Before hiatal hernia repair:

  1. Patient experiences symptoms of gastroesophageal reflux disease (GERD) such as heartburn, regurgitation, chest pain, and difficulty swallowing.
  2. Patient undergoes diagnostic tests such as endoscopy, pH monitoring, and imaging studies to confirm the presence of a hiatal hernia.
  3. Treatment options such as medications, lifestyle modifications, and dietary changes are explored to manage symptoms.
  4. Patient decides to undergo hiatal hernia repair surgery due to persistent symptoms or complications.

After hiatal hernia repair:

  1. Patient undergoes minimally invasive mesh-augmented hiatal reconstruction using a 3D mesh.
  2. Postoperative complications occur in 17.1% of patients, with only 2.2% requiring invasive treatment under general anesthesia.
  3. Early recurrence is observed in 1 patient who undergoes redo surgery during the initial stay.
  4. Overall mortality rate is 0%.
  5. During follow-up, 72.7% of patients report being relatively asymptomatic, with improved GERD-associated symptoms.
  6. 17.4% of patients experience recurrent hiatal hernias and relevant symptoms, leading to reoperation in 9.1% of cases.
  7. The study concludes that mesh-augmented hiatal hernia repair results in low postoperative morbidity and recurrence rates, with improved patient-reported outcomes. Further research is needed to investigate the technical approach in more detail.

What to Ask Your Doctor

  1. What is a hiatal hernia and why do I need surgery to repair it?
  2. What are the potential risks and complications of mesh-augmented hiatal hernia repair?
  3. How long will the recovery process be and what can I expect during the postoperative period?
  4. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  5. What are the chances of the hernia recurring after the repair?
  6. How will the mesh affect my body and are there any potential long-term effects?
  7. Will I need any follow-up procedures or tests after the surgery?
  8. How experienced are you in performing mesh-augmented hiatal hernia repairs and what is your success rate?
  9. Are there any alternative treatments or techniques available for my condition?
  10. What are the expected outcomes in terms of symptom relief and improvement in quality of life after the surgery?

Reference

Authors: Thomas F, Nagel A, Mueller MH. Journal: Hernia. 2025 Jun 3;29(1):192. doi: 10.1007/s10029-025-03386-9. PMID: 40459763