Our Summary

This research paper is a review of scientific literature on the use of mesh in a specific type of surgery to repair hiatal hernias (a condition where part of the stomach pushes up into the chest through an opening in the diaphragm). The use of mesh in these surgeries is controversial and researchers wanted to find out how useful it is for patients with large hiatal hernias, obesity, recurring hernias, and complex hernias.

The researchers looked at articles published between 2000 and 2020 which discussed this type of surgery with or without the use of mesh. They evaluated how surgery outcomes, patient quality of life, and recurrence rates differed among patients with different types of hernias.

They found that the outcomes for patients with large hernias who had mesh used in their surgery varied widely. For patients with obesity, weight loss procedures are recommended, but it’s unclear if using mesh in hernia repair helps these patients. Using mesh in repeat surgeries might improve quality of life and reduce hernia recurrence. However, there’s limited evidence to support using mesh in surgeries for complex hernias.

Overall, the data on this topic is mixed and doesn’t clearly show whether using mesh is better than not using it. More research is needed to figure out which patients might benefit from the use of mesh in hernia repair surgeries.

FAQs

  1. What is the current understanding of the usefulness of mesh in laparoscopic hiatal hernia repair?
  2. Does mesh reinforcement during a redo laparoscopic hiatal hernia repair improve quality of life and reduce hernia recurrence?
  3. Is there substantial evidence supporting the use of mesh in patients undergoing laparoscopic hiatal hernia repair for complicated hiatal hernia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hiatal hernia repair is to discuss with their surgeon the potential benefits and risks of using mesh reinforcement during the procedure. Mesh reinforcement may be beneficial in certain cases, such as large hiatal hernias or recurrent hernias, but the decision to use mesh should be made on a case-by-case basis. It is important for the patient to have a thorough discussion with their surgeon to understand the potential outcomes and implications of using mesh during hiatal hernia repair.

Suitable For

Patients who may be recommended for hiatal hernia repair with mesh reinforcement include those with large hiatal hernias, obesity, recurrent hiatal hernias, and complicated hiatal hernias. Morbidly obese patients with hiatal hernias may benefit from a weight-loss procedure in addition to hernia repair. Mesh reinforcement during redo laparoscopic hiatal hernia repair may be beneficial in terms of quality of life improvement and reducing hernia recurrence. However, the use of mesh in patients undergoing hiatal hernia repair for complicated hernias is still unclear and further research is needed to determine the benefits of mesh placement in these patients. Overall, the decision to use mesh in hiatal hernia repair should be based on individual patient factors and further research is needed to determine which patients would benefit most from mesh reinforcement.

Timeline

  • Before hiatal hernia repair:
  1. Patient experiences symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and nausea.
  2. Patient undergoes diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the presence of a hiatal hernia.
  3. Treatment may include lifestyle changes, medication, and dietary modifications to manage symptoms.
  • After hiatal hernia repair:
  1. Patient undergoes laparoscopic hiatal hernia repair, which may or may not involve the use of mesh reinforcement.
  2. Recovery period typically involves pain management, dietary restrictions, and gradual return to normal activities.
  3. Patient experiences symptom improvement, such as reduced heartburn and regurgitation.
  4. Follow-up appointments are scheduled to monitor healing and address any complications.
  5. Long-term outcomes include improved quality of life and reduced risk of hernia recurrence.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hiatal hernia repair using mesh reinforcement?
  2. How long is the recovery process after hiatal hernia repair with mesh?
  3. What is the success rate of hiatal hernia repair with mesh reinforcement?
  4. Are there any specific dietary or lifestyle changes I should make after the surgery?
  5. How soon after the surgery can I expect to see improvement in my symptoms?
  6. Will I need any follow-up appointments or tests after the surgery?
  7. Are there any long-term effects or considerations I should be aware of after hiatal hernia repair with mesh reinforcement?
  8. How experienced are you in performing hiatal hernia repair with mesh reinforcement?
  9. Are there any alternative treatment options for hiatal hernia that do not involve mesh reinforcement?
  10. What can I do to minimize the risk of hernia recurrence after the surgery?

Reference

Authors: Laxague F, Sadava EE, Herbella F, Schlottmann F. Journal: Dis Esophagus. 2021 Jun 14;34(6):doaa125. doi: 10.1093/dote/doaa125. PMID: 33333552