Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

Giorgio Romano, Giuseppe Di Buono, Antonino Agrusa, Gaspare Gulotta, Daniela Chianetta, Giovanni De Vita, Giuseppe Frazzetta, Silvia Di Giovanni, Vincenzo Sorce

Research output: Contribution to journalArticle

Abstract

Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.
Original languageEnglish
Number of pages0
JournalCASE REPORTS IN SURGERY
Volume2014
Publication statusPublished - 2014

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Hiatal Hernia
Herniorrhaphy
Leg
Fundoplication
Gastroesophageal Reflux
Recurrence
Esophagitis
Manometry
Esophagus
Endoscopy
Acids
Therapeutics

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Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience. / Romano, Giorgio; Di Buono, Giuseppe; Agrusa, Antonino; Gulotta, Gaspare; Chianetta, Daniela; De Vita, Giovanni; Frazzetta, Giuseppe; Di Giovanni, Silvia; Sorce, Vincenzo.

In: CASE REPORTS IN SURGERY, Vol. 2014, 2014.

Research output: Contribution to journalArticle

Romano, Giorgio ; Di Buono, Giuseppe ; Agrusa, Antonino ; Gulotta, Gaspare ; Chianetta, Daniela ; De Vita, Giovanni ; Frazzetta, Giuseppe ; Di Giovanni, Silvia ; Sorce, Vincenzo. / Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience. In: CASE REPORTS IN SURGERY. 2014 ; Vol. 2014.
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abstract = "Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90{\%} of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42{\%} recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.",
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AU - Romano, Giorgio

AU - Di Buono, Giuseppe

AU - Agrusa, Antonino

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AU - Chianetta, Daniela

AU - De Vita, Giovanni

AU - Frazzetta, Giuseppe

AU - Di Giovanni, Silvia

AU - Sorce, Vincenzo

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AB - Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.

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