ArticleSurgical endoscopy2016
The use of crural relaxing incisions with biologic mesh reinforcement during laparoscopic repair of complex hiatal hernias.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis of laparoscopic mesh versus suture repair of hiatus hernia: objective and subjective outcomes.Surgical endoscopy · 2017Pooled it
- Frailty predicts recurrence after laparoscopic Nissen fundoplication with mesh cruroplasty for giant sliding hiatal hernia with severe reflux esophagitis in elderly patients: a multicenter retrospective study.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Massive hiatal hernia through a prior diaphragmatic relaxing incision: case report with a literature review.Journal of surgical case reports · 2025Article
- Comparison of Nissen vs. Toupet fundoplication in laparoscopic hiatal hernia repair for gastroesophageal reflux disease with extra-esophageal symptoms.Frontiers in medical technology · 2025Article
- BRAZILIAN HERNIA AND ABDOMINAL WALL SOCIETY STATEMENT ON LARGE HIATAL HERNIAS MANAGEMENT.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024Article
- Impact of laparoscopic repair on type III/IV giant paraesophageal hernias: a single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- Diaphragmatic relaxing incisions for complex hiatal reconstruction: longer-term follow-up confirms safety, efficacy and rare complications.Surgical endoscopy · 2023Article
- Large hiatus hernia: time for a paradigm shift?BMC surgery · 2022Article
- Characteristics and outcomes of patients undergoing paraesophageal hernia repair with selective use of biologic mesh.Surgical endoscopy · 2022Article
- The use of biosynthetic mesh in giant hiatal hernia repair: is there a rationale? A 3-year single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Management of paraesophageal hernia review of clinical studies: timing to surgery, mesh use, fundoplication, gastropexy and other controversies.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2020Article
- Use of computed tomography volumetric measurements to predict operative techniques in paraesophageal hernia repair.Surgical endoscopy · 2020Article
- Minimally invasive surgery for large hiatal hernia.Annals of gastroenterological surgery · 2019Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLaparoscopic hiatal hernia repair has a better chance of success if the hiatus is closed without tension. This study attempts to answer the following questions: (1) What is the rate of hiatal hernia recurrence in patients who undergo hiatal closure with diaphragmatic relaxing incisions? (2) Can biologic mesh be safely substituted for synthetic mesh as coverage of the relaxing incisions?
methodsWe identified all patients who underwent laparoscopic hiatal hernia repair at our institution between 2007 and 2013 and reviewed their clinical records. Radiologic recurrence was identified by an experienced radiologist and defined as the presence of any abdominal contents located above the diaphragm on esophagram. Clinical recurrence was defined as little or no improvement in symptoms, the development of a new symptom, or the need for medical, endoscopic, or surgical treatment of postoperative symptoms.
resultsA minimum of 6 months of radiologic and clinical follow-up was available for 146 (40 %) patients, including 16 with relaxing incisions. There were 66 (45 %) recurrent hernias detected on esophagram. There was no difference in the rate of recurrent hiatal hernia among the three groups: Primary closure of the hiatus (21/36 [58 %]), primary closure with biologic mesh reinforcement (36/94 [38 %]), and relaxing incision with biologic mesh reinforcement (9/16 [56 %]; p = 0.428). Two reoperations were performed on patients who underwent left relaxing incisions and developed symptomatic diaphragmatic hernias through the left relaxing incisions. There were no complications associated with use of biologic mesh at the hiatus.
conclusionsRate of recurrent hiatal hernia is similar between patients who undergo diaphragmatic relaxing incisions and patients who undergo primary hiatal closure. Relaxing incisions can be safely performed on either crus; however, biologic mesh should not be used to patch a left-sided relaxing incision due to the risk of developing a diaphragmatic hernia.
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