Research On Application Of Laparoscopic Esophageal Hiatal Hernia Repair With Mesh Reinforcement

Objective:To approach the efficacy of laparoscopic tension-free esophageal hiatal hernia repair with Mesh, and to discuss its indication.Methods:Retrospectively analyzed the patients underwent laparoscopic esophageal hiatal hernia repair from January 2004 to December 2010, compared the different ways of hernioplasty.Results:We have checked totally 18 patients, fifteen of them underwent the traditional method (Nissen fundoplication without Mesh), two to three interrupted sutures were applied on the right and left hiatal crura, followed by 360 degrees of Nissen fundoplication, the mean oprative time was 147.7 min, the mean blood loss was 68 ml, and the mean postoperative hospitalization was 5.3 days, one patient accepted reoperation 4 months after the first laparoscopic Nissen fundoplication because of recurrence. Other three patients underwent the laparoscopic tension-free esophageal hiatal hernia repair (Nissen fundoplication with Mesh reinforcement). the mean oprative time was 246.7 min. the mean blood loss was 30 ml. and the mean postoperative hospitalization was 7 days. there was no postoperative recurrence.Conclusions:The traditional method of laparoscopic interrupted sutures of hiatal crus (Nissen fundoplication without Mesh) has a high rate of hiatal hernia recurrence. the attempt of laparoscopic tension-free esophageal hiatal hernia repair (Nissen fundoplication with Mesh reinforcement) is available.