Hiatal hernia repair with mesh

A survey of SAGES members

Constantine T. Frantzides, Mark Alan Carlson, Sofronis Loizides, Anastasia Papafili, Mihn Luu, Jacob Roberts, Tallal Zeni, Alexander Frantzides

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Background Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh may reduce this recurrence rate. The indication for mesh use, the type of mesh to use, and the placement technique are controversial. A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clinical problem. Methods A questionnaire on the technique and results of mesh hiatal herniorrhaphy was sent to 1,192 members of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES). Results There were 275 responses; 261 of these were analyzed. A total of 5,486 hiatal hernia repairs with mesh were reported; 77% and 23% were performed laparoscopically vs open, respectively. The most common indication for mesh usage was an increased size hiatal defect (46% of respondents). The most common mesh types were biomaterial (28%), polytetrafluoroethylene (25%), and polypropylene (21%). Suture anchorage was the most common fixation technique (56% of respondents). The findings showed a failure rate of 3%, a stricture rate of 0.2%, and an erosion rate of 0.3%. Biomaterial tended to be associated with failure, whereas nonabsorbable mesh tended to be associated with stricture and erosion. Conclusions The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.

Original languageEnglish (US)
Pages (from-to)1017-1024
Number of pages8
JournalSurgical Endoscopy
Volume24
Issue number5
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Fingerprint

Hiatal Hernia
Herniorrhaphy
Biocompatible Materials
Recurrence
Pathologic Constriction
Polypropylenes
Polytetrafluoroethylene
Sutures
Surveys and Questionnaires
Surgeons

Keywords

  • Biomaterial
  • Erosion
  • Gastroesophageal reflux disease
  • Hiatal hernia repair
  • Hiatal herniorrhaphy
  • Mesh
  • Paraesophageal hernia
  • Prosthetic
  • Recurrence
  • Stricture

ASJC Scopus subject areas

  • Surgery

Cite this

Frantzides, C. T., Carlson, M. A., Loizides, S., Papafili, A., Luu, M., Roberts, J., ... Frantzides, A. (2010). Hiatal hernia repair with mesh: A survey of SAGES members. Surgical Endoscopy, 24(5), 1017-1024. https://doi.org/10.1007/s00464-009-0718-6

Hiatal hernia repair with mesh : A survey of SAGES members. / Frantzides, Constantine T.; Carlson, Mark Alan; Loizides, Sofronis; Papafili, Anastasia; Luu, Mihn; Roberts, Jacob; Zeni, Tallal; Frantzides, Alexander.

In: Surgical Endoscopy, Vol. 24, No. 5, 01.01.2010, p. 1017-1024.

Research output: Contribution to journalArticle

Frantzides, CT, Carlson, MA, Loizides, S, Papafili, A, Luu, M, Roberts, J, Zeni, T & Frantzides, A 2010, 'Hiatal hernia repair with mesh: A survey of SAGES members', Surgical Endoscopy, vol. 24, no. 5, pp. 1017-1024. https://doi.org/10.1007/s00464-009-0718-6
Frantzides CT, Carlson MA, Loizides S, Papafili A, Luu M, Roberts J et al. Hiatal hernia repair with mesh: A survey of SAGES members. Surgical Endoscopy. 2010 Jan 1;24(5):1017-1024. https://doi.org/10.1007/s00464-009-0718-6
Frantzides, Constantine T. ; Carlson, Mark Alan ; Loizides, Sofronis ; Papafili, Anastasia ; Luu, Mihn ; Roberts, Jacob ; Zeni, Tallal ; Frantzides, Alexander. / Hiatal hernia repair with mesh : A survey of SAGES members. In: Surgical Endoscopy. 2010 ; Vol. 24, No. 5. pp. 1017-1024.
@article{e0941bcdb2784109a2d10ef9b4bf18f8,
title = "Hiatal hernia repair with mesh: A survey of SAGES members",
abstract = "Background Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh may reduce this recurrence rate. The indication for mesh use, the type of mesh to use, and the placement technique are controversial. A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clinical problem. Methods A questionnaire on the technique and results of mesh hiatal herniorrhaphy was sent to 1,192 members of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES). Results There were 275 responses; 261 of these were analyzed. A total of 5,486 hiatal hernia repairs with mesh were reported; 77{\%} and 23{\%} were performed laparoscopically vs open, respectively. The most common indication for mesh usage was an increased size hiatal defect (46{\%} of respondents). The most common mesh types were biomaterial (28{\%}), polytetrafluoroethylene (25{\%}), and polypropylene (21{\%}). Suture anchorage was the most common fixation technique (56{\%} of respondents). The findings showed a failure rate of 3{\%}, a stricture rate of 0.2{\%}, and an erosion rate of 0.3{\%}. Biomaterial tended to be associated with failure, whereas nonabsorbable mesh tended to be associated with stricture and erosion. Conclusions The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.",
keywords = "Biomaterial, Erosion, Gastroesophageal reflux disease, Hiatal hernia repair, Hiatal herniorrhaphy, Mesh, Paraesophageal hernia, Prosthetic, Recurrence, Stricture",
author = "Frantzides, {Constantine T.} and Carlson, {Mark Alan} and Sofronis Loizides and Anastasia Papafili and Mihn Luu and Jacob Roberts and Tallal Zeni and Alexander Frantzides",
year = "2010",
month = "1",
day = "1",
doi = "10.1007/s00464-009-0718-6",
language = "English (US)",
volume = "24",
pages = "1017--1024",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Hiatal hernia repair with mesh

T2 - A survey of SAGES members

AU - Frantzides, Constantine T.

AU - Carlson, Mark Alan

AU - Loizides, Sofronis

AU - Papafili, Anastasia

AU - Luu, Mihn

AU - Roberts, Jacob

AU - Zeni, Tallal

AU - Frantzides, Alexander

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Background Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh may reduce this recurrence rate. The indication for mesh use, the type of mesh to use, and the placement technique are controversial. A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clinical problem. Methods A questionnaire on the technique and results of mesh hiatal herniorrhaphy was sent to 1,192 members of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES). Results There were 275 responses; 261 of these were analyzed. A total of 5,486 hiatal hernia repairs with mesh were reported; 77% and 23% were performed laparoscopically vs open, respectively. The most common indication for mesh usage was an increased size hiatal defect (46% of respondents). The most common mesh types were biomaterial (28%), polytetrafluoroethylene (25%), and polypropylene (21%). Suture anchorage was the most common fixation technique (56% of respondents). The findings showed a failure rate of 3%, a stricture rate of 0.2%, and an erosion rate of 0.3%. Biomaterial tended to be associated with failure, whereas nonabsorbable mesh tended to be associated with stricture and erosion. Conclusions The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.

AB - Background Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh may reduce this recurrence rate. The indication for mesh use, the type of mesh to use, and the placement technique are controversial. A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clinical problem. Methods A questionnaire on the technique and results of mesh hiatal herniorrhaphy was sent to 1,192 members of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES). Results There were 275 responses; 261 of these were analyzed. A total of 5,486 hiatal hernia repairs with mesh were reported; 77% and 23% were performed laparoscopically vs open, respectively. The most common indication for mesh usage was an increased size hiatal defect (46% of respondents). The most common mesh types were biomaterial (28%), polytetrafluoroethylene (25%), and polypropylene (21%). Suture anchorage was the most common fixation technique (56% of respondents). The findings showed a failure rate of 3%, a stricture rate of 0.2%, and an erosion rate of 0.3%. Biomaterial tended to be associated with failure, whereas nonabsorbable mesh tended to be associated with stricture and erosion. Conclusions The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.

KW - Biomaterial

KW - Erosion

KW - Gastroesophageal reflux disease

KW - Hiatal hernia repair

KW - Hiatal herniorrhaphy

KW - Mesh

KW - Paraesophageal hernia

KW - Prosthetic

KW - Recurrence

KW - Stricture

UR - http://www.scopus.com/inward/record.url?scp=77955660536&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955660536&partnerID=8YFLogxK

U2 - 10.1007/s00464-009-0718-6

DO - 10.1007/s00464-009-0718-6

M3 - Article

VL - 24

SP - 1017

EP - 1024

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

IS - 5

ER -