title: Hiatal hernia repair with gore bio-a tissue reinforcement: our experience.
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.
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Agrusa
authors.initials: A
authors.lastname: Antonino
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Romano
authors.initials: R
authors.lastname: Giorgio
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Frazzetta
authors.initials: F
authors.lastname: Giuseppe
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: De Vita
authors.initials: de V
authors.lastname: Giovanni
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Di Giovanni
authors.initials: DG
authors.lastname: Silvia
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Chianetta
authors.initials: C
authors.lastname: Daniela
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Di Buono
authors.initials: DB
authors.lastname: Giuseppe
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Sorce
authors.initials: S
authors.lastname: Vincenzo
authors.affiliation: Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo., U.O.C Chirurgia Generale e d'Urgenza, Azienda Ospedaliera Policlinico Universitario "Paolo Giaccone", Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy.
authors.forename: Gulotta
authors.initials: G
authors.lastname: Gaspare