title: Laparoscopic repair of voluminous symptomatic hiatal hernia using absorbable synthetic mesh.
abstract: BACKGROUND
  Hiatal hernia is a common disorder and a controversial topic. In symptomatic voluminous hernias laparoscopic surgery and use of mesh can be considered. An initial experience in voluminous hiatal hernia laparoscopic repair using absorbable glycolic acid/trimethylene carbonate synthetic mesh is reported.
  
  
  METHODS
  Retrospective study from an institutional database was performed to analyze laparoscopic hiatal hernia repair using absorbable synthetic mesh from January 2010 to December 2013. All preoperative symptoms and exams were collected and a standardized procedure was performed. Clinical and radiological follow-up was performed.
  
  
  RESULTS
  Eight patients underwent laparoscopic repair of hiatal hernia performed by two highly skilled laparoscopic surgeons. One Toupet and seven Nissen fundoplications were tailored. No conversions into laparotomy, neither intraoperative complications nor mortality occurred. After a median follow-up of 23.5 months (range 14 - 44) no mesh complications occurred and all patients are asymptomatic. Two radiological recurrences (25%) were detected.
  
  
  CONCLUSIONS
  Voluminous symptomatic hiatal hernias can be successfully treated in a high-volume and long-term experienced laparoscopic surgical center by the use of an absorbable synthetic mesh. Further studies and a longer-term follow-up are necessary to confirm this preliminary report.
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Berselli
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livraghi
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Latham
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Farassino
authors.affiliation: b 2 Department of Specialist Medicine, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Rota Bacchetta
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Noemi
authors.initials: N
authors.lastname: Pasqua
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Ileana
authors.initials: I
authors.lastname: Ceriani
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Segato
authors.affiliation: a 1 Department of Surgery, Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi , Varese, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cocozza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004146:Dioxanes / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006016:Glycolates / Q000737:chemistry; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh
chemical_list: D004146:Dioxanes; D006016:Glycolates; C031149:glycolic acid; C443643:trimethylene carbonate
keywords: Gastroesophageal reflux disease (GERD); absorbable mesh; fundoplication; hiatal hernia; laparoscopy; material science; minimally invasive surgery