Giant Hiatal Hernia and P4HB Phasix TMST Mesh Hiatoplasty Outcomes

Abstract

Surgical repair of giant hiatal hernia (GHH) and associated high recurrence rate defy technological advances in surgical sciences despite better instrumentation and availability of various mesh prostheses. Aim: This study evaluates the safety and efficacy of long-lasting biosynthetic absorbable Poly 4 Hydroxybutyrate Phasix TMST mesh outcomes in patients with GHH undergoing hiatal hernia repair. Methods: We studied a prospectively maintained database of all patients who underwent GHH repair between September 2020 and October 2023. Primary outcome measures were 30-day mortality and postoperative morbidities. Secondary outcome measures were 90-day readmission rates, patient-reported outcomes derived through modified Visick grading and recurrence of hiatus hernia. Results: 44 patients were included in this study. Median follow-up is twenty-four months. There was no mortality at 30 days. 4.5% (n=2) experienced significant complications at 30 days. Median length of stay was 3 days. 81% reported clinical improvement with enhanced Visick grade, and proton-pump inhibitor (PPI) cessation rate was 77.4%. There were no readmissions at 90 days. 9.1% who reported symptom recurrence had anatomical hiatus hernia recurrence. Conclusion: The study showed laparoscopic hiatoplasty with P4B Phasix TMST mesh has low morbidity and recurrence with medium-term follow-up.