Laparoscopic large hiatal hernia plasty with self-fixating ProGripmesh. Improved efficiency

Abstract

The aim — to study the possibility of ProGrip self‑fixating mesh for laparoscopic plasty for large hiatal hernia (HH).Materials and methods. The present work is based on a retrospective analysis of the operative results of 122 patients with large HH. The age of the operated patients was 39 to 82 years. The patient age ranged from 39 to 82 years, the average age was 64.8 ± 11.2 years. 48 (39.3 %) patients had signs of obesity (BMI > 30 kg/m2). Long‑term results were studied after 6, 12 and 24 months after surgery. All patients were studied with 24h pH‑metry of the esophagus with the DeMeester index calculation at 6th and 12th months.Results and discussion. ProGrip mesh germinated quickly by own tissues and reliably strengthen the performed cruroraphia. There was only 1 recurrence in the group of patients with ProGrip mesh during all supervision term. Functional operative results were positive in the majority of cases. Mean Quality of Life Index before the operation was 35, after the operation — 9 (p < 0.05). 24hr pH‑metry showed a decrease in DeMeester index from 78.0 ± 15.0 before the operation to 13.6 ± 4.0 after surgery (p < 0.01). Comparison of the operative results with the ProGrip mesh and results of 128 operations performed with conventional polypropylene meshes, showed the advantage of ProGrip mesh use.Conclusions. The first experience with self‑fixating ProGrip mesh to strengthen cruroraphia demonstrated safety and high efficiency of the new method. The use of ProGrip mesh allows 1.5 times to reduce the operation time and 5 times to reduce the recurrence rate after laparoscopic fundoplication.