OGBN O08 The Safety and Efficacy of Laparoscopic Hiatus Hernia Repair with Biosynthetic Mesh (Phasix-ST®): A Single Centre Experience

Abstract

Abstract Background Surgical management of large hiatus hernia (> 5 cm defect) remains challenging due to high recurrence rates. Mesh augmentation in laparoscopic hiatal hernia repair has been used to reduce recurrences but carries risks such as mesh erosion, contraction, infection, and reaction to the foreign body. Introducing biosynthetic meshes offers a promising adjunct to primary suture repair of hiatal defects with enhanced tissue integration and reduced risk of infection. Phasix™ ST mesh is a biosynthetic mesh made of Poly-4-Hydroxybutyrate (P4HB). This study evaluates early patient outcomes following laparoscopic hiatal hernia repair with Phasix™ ST mesh, including its safety and efficacy profile. Methods This study was to evaluate outcomes of laparoscopic hiatus hernia repair using Phasix™ ST mesh in adult patients (>18 years) at our institution. All patients undergoing this procedure between September 2020 to April 2023 were identified from a prospectively maintained database. Our standardised technique involved on-lay crural reinforcement with Phasix™ ST mesh after primary closure of the hiatal defect, followed by partial fundoplication. Patient records were reviewed retrospectively to assess these end-point measures: postoperative mortality and morbidity at 30 days, functional results reported during the follow-up period, and recurrence rates of hiatus hernia. Results Conclusions This is the first study in the United Kingdom demonstrating that laparoscopic hiatus hernia repair with the use of Phasix™ ST mesh for crural reinforcement has low-rate complications, with most patients reporting symptom improvement and discontinuing PPI use in the early-term follow–up. Further long-term studies are needed to validate these findings.