A discussion in December included hiatal mesh for paraesophageal hernia repair.
Summary: In their 2006 study involving 4 institutions, Oelschlager et al hypothesized that using a small intestinal submucosa (SIS) to reinforce the closure of the hiatus in patients with paraesophageal hernia (PEH) would result in lower recurrence rate and improved outcomes. Indeed, they found that “adding a biologic prosthesis during LPEHR reduces the likelihood of recurrence at 6 months, without mesh-related complications or side effects” (p.481). In the 2006 publication, the authors admit the limitations of their 6 month follow-up, citing one co-investigator’s work that “created PEHs in dogs and repaired them with SIS. None of the dogs developed a stricture, erosion, dysphagia, or recurrence at 1 year” (p.487).