Laparoscopic nissen fundoplication for management of hiatal hernia with selective use of mesh in some cases

ABSTRACT

Laparoscopic repair of hiatal hernia with selective use of mesh was carried out in 20 patients [9 men "45%" and 11 women "55%"] with the mean age 48 years, in the period from January 2002 to January 2005. The patient suffering from, heart burn, regurgitation, dysphagia, epigastric or chest pain, cough and epigastric fullness. Esophagogastroduodenoscopy and barium meal studies reveal, type I 12 cases [60%], type II 2 cases [10%], type III 6 cases [30%]. Laparoscopic fundoplication without use of mesh was done in 15 [75%] of cases and with use of mesh in 5 [25%] cases. The average operative time was 115 minutes. The mean hospital stay ranged from 4 to 11 days. The operation was successful in 19 [95%] patients. One [5%] case are converted to open surgery because of gastric perforation. The long term follow up reveals 4 cases [20%] complaining of heart burn and dysphagia. Two [10%] of the 4 patients developed recurrence. The aim of our work was to evaluate the accuracy of laparoscopic repair of hiatus hernia with selective use of mesh in some cases