2008 Annual Meeting Abstracts
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A Simplified Technique for Placement of Biologic Mesh in Paraesophageal Hernia Repair (Peh)
Tayyab S. Diwan*, Danny V. Martinec, Michael Ujiki, Christy M. Dunst, Lee L. Swanstrom
Minimally Invasive Surgery, Legacy Health System, Portland, OR
The placement of mesh in the crural closure of PEH repairs has been shown to decrease hernia recurrence rates. Synthetic mesh is easy to use but has a high rate of esophageal erosion and therefore has been largely abandoned. Use of biologic mesh decreases the risk of erosion and recurrence rates, but there is currently no well described method for placement. We present a method which requires no additional sutures or staples and achieves excellent contact and reinforcement of the crural closure. Our method incorporates biological mesh into the standard closure using pledgeted polyester sutures placed in a horizontal mattress fashion. This technique has worked well in over 150 PEH operations.
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