Question

Hernias are protrusions of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. Hernia may involve tissues such as the ABDOMINAL WALL or the respiratory DIAPHRAGM. Hernias may be internal, external, congenital, or acquired. Is the use of mesh reinforcement necessary for giant hiatal hernia surgical repair? 230/250 word discussion pls ref

Answer 1

Mesh reinforcement for giant Hiatal hernia:

Hernia is a disorder in which a part of the body protrudes abnormally through a tear or opening in an adjacent part, especially of the abdomen. Hiatal hernia is refers to the protrusion of abdominal content through hiatus of the diaphragm to the thoracic cavity. Giant hiatal hernia is a type of hernia in which 30% of stomach is in the chest, protruded through hiatus of the diaphragm.

The main treatment procedure for the large hiatal hernia is the surgical repair of hiatus hernia. The recurrence rate of hiatal hernia is more when compared to the other type of hernia after the surgery. Mesh reinforcement is used for the surgical repair of hernia is used by some health care facilities to reduce the risk of the recurrence of hiatal hernia.

There is still arguments exist related to the use of Mesh reinforcement and its effectiveness in the surgical repair of giant hiatal hernia. There are no relevant studies to prove the effectiveness of the use of Mesh reinforcement in preventing the recurrence of hiatal hernia. Many Metaanalysis studies show that there is no significant difference with the mesh use when comparing with the suture use in preventing the recurrence and decreasing the complications.

Certain complications related to the use of biological mesh also reported such as higher rate of Postoperative dysphagia( incidence is less in simple suture closure). Dense fibrosis, esophageal stenosis, mesh erosion are the other reported complications . Studies have shown that reoperation complications ( increased blood loss, increase in operating time) also more in patients with previous mesh use when comparing with non mesh users.