Transmural Gastric Migration of Dual-sided PTFE/ePTFEE Mesh after Laparoscopic Surgery for a Recurrent Hiatal Hernia with Dysphagia: Case Report
D. Acin-Gandara, C. Miliani-Molina, J.A. Carneros-Martin, J. Martinez-Pineiro, M. De Vega Iraneta, F. Pereira-PerezClinical case, no. 4, 2014
Several series have shown that laparoscopic fundoplication isfeasible and safe for the treatment of hiatal hernia, although ahigh recurrence rate of 42% has been published. The use ofmesh repair in these hernias has shown fewer recurrences thanprimary suture with small number of complications reported.Some of these are severe fibrosis within the hiatus, mesherosion of the intestinal wall, esophageal strictures, meshmigration into the upper gastrointestinal tract and esophagealperforations. We present a case with late erosion and completetransmural gastric migration of the mesh after surgery. In thesecases, the patients may require complex surgical intervention.That was not the case in our patient, who did not requirefurther surgery because the mesh migrated completely. It istherefore advisable to use a mesh very selectively for thelaparoscopic repair of hiatal hernias, taking into account thesurgeon's experience, the anatomy of the hiatus and thesymptoms of the patient.
