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Case Reports in Surgery
Volume 2014 (2014), Article ID 851278, 5 pages
Case Report

Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

Dipartimento di Chirurgia Generale d’Urgenza e dei Trapianti d’Organo., U.O.C Chirurgia Generale e d’Urgenza, Azienda Ospedaliera Policlinico Universitario “Paolo Giaccone”, Via Liborio Giuffrè 28, Palermo, 90100 Sicily, Italy

Received 8 December 2013; Accepted 18 February 2014; Published 22 April 2014

Academic Editors: A. Cho and A. A. Saber

Copyright © 2014 Agrusa Antonino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.