[Mesh suture in the treatment of diaphragmatic hernias].

Abstract

The paper studies the results of surgical treatment of the first 25 patients with diaphragmatic hernias who underwent laparoscopic surgeries for hiatal hernias using polypropylene mesh sutures using the proprietary method.

Material and methods: Polypropylene mesh strips were used instead of traditional sutures to seal the crura of the diaphragm in 25 patients. The intervention technique and treatment outcomes are described. The study included 25 patients, 5 males and 20 females, operated on between 2019 and 2024 with a diagnosis of hiatal hernia (HH), aged 38 to 79 years.

Results: The mean surgery duration was 83.4 minutes (50 to 120 minutes), and intraoperative and postoperative complications were not observed. The mean hospital stay was 1.5 days (1 to 4 days). Four patients (16%) had a recurrence of hernia diagnosed using imaging studies, but there were no clinically significant recurrences in all 25 patients. Twenty (80%) patients permanently discontinued proton pump inhibitors (PPIs), and 2 (8%) significantly reduced their dose. Eighteen (72%) patients had complete resolution of their HH-related symptoms; in 4 (16%) patients, these symptoms significantly reduced. All patients were satisfied with the treatment outcomes.

Conclusions: The use of mesh sutures to seal the crura of the diaphragm supports the concept of pressure distribution and muscle resistance to incision, which is often seen with traditional suture material. In addition, the mesh material stimulates scar tissue growth through the pores of the prosthesis, strengthening the suture line.