Laparoscopic repair of paraesophageal hernia with selective use of mesh.

The laparoscopic approach to PEH, in use for close to a decade, shows promising results. However, data on the long-term follow-up of patients who undergo this procedure are still lacking, and the use of mesh is debatable. We retrospectively investigated 33 patients who underwent this procedure over a 30-month period. In 10 patients, the repair was performed using a mesh prosthesis. There was one (3%) intraoperative and four (12%) early postoperative complications, with one mortality (3%). The average postoperative stay was 3 days. During a 58-month follow-up period, 18% of the patients developed small, sliding recurrent hernias, with a higher rate in the primary repair group (18% vs. 10%). Surgical outcome was scored good-to-excellent on a questionnaire by 84.5% of the patients. Laparoscopic repair of PEH is feasible and safe. While small recurrences do occur, functional results remain good. The use of mesh should be tailored to the specific patient.