Mesh repair of hiatal hernia: An ongoing controversy

The success of laparoscopic funduplication has increased the use of the laparoscopic approach in the treatment of paraesophageal or mixed hiatal hernia. The results show that laparoscopic repair is feasible and safe, although the incidence of recurrence is high and consequently some authors recommend the use of mesh to reinforce the hiatal closure. The present review aims to analyze published experience on the use of mesh to prevent recurrence after laparoscopic repair of paraesophageal hiatal hernias. There are few comparative or randomized studies comparing the use of mesh with conventional closure. However, the use of mesh prevents hernia recurrence and has a low complication rate. The information available allows us to conclude that the use of mesh in hiatal hernia repair is safe and prevents recurrence. However, information on the long-term results is scarce and severe complications can occur. Consequently, the selective use of mesh, based on the surgeon's clinical experience, is recommended.