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Background <p>Giant diaphragmatic hernias (GDH) are rare but clinically significant, often leading to severe respiratory and gastrointestinal complications. Surgical repair is challenging, with high recurrence rates, especially in large defects where tension-free closure is difficult. This study evaluates the effectiveness of the spider-web-like suturing technique with composite mesh reinforcement in laparoscopic GDH repair.</p> Methods <p>A&#xa0;retrospective analysis of nine patients who underwent laparoscopic GDH repair using the spider-web-like suturing technique between May 2016 and February 2021 was conducted. Patient demographics, preoperative symptoms, intraoperative findings, surgical parameters, and postoperative outcomes were analyzed. The technique involved reducing the defect size with spider-web suturing before mesh placement to enhance mechanical support and prevent recurrence.</p> Results <p>The mean age was 51.2&#xa0;years, and the mean hernia defect size was 12.1 cm. The procedure was successfully completed laparoscopically in all cases, with a&#xa0;mean surgical time of 191.1 min and hospital stay of 4.4&#xa0;days. No surgery-related mortality or major complications were observed. Minor complications included transient abdominal distension (all patients) and temporary nausea/indigestion (2&#xa0;patients). The mean follow-up was 37.7&#xa0;months, with 89.4% symptom resolution and 93.3% patient satisfaction. No recurrence or mesh-related complications occurred.</p> Conclusion <p>The laparoscopic spider-web-like suturing technique with composite mesh reinforcement provides an effective, durable, and minimally invasive approach for GDH repair. It offers a&#xa0;low recurrence risk, enhanced mesh stability, and improved patient outcomes. While initial results are promising, further studies with larger cohorts and longer follow-up periods are needed to confirm long-term efficacy.</p>

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Laparoscopic repair of giant diaphragmatic hernias: evaluating the efficacy of the spider-web-like suturing technique combined with composite mesh reinforcement

  • 期刊论文

  • 发表日期：

    2025年7月12日

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  • Fahri Yetişir,
  • Ertan Piri,
  • Yasin Akın,
  • Ramazan Tiken,
  • Mete Yarkın Yetişir

摘要

Background

Giant diaphragmatic hernias (GDH) are rare but clinically significant, often leading to severe respiratory and gastrointestinal complications. Surgical repair is challenging, with high recurrence rates, especially in large defects where tension-free closure is difficult. This study evaluates the effectiveness of the spider-web-like suturing technique with composite mesh reinforcement in laparoscopic GDH repair.

Methods

A retrospective analysis of nine patients who underwent laparoscopic GDH repair using the spider-web-like suturing technique between May 2016 and February 2021 was conducted. Patient demographics, preoperative symptoms, intraoperative findings, surgical parameters, and postoperative outcomes were analyzed. The technique involved reducing the defect size with spider-web suturing before mesh placement to enhance mechanical support and prevent recurrence.

Results

The mean age was 51.2 years, and the mean hernia defect size was 12.1 cm. The procedure was successfully completed laparoscopically in all cases, with a mean surgical time of 191.1 min and hospital stay of 4.4 days. No surgery-related mortality or major complications were observed. Minor complications included transient abdominal distension (all patients) and temporary nausea/indigestion (2 patients). The mean follow-up was 37.7 months, with 89.4% symptom resolution and 93.3% patient satisfaction. No recurrence or mesh-related complications occurred.

Conclusion

The laparoscopic spider-web-like suturing technique with composite mesh reinforcement provides an effective, durable, and minimally invasive approach for GDH repair. It offers a low recurrence risk, enhanced mesh stability, and improved patient outcomes. While initial results are promising, further studies with larger cohorts and longer follow-up periods are needed to confirm long-term efficacy.