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<p>Hiatal hernia (HH) repair remains a complex and evolving field, especially regarding the selective use of mesh reinforcement. This retrospective study evaluates a modified, patient-tailored approach to guide mesh use in laparoscopic hiatoplasty. Sixty-three patients were analysed using adapted criteria based on hernia type, hiatal diameter, crural tropism, and recurrence. While 50.8% scored above the threshold, suggesting mesh augmentation, only 6.3% received it, highlighting a significant disconnect between evidence-based indications and past surgical practice. The modified model enabled preoperative planning using existing documentation and imaging, enhancing decision-making even in retrospective settings. Our findings underline the value of structured, individualised surgical strategies to optimise outcomes, reduce recurrence, and align interventions with patient-specific anatomical risk factors. A prospective validation study is warranted to standardise and expand this tailored approach.</p>

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Retrospective Assessment of a Modified Patient-Tailored Approach Model in Hiatal Hernia Repair: Mesh or No Mesh?

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月15日

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  • Diana Musová,
  • Marek Smolár,
  • Miloslav Mišánik,
  • Andrej Kollár,
  • Michal Hošala,
  • Juraj Miklušica

摘要

Hiatal hernia (HH) repair remains a complex and evolving field, especially regarding the selective use of mesh reinforcement. This retrospective study evaluates a modified, patient-tailored approach to guide mesh use in laparoscopic hiatoplasty. Sixty-three patients were analysed using adapted criteria based on hernia type, hiatal diameter, crural tropism, and recurrence. While 50.8% scored above the threshold, suggesting mesh augmentation, only 6.3% received it, highlighting a significant disconnect between evidence-based indications and past surgical practice. The modified model enabled preoperative planning using existing documentation and imaging, enhancing decision-making even in retrospective settings. Our findings underline the value of structured, individualised surgical strategies to optimise outcomes, reduce recurrence, and align interventions with patient-specific anatomical risk factors. A prospective validation study is warranted to standardise and expand this tailored approach.