Tension-free hiatal hernia repair using ligamentum teres in paraesophageal hernia treatment

Abstract

<br><b>Introduction:</b> Repair of type 2 and 3 hiatal hernias (paraesophageal and mixed) remains technically challenging with a risk of complications and recurrence of up to 40%. The use of a synthetic mesh is associated with possible serious complications. However, the effectiveness of biological materials remains unclear and requires further research.</br> <br><b>Aim:</b> The aim of this study was to present the experience of our clinic in the management of large type 2 and 3 hiatal hernias using the round ligament of the liver and to emphasize potential benefits of this procedure.</br> <br><b>Material and methods:</b> The study involved 6 patients, 3 females and 3 males aged 37–58, with large paraesophageal hernias diagnosed on radiological imaging and endoscopy. In those patients, Nissen fundoplication and hiatal hernia repair using the round ligament of the liver were performed. The patients were followed up for six months, and then imaging and endoscopy were repeated.</br> <br><b>Results:</b> No clinical or radiological signs of hiatal hernia recurrence were observed in any of the six patients during the six- -month follow-up. Two patients reported dysphagia, and the mortality rate was 0%.</br> <br><b>Conclusions:</b> Hiatal hernia repair with the vascularized round ligament of the liver can be an effective and safe method of treatment for large hiatal hernias.</br>