Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias
Objectives. Nonreinforced tensile repair of giant hiatal hernias is susceptible to recurrence, and the role of mesh graft implantation remains controversial. Creating a new and viable choice without the use of high-cost biological allografts is desirable. This study presents the application of dermi...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2018/9069430 |
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| author | Balázs Kovács Mikolt Orosz Máté Csucska Saurabh Singhal Árpád Juhász Zoltán Lóderer |
| author_facet | Balázs Kovács Mikolt Orosz Máté Csucska Saurabh Singhal Árpád Juhász Zoltán Lóderer |
| author_sort | Balázs Kovács |
| collection | DOAJ |
| description | Objectives. Nonreinforced tensile repair of giant hiatal hernias is susceptible to recurrence, and the role of mesh graft implantation remains controversial. Creating a new and viable choice without the use of high-cost biological allografts is desirable. This study presents the application of dermis graft reinforcement, a cost-efficient, easily adaptable alternative, in graft reinforcement of giant hiatal hernia repairs. Methods. A 62-year-old female patient with recurrent giant hiatal hernia (9 × 11 cm) and upside down stomach, immediately following the Belsey repair done in another department, was selected for the pilot procedure. The standard three-stitch nonabsorbable reconstruction of diaphragmatic crura was undertaken via laparoscopic approach. A 12 × 6 cm dermis autograft was harvested from the loose abdominal skin. “U” figure onlay reinforcement of diaphragm closure was secured with titanium staples. The procedure was completed with a standard Dor fundoplication. One- and seven-month follow-ups were conducted. Results. No short-term postoperative complications were observed. One-month follow-up showed normal anatomical location of abdominal viscera on computed tomography imaging. High-resolution manometry showed normal lower esophageal sphincter pressure. Preoperative abdominal complaints were resolved. Procedural costs were lower than the average cost following mesh graft reinforcement. Conclusion. Dermis graft reinforcement is a cheap, easily adaptable procedure in the repair of giant hiatal hernias, even in the setting of laparoscopic reoperative procedure. |
| format | Article |
| id | doaj-art-f06bedd7cf464f8cacb1bb5ab85de112 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-f06bedd7cf464f8cacb1bb5ab85de1122025-02-03T01:24:15ZengWileyCase Reports in Surgery2090-69002090-69192018-01-01201810.1155/2018/90694309069430Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal HerniasBalázs Kovács0Mikolt Orosz1Máté Csucska2Saurabh Singhal3Árpád Juhász4Zoltán Lóderer5Department of Vascular, Plastic and General Surgery, Markusovszky University Teaching Hospital, Szombathely, HungaryDepartment of Vascular, Plastic and General Surgery, Markusovszky University Teaching Hospital, Szombathely, HungaryDepartment of Vascular, Plastic and General Surgery, Markusovszky University Teaching Hospital, Szombathely, HungaryNorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Vascular, Plastic and General Surgery, Markusovszky University Teaching Hospital, Szombathely, HungaryDepartment of Vascular, Plastic and General Surgery, Markusovszky University Teaching Hospital, Szombathely, HungaryObjectives. Nonreinforced tensile repair of giant hiatal hernias is susceptible to recurrence, and the role of mesh graft implantation remains controversial. Creating a new and viable choice without the use of high-cost biological allografts is desirable. This study presents the application of dermis graft reinforcement, a cost-efficient, easily adaptable alternative, in graft reinforcement of giant hiatal hernia repairs. Methods. A 62-year-old female patient with recurrent giant hiatal hernia (9 × 11 cm) and upside down stomach, immediately following the Belsey repair done in another department, was selected for the pilot procedure. The standard three-stitch nonabsorbable reconstruction of diaphragmatic crura was undertaken via laparoscopic approach. A 12 × 6 cm dermis autograft was harvested from the loose abdominal skin. “U” figure onlay reinforcement of diaphragm closure was secured with titanium staples. The procedure was completed with a standard Dor fundoplication. One- and seven-month follow-ups were conducted. Results. No short-term postoperative complications were observed. One-month follow-up showed normal anatomical location of abdominal viscera on computed tomography imaging. High-resolution manometry showed normal lower esophageal sphincter pressure. Preoperative abdominal complaints were resolved. Procedural costs were lower than the average cost following mesh graft reinforcement. Conclusion. Dermis graft reinforcement is a cheap, easily adaptable procedure in the repair of giant hiatal hernias, even in the setting of laparoscopic reoperative procedure.http://dx.doi.org/10.1155/2018/9069430 |
| spellingShingle | Balázs Kovács Mikolt Orosz Máté Csucska Saurabh Singhal Árpád Juhász Zoltán Lóderer Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias Case Reports in Surgery |
| title | Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias |
| title_full | Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias |
| title_fullStr | Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias |
| title_full_unstemmed | Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias |
| title_short | Autologous Dermis Graft Implantation: A Novel Approach to Reinforcement in Giant Hiatal Hernias |
| title_sort | autologous dermis graft implantation a novel approach to reinforcement in giant hiatal hernias |
| url | http://dx.doi.org/10.1155/2018/9069430 |
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