New Ovine Polymer-Reinforced Bioscaffold in Hiatal Hernia Repair

Background And Objectives: Biologic and resorbable synthetic materials are used commonly for crural repair reinforcement during laparoscopic hiatal herniorrhaphy. Recently, an ovine polymer-reinforced bioscaffold (OPRBS) has been developed for reinforcement of abdominal wall and hiatal herniorrhaphies. This is the first reported series on use of OPRBS in hiatal hernia repairs.

Methods: A retrospective chart review was conducted for consecutive series of patients (n = 25) undergoing laparoscopic or open hiatal herniorrhaphy between August 2016 and May 2017. Data collected included demographics, comorbidities and symptoms, details of operation, complications, and postoperative followup.

Results: Laparoscopic repair was completed in 23 of 24 patients. Reinforcement with OPRBS was accomplished in all cases. Fundoplication was constructed in 24 of 25 patients (96%). Mean followup was 14.2 months. Good-to-excellent symptom control or resolution has been achieved for heartburn (95%), dysphagia (94.7%), regurgitation (100%), nausea and vomiting (100%), dyspnea (100%), and chest pain or discomfort (85.7%). Postoperative esophagogastroduodenoscopy with dilation resulted in resolution of persistent postoperative dysphagia in two patients (8%). To date there have been no clinical recurrences of hiatal hernia.

Conclusion: OPRBS in hiatal hernia repair have been associated with excellent early patient outcomes in this study. OPRBS represent a new paradigm in hernia repair, as it is the first clinically available biological repair material reinforced with embroidered resorbable or permanent synthetic polymer. Relative weaknesses of the current study include the small sample size (n = 25), and short-term (mean = 14.2 months) followup. Long-term followup and additional studies will be required to confirm these findings.