HIATAL HERNIA REPAIR WITH NOVEL LIVER LIGAMENT RELEASE AND MESH PLACEMENT

Hiatal hernia is a complex pathological condition characterized by a high recurrence rate regardless of mesh placement during repair.The anterior aspect was more frequently associated with recurrence. The objective of this study was to compare the recurrence rate of hernia using a novel technique of mesh placement with the conventional procedure. A retrospective single-center study was conducted on patients who underwent robotic hernia repair with mesh placement. Of the 147 patients, 26 underwent mesh placement utilizing the keyhole/starburst technique, while 121 patients underwent mesh placement employing a novel technique. Recurrence was observed in 8 (6.6%) out of 121 patients in the new group and 5 (20.8%) out of 19 patients in the old group, with a p-value of 0.042, indicating a statistically significant difference and a substantial improvement in heartburn rates and overall symptomatic amelioration. Our study demonstrated that the placement of a 7 × 10 cm mesh using the keyhole technique, augmented anteriorly by positioning it beneath the left triangular ligament, provides enhanced structural support and reduces the recurrence rate of hiatal hernia.