A Review of Experimental Studies for Available Evidence on the Use of Prosthetic Material in Hiatal Hernia Repair

Abstract

Aim: The benefits of prosthetic material in hiatal hernia repair have been well documented. However, the associated risks are substantial and they are related to the technique, and also the choice of material. Experimental data are invaluable to understand and evaluate the interaction of different meshes with the host tissue. The purpose of this article is to summarize the available experimental evidence in the repair of hiatal hernias with the use of prosthetic materials in animal models.  Methods: A review of the literature from January 1990 to December 2014 was carried out for articles presenting experimental data on hiatal hernia repair. Results: After discarding non relevant articles, 28 articles were identified. A variety of synthetic and absorbable materials were studied. Review of the available studies showed that there is great variability between synthetic materials regarding tissue integration, shrinkage and adhesion formation, however they have greater mechanical strength when compared to biological/absorbable materials, which have a tendency to better integration. Biological adhesives seem to be an effective alternative method of mesh fixation. Conclusions: Experimental data are essential in order to fully appreciate the process of repair of a hiatal hernia with a prosthetic material. The articles reviewed provide insight into the properties of different prosthetic materials. However, there were large variations in their quality and the methods used. Data from animal studies are an excellent way of evaluating the multitude of materials that have recently become available. Good quality, comparative animal studies are essential in an effort to further improve outcomes for patients who undergo hiatal hernia repair.