Introduction. Despite an absence of recent supportive evidence, mesh is frequently used as an adjunct to suture closure during hiatal hernia repair to increase repair durability. Erosion of non-absorbable mesh is a well-recognized complication of this approach. We present a case series of three patients with asymptomatic erosion of light weight polypropylene mesh (LWPM).
Case Presentations. From a series of 515 patients undergoing hiatal repair with LWPM, three cases of mesh erosion were identified. In one male patient, mesh erosion was identified on gastroscopy for ongoing reflux symptoms 3.5 years after hiatal repair. He had ongoing reflux symptoms and a recurrent hiatal failure, and ultimately underwent Roux-en-Y gastric bypass 13 years later with resolution of reflux symptoms. Mesh erosion was identified incidentally in 2 females, of which one who underwent gastroscopy and colonoscopy for investigation of iron deficiency; and the other, a gastroscopy for bleeding gastric ulceration unrelated to mesh erosion 12 years after hiatal repair. Both patients were otherwise asymptomatic. No patient required mesh removal.
Discussion and Conclusions. Mesh erosion is a well-recognised and feared complication of mesh augmented hiatal repair. Erosion of LWPM may be associated with fewer symptomatic implications than previously anticipated.