Early Results of the Use of Acellular Dermal Allograft in Type III Paraesophageal Hernia Repair

BACKGROUND Type III paraesophageal hernias are diaphragmatic defects with the risk of serious complications. High recurrence rates associated with primary suture repair are significantly improved with the use of a tension-free repair with prosthetic mesh. However, mesh in the hiatus is associated with multiple complications. A bio-engineered material from donated human tissue offers an attractive alternative material for hernia repair. This report is on the first series of laparoscopic type III paraesophageal hernia repairs with acellular dermal allografts (Allo-Derm, Lifecell Corporation, Branchburg, NJ) in 11 patients with follow-up evaluation. METHODS From August 2003 to June 2004, 11 patients underwent laparoscopic repair of type III paraesophageal hernias with acellular dermal allografts. Patients were evaluated postoperatively with a symptoms questionnaire and barium esophagram. RESULTS All patients were available for follow-up; however, 2 refused a barium esophagram. Average length of hospital stay was 3 days. Follow-up evaluation was at a mean interval of 1 year. Postoperatively, 9 of 11 patients reported no symptoms. Barium esophagram revealed one recurrence in an asymptomatic patient. CONCLUSION Type III paraesophageal hernia can be laparoscopically repaired successfully with acellular dermal allografts.