Purpose: The aim of this study was to evaluate the current opinion of the individual European surgeons on the use of mesh in large hiatal hernia repair.
Methods: A Web-based questionnaire was e-mailed to European upper gastrointestinal surgeons identified by the European Association for Endoscopic Surgery.
Results: The questionnaire was completed by 165 surgeons. Mesh is routinely applied by 24 respondents (14.5%), selectively by 128 (77.6%), never used by 11 (6.7%), and 2 failed to respond. A polypropylene mesh is used by 81 (52.6%), polyester by 24 (15.6%), PTFE by 12 (7.8%), ePTFE by 49 (31.8%), and biomesh by 43 respondents (27.9%). A vast variation in mesh configuration and positioning is used. Esophageal erosions were encountered by 33 (20.0%) and esophageal stenosis due to dense fibrosis by 34 (20.6%).
Conclusions: The results of this survey are very instructive for the individual surgeons throughout the world as these illustrate how colleagues in Europe handle the controversial issues in large hiatal hernia repair.