Cardiac Tamponade by Tack Fixation of a Hiatal Mesh. Should Tacks Still Be Used in the Diaphragm?
Year: 2020
Type: article
Study design: Case Report
Abstract: Since the first successful use of mesh in hernia surgery, the development and progress in materials, techniques, and procedures have increased exponentially; consequently, surgeons started to use meshes for hiatal hernia repair to prevent postoperative hernia recurrences and complications. Nonetheless, there are alarming reports in literature concerning cardiac tamponade as an apparently rare complication of hiatal mesh placement, especially when fixation is performed with tacks. A 50-year-old female diagnosed with gastroesophageal reflux disease undergoes an elective laparoscopic Nissen fundoplication and hiatal hernia repair with tack fixation of the mesh; on the fourth postoperative day she was readmitted with cardiac tamponade diagnosed via echocardiography, and CT scan showed proximity of the tacks to the pericardium. She underwent a failed attempt of ultrasound guided pericardiocentesis (PC), therefore, a pericardial window was performed. The ideal method for diaphragmatic mesh fixation is still controversial. Some recent articles alert of this potential risk; although the manufacturers contraindicate the use of tacks in the diaphragm, one-third of surgeons prefer this method.
Source: Cureus
DOI: 10.7759/cureus.8416
Authors: Ramon Vidrio Duarte, Eduardo Vidrio Duarte, Juan Gutierrez Ochoa, Luis H Ortega León, Carolina Solis Rojas
Institutions: Hospital General de México, Universidad Anáhuac
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3034000596