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Objective:To nd out whether to place mesh routinely or not during open or laparoscopic Nissen's fundoplication for the surgical treatment of Paraesophageal Hiatus Hernias. Paraesophageal hernias accounts for 15 % to 20 Background: % of total hiatus hernias. this includes type 2 (true paraoesophageal), type 3 (mixed), type 4 (complex). These can be symptomatic as well as asymptomatic or found incidentally. Late diagnosis of these can lead to emergency presentations that's why all symptomatic paraoesophageal hernias should be managed surgically. In this prospective study we selected 20 patients of paraesopha Material And Methods: geal hiatus hernia over the period of time and did Nissen's fundoplication, in which 10 patients were operated laparoscopically and rest 10 were operated by open method selected randomly. In ve cases of both open and laparoscopic Nissen's fundoplication procedure meshplasty was done to compare clinical outcome of patient with or without meshplasty. During our surgical procedure we did cruroplasty, meshplasty, fundoplication, and gastropexy. Results:The total Intra operative time of open surgery was less then laparoscopic procedure also mesh placement was somehow difcult in laparoscopic procedure, it was superior only in cosmesis. The clinical outcome of use of mesh or not, with or without gastropexy in our study were almost th same that was examined by radiological evidences and routine follow up for 3 weeks. All patients with Conclusion: paraesophageal hiatus hernia should undergo surgical procedure as early soon as possible to prevent acute symptoms and life-threatening complications like volvulus, strangulation, incarceration, perforation. There is no clinical signicance of use of mesh or gastropexy in laparoscopic or open Nissen's fundoplication in our study. Our study supports use open procedure of Nissen's fundoplication surgery with multiple evidences.
Yadav et al. (Sat,) studied this question.