Cardiac complications after laparoscopic large hiatal hernia repair. Is it related with staple fixation of the mesh? -Report of three cases

• Three cases with different clinical expression of cardiac tamponade after laparoscopic large hiatal hernia repair.
• We review cardiac complications related to laparoscopic hiatal hernia repair.
• It is necessary to consider the risk of injury to the surrounding tissues during the anchorage of the mesh to the diaphragm.
• Cardiac complications must be considered in the postoperative period of mesh hiatoplasty.

IntroductionLaparoscopic Nissen operation with mesh reinforcement remains being the most popular operation for large hiatal hernia repair. Complications related to mesh placement have been widely described. Cardiac complications are rare, but have a fatal outcome if they are misdiagnosed.Presentation of casesWe sought to outline our institutional experience of three patients who developed cardiac complications following a laparoscopic Nissen operation for large hiatal hernia repair.DiscussionLaparoscopic hiatoplasty and Nissen fundoplication are safe and effective procedures for the hiatal hernia repair, but they are not exempt from complications. Fixation technique and material used must be taken into account. We have conducted a review of the literature on complications related to these procedures.ConclusionIn the differential diagnosis of hemodynamic instability after laparoscopic hiatal hernia repair, cardiac tamponade and other cardiac complications should be considered.