About 16-37% of bariatric patients are estimated to have a hiatal hernia. To address the lack of long-term data showing the efficacy of bioabsorbable mesh in reducing recurrence of hiatal hernia in patients who underwent bariatric surgery, we evaluated the literature and performed a meta-analysis.


We performed a literature search using PubMed and MEDLINE with search terms including 'hiatal hernia recurrence', 'bariatric surgery', 'bioabsorbable mesh', 'Gore BIO-A', and 'trimethylene carbonate'. Analysis was conducted to compare surgical time, length of stay, recurrence rate, hernia size, and changes in BMI before and after surgery between mesh group (MG) and non-mesh(NM) patients. The meta-analysis was described using standardized mean difference, weighted mean difference, effect size (ES), and 95% confidence interval(CI). An I-square statistic was computed to assess heterogeneity.


Thirteen studies with 1374 patients were included in our meta-analysis. There were seven studies with 689 patients in the MG and ten studies with 685 patients in the NM. Increased hernia size was noted in NM (13 cm2) compared to MG (8.4 cm2) (95%CI -2.19- -0.02; p=0.046), though no difference was noted in perioperative BMI (95%CI -10.44 - -1.02; p=0.09). The MG had less recurrence compared to NM (Effect Size: 2% vs. 13%; 95% CI -0.24- -0.01; p=0.041). Average follow-up was 25.5 months for the MG group and 30.2 for the NM group.


Repair with the bioabsorbable mesh placed at the time of the index bariatric surgery is more effective at reducing the recurrence rate of hernia than simple suture cruroplasty.