Laparoscopic Repair of a Type IV Hiatal Hernia Using Gore Bio-A® Mesh: A Case Report and Literature Review.

Type IV hiatal hernia represents a complex and rare form of hiatal hernia, characterized by the protrusion of multiple abdominal organs, such as the stomach, spleen, and colon, into the mediastinum. The surgical approach is complex and requires meticulous technique to reduce the risk of complications and recurrences. We report the case of a patient with a type IV hiatal hernia who underwent laparoscopic repair with crural plasty and placement of Gore Bio-A® absorbable mesh (W. L. Gore & Associates, Newark, DE, USA), anti-reflux surgery (Nissen fundoplication), and simultaneous cholecystectomy. Postoperative evolution was satisfactory, with a one-year follow-up period showing no recurrences or complications. The specific surgical indications for type IV hernias are discussed, along with the current evidence on the use of absorbable meshes in hiatal repair.