haemopericardium resulting from perforation of the pericardial sac during laparoscopic hiatus hernia repair
AI-generated summary
Mrs Christine Flynn, aged 68, died from haemopericardium and pericardial tamponade following laparoscopic hiatus hernia repair. A 2mm perforation of the pericardial sac occurred during surgery, likely from mesh tacks placed near the diaphragm. She developed hypotension two hours post-operatively, followed by nausea, collapse, and cardiac arrest. The coroner accepted expert opinion that mesh fixation with tacks in hiatus hernia repair carries catastrophic risks including pericardial injury, with no clear advantage over non-mesh repair. Clinicians should be alert to this risk and consider alternative fixation methods such as glue or avoid mesh entirely in hiatal hernia repairs.
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