A 61-year-old female with a history of gastroesophageal reflux disease and hiatal hernia developed hemopericardium and tamponade one day after laparoscopic hiatal hernia repair and Toupet fundoplication. The patient underwent emergency pericardiocentesis and subsequent surgical pericardial window. During surgery, a tack that had been used to secure the mesh to the inferior aspect of the diaphragm was found to have penetrated the pericardium near the right ventricle. The patient recovered without further complications.
A 79-year-old woman underwent laparoscopic hiatal hernia repair with mesh implantation. Tacks were used to secure the mesh to the diaphragm. Nine hours after surgery the patient died from circulatory collapse. Autopsy showed perforation of the pericardium and the right coronary artery by a tacker.