Barbed Sutures at the Hiatus: What’s the Evidence?

Barbed sutures for cruroplasty appear time-efficient and may lower recurrence when combined with mesh in larger hernias. However, current evidence is sparse, heterogeneous, and based largely on retrospective series. Given the off-label nature of diaphragmatic use, prospective studies with standardized recurrence definitions are needed to clarify safety and long-term efficacy.