Delayed Mesh Infection: A Rare Complication of Laparoscopic Inguinal Hernia Repair (TEP—Totally Extra-Peritoneal Repair)
- 1 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 2 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 3 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 4 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 5 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 6 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 7 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 8 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 9 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
- 10 Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
Abstract
Hernias are amongst the oldest afflictions of mankind. The tension-free mesh repairs revolutionized and radically changed the whole concept of anatomical tissue repairs. The introduction of mesh, though beneficial, posed a new set of postoperative problems with the mesh infection being the most morbid one. Laparoscopic surgery has been able to reduce the incidence of mesh infection as opposed to the open hernia repairs. The infection occurs mostly early but rarely does it present several years after the surgery. Herein we report our case of delayed mesh infection developing 6 years postoperatively. This is our first such case in a series of more than 1000 laparoscopic hernia repairs over a period of 6 years (2010 - 2016). The patient needed an open exploration which revealed a large preperitoneal cavity containing 770 ml of pus with a mesh floating in it. The mesh was removed and the thorough toileting of the wound was done.
- Schultz, C., Baca, I. and Gotzen, V. (2001) Laparoscopic Inguinal Hernia Repair. Surgical Endoscopy, 15, 582-584. http://dx.doi.org/10.1007/s004640000376
- Kapiris, S.A., Brough, W.A., Royston, C.M., et al. (2001) Laparoscopic Transabdominal Preperitoneal (TAPP) Hernia Repair. A 7-Year Two-Center Experience in 3017 Patients. Surgical Endoscopy, 15, 972-975. http://dx.doi.org/10.1007/s004640080090
- Moon, V., Chaudry, G.A., Choy, C., et al. (2004) Mesh Infection in the Era of Laparoscopy. Journal of Laparoendoscopic & Advanced Surgical Techniques and Videoscopy, 14, 349-352. http://dx.doi.org/10.1089/lap.2004.14.349
- Deysine, M. (1998) Pathophysiology, Prevention, and Management of Prosthetic Infections in Hernia Surgery. Surgical Clinics of North America, 78, 1105-1115. http://dx.doi.org/10.1016/S0039-6109(05)70372-8
- Patti, J.M., Allen, B.L., McGavin, M.J., et al. (1994) MSCRAMM-Mediated Adherence of Microorganisms to Host Tissues. Annual Review of Microbiology, 48, 585-617. http://dx.doi.org/10.1146/annurev.mi.48.100194.003101
- Parra, J.A., Revuelta, S., Gallego, T., et al. (2004) Prosthetic Mesh Used for Inguinal and Ventral Hernia Repair: Normal Appearance and Complications in Ultrasound and CT. The British Journal of Radiology, 77, 261. http://dx.doi.org/10.1259/bjr/63333975
- Avtan, L., Avci, C., Bulut, T. and Fourtanier, G. (1997) Mesh Infections after Laparoscopic Inguinal Hernia Repair. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 7, 192-195. http://dx.doi.org/10.1097/00019509-199706000-00002
- Hofbauer, C., Andersen, P.V., Juul, P. and Qvist, N. (1998) Late Mesh Rejection as a Complication to Transabdominal Preperitoneal Laparoscopic Hernia Repair. Surgical Endoscopy, 12, 1164-1165. http://dx.doi.org/10.1007/s004649900807
- Foschi, D., Corsi, F., Cellerino, P., Trabucchi, A. and Trabucchi, E. (1998) Late Rejection of the Mesh after Laparoscopic Hernia Repair. Surgical Endoscopy, 12, 455-457. http://dx.doi.org/10.1007/s004649900704
- Jalilvand, A., Sarker, S. and Fisichella, P.M. (2015) A Rare Case of Mesh Infection 3 Years after a Laparoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 25, e69-e71. http://dx.doi.org/10.1097/SLE.0000000000000093
- Singh-Ranger, D., Taneja, T., Sroden, P., et al. (2007) A Rare Complication Following Laparoscopic TEP Repair: Case Report and Discussion of the Literature. Hernia, 11, 453-456. http://dx.doi.org/10.1007/s10029-007-0206-7