Strangulated appendix after transabdominal preperitoneal (TAPP) inguinal hernia repair

Area of Science:

• Gastroenterology
• Surgical Innovation
• Abdominal Surgery

Background:

• Transabdominal preperitoneal (TAPP) inguinal hernia repair is a common laparoscopic procedure.
• Mesh-related complications, though infrequent, can occur after TAPP repair.
• This study focuses on an unusual mesh complication involving the appendix.

Observation:

• A 48-year-old male presented with symptoms of acute right groin pain, swelling, nausea, vomiting, and fever.
• Physical examination revealed a large, tender, and irreducible right groin mass.
• Intraoperative findings showed purulent material in the right groin without evidence of hernia recurrence.

Findings:

• Laparoscopic exploration identified the appendix strangulated between the surgical mesh and the transversalis fascia.
• The appendix exhibited signs of necrosis and perforation due to strangulation.
• This represents the first reported case of mesh-induced appendiceal strangulation after TAPP repair.

Implications:

• This case underscores a rare but serious potential complication of TAPP inguinal hernia repair.
• It highlights the importance of meticulous surgical technique and awareness of potential mesh interactions with intra-abdominal structures.
• Further investigation into mesh behavior and patient selection may be warranted to prevent such rare events.