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Updated: May 21, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Partial removal of infected parietal meshes is a safe procedure
C Sabbagh1, P Verhaeghe, O Brehant
1Department of Digestive Surgery, University Hospital, University of Picardy, Amiens, France.
Introduction:
Open tension-free hernioplasty using prosthetic meshes dramatically reduced recurrence rates after hernia or incisional hernia repair and has become the rule. Mesh infections (MI) are the major complication of prosthetic material. The aim of this study was to assess the efficacy of partial removal of mesh (PRM) therapy in the treatment of MI.
Materials And Methods:
From January 2000 to April 2010, from a prospective database, we retrospectively selected patients who underwent surgery for MI. We studied the epidemiological data (sex, age, obesity, diabetes, smoking), the operating time of the initial intervention, the presence of intestinal injuries during the first intervention, the average interval between initial surgical procedure and MI, the location of the hernia, the average size of the hernia, type of mesh used, the position of the mesh, type of surgery performed, the number through interventions required to achieve a cure, the cumulative duration of hospital stay and hernia recurrence rates.
Results:
Twenty-five patients were supported for a MI in our institution. There were 9 women (36 %) and 16 men (64 %). The median age was 59 years (range 37-78). There were 4 inguinal hernias (16 %), 15 incisional hernias (60 %) and 6 multirecurrent incisional hernias (24 %). It was performed a PRM in 92 % of cases (n = 23), a total excision of the prosthesis in 4 % of cases (n = 1) and no removal of prosthesis in 4 % of cases (n = 1). The average number of reoperations before healing was 1 (range 1-5). The mean cumulative duration of hospitalization until healing was 9.5 days (range 2-43). No visceral resection was performed.
Conclusion:
PRM is feasible in most cases allowing first to spare the capital parietal patients and secondly to avoid major surgery. In case of failure, total removal of the mesh can be discussed.
Insights
Partial mesh removal (PRM) effectively treats mesh infections after hernia repair, often avoiding major surgery. This approach preserves patient tissue and minimizes complications, with total removal reserved for treatment failures.
Area of Science:
- Abdominal Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Open tension-free hernioplasty with prosthetic meshes significantly reduces hernia recurrence rates.
- Mesh infections (MI) represent a major complication associated with prosthetic material used in hernia repair.
- Assessing therapeutic strategies for MI is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of partial mesh removal (PRM) as a treatment for mesh infections (MI) after hernia or incisional hernia repair.
- To analyze patient data and surgical outcomes related to PRM for MI.
- To determine the feasibility and success rates of PRM in managing prosthetic mesh complications.
Main Methods:
- Retrospective analysis of a prospective database of patients treated for MI between January 2000 and April 2010.
- Inclusion criteria: patients who underwent surgery for MI.
- Data collected: epidemiological factors, initial surgery details, interval to MI, hernia characteristics, mesh type, surgical procedures for MI, reoperations, hospitalization duration, and recurrence rates.
Main Results:
- Twenty-five patients were treated for MI; 92% underwent PRM.
- The average number of reoperations before healing was 1, with a mean cumulative hospitalization of 9.5 days.
- No visceral resections were performed, and hernia recurrence rates were not specified but PRM was feasible in most cases.
Conclusions:
- Partial mesh removal (PRM) is a feasible and effective primary treatment for mesh infections (MI).
- PRM allows for preservation of parietal tissues and avoidance of major surgical procedures.
- Total mesh excision can be considered as a secondary option in cases of PRM failure.
