Formation of a chronic pain syndrome due to mesh shrinkage after laparoscopic intraperitoneal onlay mesh (IPOM)

The case of a 58-year-old male patient who developed a chronic pain syndrome after laparoscopic intraperitoneal onlay mesh for treatment of a large symptomatic umbilical hernia combined with rectus diastasis is reported. Twelve months after an uncomplicated initial surgery, the patient presented with progressive signs of a foreign body sensation and pain in the anterior abdominal wall. Computed tomography examination revealed no pathologic findings but a marked shrinkage of the mesh implant. Because of further progressive symptoms, explorative laparotomy was performed. Mesh shrinkage and adhesions with a surrounding chronic tissue reaction were found as the cause of the pain syndrome. This case demonstrates a case of a chronic pain syndrome due to mesh shrinkage 12 months after initial ventral hernia repair. Mesh shrinkage should therefore be taken into consideration in patients with progressive pain chronic syndromes after laparoscopic ventral hernia repair.