Related Experiment Video
Updated: May 5, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Central rupture and bulging of low-weight polypropylene mesh following recurrent incisional sublay hernioplasty
M Zuvela1, D Galun, A Djurić-Stefanović
1First Surgical Clinic, Clinical Centre of Serbia, Koste Todorovica 6, 11 000, Belgrade, Serbia.
Abstract:
A recurrent incisional hernia resulting from the rupture of low-weight polypropylene mesh is rarely reported in the literature. Three patients with recurrent incisional hernia due to low-weight polypropylene mesh central rupture were operated 5, 7 and 13 months after initial sublay hernioplasty. The posterior myofascial layer was fully reconstructed in all patients during the hernioplasty, whereas the anterior myofascial layer was only partially reconstructed. The recurrent hernia was managed using heavy-weight polypropylene mesh; in two patients, a new sublay hernioplasty was performed and in one patient an "open preperitoneal flat mesh technique" was performed under local anaesthesia as a day case procedure. If closing of the anterior myofascial layer cannot be ensured during the incisional hernioplasty, the use of low-weight polypropylene meshes should be avoided; preference should be given to the heavy-weight polypropylene meshes.
Insights
Rupture of low-weight polypropylene mesh can cause recurrent incisional hernias. Heavy-weight mesh is recommended when anterior myofascial closure is uncertain during incisional hernioplasty.
Area of Science:
- Surgical innovation
- Hernia repair techniques
- Biomaterial science
Background:
- Recurrent incisional hernias pose a significant challenge in abdominal surgery.
- Polypropylene mesh is commonly used for hernia repair, but material properties can influence outcomes.
- Low-weight meshes may have different mechanical properties compared to standard or heavy-weight options.
Observation:
- Three cases of recurrent incisional hernia were identified.
- The recurrence was attributed to central rupture of previously implanted low-weight polypropylene mesh.
- Patients underwent repair 5, 7, and 13 months post-initial sublay hernioplasty.
Findings:
- Partial anterior myofascial layer reconstruction during initial hernioplasty was noted in these cases.
- Recurrent hernias were successfully managed using heavy-weight polypropylene mesh.
- Surgical approaches included sublay hernioplasty and an open preperitoneal flat mesh technique under local anesthesia.
Implications:
- Avoid low-weight polypropylene meshes when anterior myofascial closure cannot be guaranteed during incisional hernioplasty.
- Heavy-weight polypropylene meshes are suggested as a safer alternative in such scenarios.
- This highlights the importance of mesh selection based on surgical technique and patient factors.
