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Central mesh failure after laparoscopic IPOM procedure
Jeroen Van Besien1, Koen Vindevoghel1, Casper Sommeling1
1a Department of General Surgery , OLV van Lourdes , Waregem , Belgium.
Acta Chirurgica Belgica
|July 19, 2016
Summary
Mesh failure after laparoscopic ventral hernia repair is rare. This case shows small intestine herniation through a defect in the mesh, suggesting potential trauma from fixation devices.
Area of Science:
- Abdominal Surgery
- Surgical Materials Science
- Hernia Repair
Background:
- Ventral hernia repair frequently utilizes prosthetic meshes.
- Laparoscopic intraperitoneal onlay mesh (IPOM) is a common technique.
- Mesh failure, though uncommon, can lead to hernia recurrence.
Observation:
- A 42-year-old male presented with umbilical hernia recurrence 4 years post-IPOM.
- Laparoscopy revealed small bowel herniation through a central defect in the composite polypropylene mesh.
- The mesh was secured using the double crown technique.
Findings:
- Central mesh failure occurred, resulting in hernia recurrence.
- The defect allowed visceral herniation.
- Primary repair involved suturing fascia and mesh with non-resorbable sutures.
Implications:
- This case highlights a rare complication of IPOM repair.
- Potential mesh failure mechanism involves initial trauma from fixation devices.
- Further investigation into mesh fixation methods and material integrity is warranted.
