Mesh migration following abdominal hernia repair: a comprehensive review

This study reviewed the literature regarding mesh migration in abdominal hernia repair. The aim of this study is to interrogate incidence, common type of abdominal hernia repair leading to migration, patterns of mesh migration, and materials associated with migration.

A comprehensive literature review was conducted. PubMed and MEDLINE were searched for relevant articles in the English literature. We employed Ovid syntax from 1949 to January 2010, the Cochrane Library, Google and Google Scholar. The clinical trial database Clinicaltrials.gov was reviewed. Letters to the editor were reviewed to extract cross-references. Multiple keywords were used alone and in combination to extract all relevant articles.

In total, 287 unique English citations were reviewed. Of these, 84 articles were selected and consisted of 3 case series, 77 case reports, 2 literature reviews, 1 retrospective study, and 1 prospective, observational study. In an analysis of available cases, the average age was 59.8 ± 13.8 years with a male predominance (76.2%). The index hernia repair was inguinal in 62.9%, incisional/ventral in 28.1%, umbilical in 6.7%, and other in 2.2%. Within the inguinal hernia group, 51.8% were open repairs, 42.9% were laparoscopic, and 1.8% were robotic. Implicated mesh materials included polypropylene, PTFE, and composite mesh. Migration commonly affected multiple organs (31.5%).

It is likely that more cases of mesh migration will appear in the literature. Reports are heterogeneous and highlight the diversity of this complication. A standardized method of reporting is needed to develop guidelines and recommendations for this presentation.