Ultrasound Appearance of Mesh After Transabdominal Preperitoneal Inguinal Hernia Repair

The linear geometry of the meshes undergoes significant changes after the transabdominal preperitoneal (TAPP) inguinal hernia repair, caused not only by the presence or absence of mesh fixation but also by reparative processes occurring in the area of surgical intervention. To assess the position of mesh in the preperitoneal space after the TAPP inguinal hernia repair using ultrasonography in the immediate and late postoperative periods. A total of 65 patients who underwent inguinal hernia repair with TAPP were examined. In all cases, a lightweight large-pore monofilament polypropylene mesh (size 10 × 15 cm) was used as a prosthesis. Follow-up examinations and ultrasonography of the mesh were carried out on the first postoperative day and at 1, 3, 6, and 12 months of the follow-up period. Ultrasonography demonstrated mesh in two distinctly different appearances. Although it was seen as an echogenic structure with mild acoustic shadowing, the shape was either wavy or straight linear depending on the method and time elapsed from surgery. Thus, in patients without mesh fixation, it has a wavy appearance on the first day and at 1 month after TAPP, whereas at 3 months it took the appearance of a straight line, and at 12 months the implant has retained the shape of a straight line. Among patients who underwent mesh fixation in the immediate postoperative period, implant appeared as a straight line, and starting from the third month it began to acquire a wavy outline. Geometry of mesh used for TAPP inguinal hernia repair undergoes significantly different changes depending on the method of mesh fixation and time of postoperative period.