Totally Extraperitoneal (TEP) Removal of an Infected Mesh by Laparoscopy after Open Preperitoneal Repair: Initial Case Report.

Prosthetic mesh infection after open or laparoscopic hernia repair is a rare complication. Superficial wound infection can be resolved by treatment with a combination of antibiotics and wound drainage, whereas deep-seated mesh infection, which can lead to chronic groin sepsis, usually requires removal of the mesh. A 56-year-old Japanese man was admitted to our hospital for the treatment of deep-seated mesh infection. The patient had undergone inguinal hernia repair at another hospital 18 months earlier. The operation was prosthetic mesh repair via an anterior approach. The patient developed deep-seated mesh infection despite conservative treatment for infection, such as abscess drainage and antibiotic therapy. Since the patient eventually developed chronic groin sepsis, he was referred to our hospital, and infected mesh was removed successfully by laparoscopic surgery via a totally extraperitoneal approach. The laparoscopic approach provides several advantages, including less postoperative pain, a shorter hospital stay, and earlier rehabilitation. Furthermore, seeding of the abdominal cavity with pus never occurs with this approach unlike the laparoscopic transabdominal preperitoneal approach.

[1]  Stuart Walker.  Repair , 2018, Design Realities.

[2]  M. Miserez.  Totally Extraperitoneal Endoscopic Inguinal Hernia Repair (TEP) , 2017 .

[3]  Neeraj Garg,et al.  Laparoscopic Management of Infected Mesh After Laparoscopic Inguinal Hernia Repair , 2015, Surgical laparoscopy, endoscopy & percutaneous techniques.

[4]  E. P. Perry,et al.  Recurrence of inguinal herniae following removal of infected prosthetic meshes: a review of the literature , 2012, Hernia.

[5]  M. Mittlboeck,et al.  Mesh Graft Infection Following Abdominal Hernia Repair: Risk Factor Evaluation and Strategies of Mesh Graft Preservation. A Retrospective Analysis of 476 Operations , 2010, World Journal of Surgery.

[6]  P. Sedman,et al.  Laparoscopic transabdominal preperitoneal (TAPP) hernia repair , 2001, Surgical Endoscopy.

[7]  M. J. Tolino,et al.  Late-onset deep mesh infection after inguinal hernia repair. , 2008, Hernia : the journal of hernias and abdominal wall surgery.

[8]  G. Tzovaras,et al.  Late-onset deep mesh infection after inguinal hernia repair , 2007, Hernia.

[9]  A. Fawole,et al.  Fate of the inguinal hernia following removal of infected prosthetic mesh , 2006, Hernia.

[10]  K. Kraft,et al.  Simultaneous bilateral laparoscopic inguinal hernia repair , 2002, Surgical Endoscopy And Other Interventional Techniques.

[11]  I. Baća,et al.  Laparoscopic inguinal hernia repair , 2001, Surgical Endoscopy.

[12]  P. O’Dwyer,et al.  Chronic groin sepsis following tension‐free inguinal hernioplasty , 1999, The British journal of surgery.

[13]  F. Schildberg,et al.  [Transabdominal preperitoneal hernia repair (TAPP). Results of 1,000 completed operations]. , 1999, Zentralblatt fur Chirurgie.

[14]  A. Darzi,et al.  Late-onset deep prosthetic infection following mesh repair of inguinal hernia. , 1998, American journal of surgery.

[15]  F. Corsi,et al.  Late rejection of the mesh after laparoscopic hernia repair , 1998, Surgical Endoscopy.

[16]  D. Litwin,et al.  Laparoscopic groin hernia surgery: the TAPP procedure. Transabdominal preperitoneal hernia repair. , 1997, Canadian journal of surgery. Journal canadien de chirurgie.

[17]  M. Birth,et al.  Laparoscopic transabdominal preperitoneal hernioplasty: results of 1000 consecutive cases. , 1996, Journal of laparoendoscopic surgery.

[18]  K. Kraft,et al.  [Laparoscopic hernioplasty (TAPP)--complications and recurrences in 900 operations]. , 1996, Zentralblatt fur Chirurgie.