Laparoscopic management of infected mesh after laparoscopic inguinal hernia repair.

PURPOSE: We present our experience with 10 patients with infected meshes after laparoscopic inguinal hernia repair in whom we explanted infected meshes laparoscopically.

METHODS

On retrospective analysis over 5 years (2007 to 2012), we identified 10 patients (6 TAPP/4 TEP) with localized deep-seated mesh infections in whom infected meshes were explanted laparoscopically. Peritoneum was incised, associated abscesses were drained, meshes were identified, separated, and extracted through 10/12 mm port.

RESULTS

Nine patients experienced resolution of symptoms after 3 weeks of surgical intervention and remained asymptomatic at mean follow-up of 20 months (range, 4 to 42 mo). One patient with recurrent abscess required surgical drainage twice. Mean hospital stay was 2.2 days (range, 1 to 9 d). Two patients developed recurrent hernia at 6 and 8 months after mesh explantation.

CONCLUSIONS

Laparoscopic explantation of infected meshes after laparoscopic hernia repair leads to less scarring and early recovery. Contamination of anterior abdominal wall after cutaneous drainage of deep-seated abscess is avoided.