Surgery Today

, Volume 42, Issue 12, pp 1253–1258 | Cite as

Rare late mesh complications following inguinal prolene hernia system hernioplasty: report of three cases

  • Marinko Zuvela
  • Zoran Krivokapic
  • Danijel Galun
  • Velimir Markovic
Case Report

Abstract

We have treated three patients who developed late mesh infections 7 years after inguinal hernioplasty caused by contact of an underlay prolene hernia system (PHS) patch with the intestines. In two patients, the cause was the development of a fistula between the underlay patch preperitoneally positioned in Bogros space and the appendix, and in one, a sigmoid colon fistula that developed as a consequence of penetration of the underlay PHS patch into the sigmoid colon. In the patients with contact of an underlay PHS patch with the appendix, total PHS excision, appendectomy, McVay herniorrhaphy and drainage through a direct inguinal approach were applied. In the patient with a sigmoid colon lesion, total PHS excision, left hemicastration, suturing of the sigmoid colon fistula, and a McVay herniorrhaphy with drainage were performed through a direct inguinal approach, followed by midline laparotomy and protective bipolar ileostomy. Late mesh infection developing several years after PHS inguinal hernioplasty is usually the consequence of intestinal erosions and fistulas due to contact between the underlay PHS patch and the intestines.

Keywords

Mesh Complication Prolene hernia system Inguinal hernioplasty 

References

  1. 1.
    Langer C, Schwartz P, Krause P, et al. In vitro study of the cellular response of human fibroblasts cultured on alloplastic hernia meshes. Influence of mesh material and structure. Chirurg. 2005;76(9):876–85.PubMedCrossRefGoogle Scholar
  2. 2.
    Klinge U, Klosterhalfen B, Birkenhauer V, et al. Impact of polymer pore size on the interfaces scar formation in a rat model. J Surg Res. 2002;103:208–14.PubMedCrossRefGoogle Scholar
  3. 3.
    Klosterhalfen B, Junge K, Klinge U. The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices. 2005;2(1):103–17.PubMedCrossRefGoogle Scholar
  4. 4.
    Gilbert A, Graham M, Voigt W. A bilayer patch device for inguinal hernia repair. Hernia. 1999;3:161–6.CrossRefGoogle Scholar
  5. 5.
    Amid PK, Friis E, Horeyseck G, Kux M. Tension-free onlay mesh hernioplasty. Op Techn Gen Surg. 1999;1(2):156–68.CrossRefGoogle Scholar
  6. 6.
    Rutkow IM, Robbins AW. “Tension-free” inguinal herniorrhaphy: a preliminary report on the “mesh plug” technique. Surgery. 1993;114:3–8.PubMedGoogle Scholar
  7. 7.
    Rives J. Surgical treatment of the inguinal hernia with Dacron patch. Principles, indications, technic and results. Int Surg. 1967;47(4):360–1.PubMedGoogle Scholar
  8. 8.
    Chuback JA, Singh RS, Sills C, Dick LS. Small bowel obstruction resulting from mesh plug migration after open inguinal hernia repair. Surgery. 2000;127:475–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Ferrone R, Scarone PC, Natalini G. Late complication of open inguinal hernia repair: small bowel obstruction caused by intraperitoneal mesh migration. Hernia. 2003;7:161–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Benedetti M, Albertario S, Niebel T, et al. Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report. Hernia. 2005;9:93–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Murphy JW, Misra DC, Silverglide B. Sigmoid colonic fistula secondary to perfix- plug, left inguinal hernia repair. Hernia. 2006;5:436–8.CrossRefGoogle Scholar
  12. 12.
    Stout CL, Foret A, Christie DB, Mullis E. Small bowel volvulus caused by migrating mesh plug. Am Surg. 2007;73:796–7.PubMedGoogle Scholar
  13. 13.
    Lo DJ, Bilimoria KY, Pugh CM. Bowel complications after prolene hernia system (PHS) repair: a case report and review of the literature. Hernia. 2008;12:437–40.PubMedCrossRefGoogle Scholar
  14. 14.
    Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinalhernia in adult patients. Hernia. 2009;13:343–403.PubMedCrossRefGoogle Scholar
  15. 15.
    Awad S, Yallalampalli S, Srour AM, Bellows CF, Albo D, Bergeret DH. Improved outcomes with the prolene hernia system mesh compared with the time-honored Lichtenstein onlay mesh repair for inguinal hernia repair. Am J Surg. 2007;193(6):697–701.PubMedCrossRefGoogle Scholar
  16. 16.
    Vironen J, Nieminen J, Eklund A, Paavolainen P. Randomozed clinical trial of Lichtentein patch or prolene hernia system for inguinal hernia repair. Br J Surg. 2005;93:33–9.CrossRefGoogle Scholar
  17. 17.
    Sanjay P, Harris D, Jones P, Woodward A. Randomized controlled trial comparing prolene hernia system and Lichtenstein nethod for inguinal hernia repair. ANZ J Surg. 2006;76:548–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Faraj D, Ruurda JP, Olsman JG, van Geffen HJ. Five-year results of inguinal hernia treatment with the prolene hernia system in a regional training hospital. Hernia. 2010;14(2):155–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Nienhuijs SW, van Oort I, Keemers-Gels ME, Strobbe LJA, Rosman C. Randomized trial comparing the prolene hernia system, mesh plug repair and Lichtenstein method for open inguinal hernia repair. Br J Surg. 2004;92:33–8.CrossRefGoogle Scholar
  20. 20.
    Kingsnorth A, LeBlanc K. Umbilical hernia in adults. In: Kingsnorth A, LeBlanc K, editors. Management of abdominal wall hernias. 3rd ed. London: Arnold; 2003. p. 228–36.Google Scholar
  21. 21.
    Kavic MS, Thomas J. Diagnosis and management of laparoscopic inguinal hernioplasty infections. In: Deysine M, editor. Hernia infections. New York: Marcel Dekker, Inc.; 2004. p. 189–205.Google Scholar

Copyright information

© Springer 2012

Authors and Affiliations

  • Marinko Zuvela
    • 1
  • Zoran Krivokapic
    • 1
  • Danijel Galun
    • 1
  • Velimir Markovic
    • 1
  1. 1.First Surgical Clinic, Clinical Center of Serbia, Medical FacultyUniversity of BelgradeBelgradeSerbia

Personalised recommendations