Complications of mesh devices for intraperitoneal umbilical hernia repair: a word of caution
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Several mesh devices for the treatment of umbilical and other small ventral hernias have become available in recent years. These meshes have a dual layer consisting of a permanent or temporary barrier against adhesion formation between the viscera and the intraperitoneally exposed part of the mesh. We have seen several patients with serious late complications of these meshes placed intraperitoneally. Some of these patients needed small bowel resection and mesh removal. Others developed a recurrence because of improper deployment of the mesh in the intraperitoneal position. We think that, if preperitoneal deployment of such mesh devices is possible, this should be the preferred position, notwithstanding the fact that these meshes have a dual layer. There is a complete lack of convincing data on these mesh devices in the medical literature. No long-term data have been published, and, for three of the four mesh devices available, no publications on their use in humans were found. We think that surgeons adopting innovative mesh devices should register and follow their patients prospectively, at least until there are enough published studies with sufficiently large patient samples, acceptable follow up times, and favourable outcomes.
KeywordsHernia repair Mesh Complications Umbilical hernia Ventral hernia Epigastric hernia
We acknowledge M. Coppens, MD, from the pathology department of our hospital for providing the figures of the explanted meshes.
Conflict of interest statement
The authors have no financial interest in this publication and no financial grant was obtained for this study.
- 3.Stabillini C, Stella M, Frascio M, De Salvo L, Fornaro R, Larghero G, Mandolfino F, Lazzara F, Gianetta E (2009) Mesh versus direct suture for the repair of umbilical and epigastric hernias. Ten-year experience. Ann Ital Chir 80:183–187Google Scholar
- 10.Nelson EC, Vidovszky TJ (2010) Composite mesh migration into the sigmoid colon following ventral hernia repair. Hernia. doi: 10.1007/s10029-009-0623-x (Epub ahead of print)
- 11.Horzic M, Vergles D, Cupurdija K, Kopljar M, Zidak M, Lackovic Z (2010) Spontaneous mesh evacuation per rectum after incisional ventral hernia repair. Hernia. doi: 10.1007/s10029-010-0655-2 (Epub ahead of print)
- 12.Carpelan-Holmström, Kruma O, Salo J, Kylänpäa L, Scheinin T (2010) Late mesh migration through the stomach wall after laparoscopic refundoplication using a dual-sided PTFE/ePTFE mesh. Hernia. doi: 10.1007/s10029-010-0633-8 (Epub ahead of print)