Complications of mesh devices for intraperitoneal umbilical hernia repair: a word of caution

Abstract

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.

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References

  1. 1.

    Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88:1321–1323

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Malik AM, Jawaid A, Talpur AH, Laghari AA, Khan A (2008) Mesh versus non-mesh repair of ventral abdominal hernias. J Ayub Med Coll Abbottabad 20:54–56

    PubMed  CAS  Google Scholar 

  3. 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 80:183–187

    Google Scholar 

  4. 4.

    Ammar SA (2010) Management of complicated umbilical hernias in cirrhotic patients using permanent mesh: randomized clinical trial. Hernia 14:35–38

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Bowley DMG, Kingsnorth AN (2000) Umbilical hernia, Mayo or mesh? Hernia 4:195–196

    Article  Google Scholar 

  6. 6.

    Halm JA, Heisterkamp J, Veen HF, Weidema WF (2005) Long-term follow-up after umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair. Hernia 9:334–337

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Hadi HIA, Maw A, Sarmah S, Kumar P (2006) Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients. Hernia 10:409–413

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Martin DF, Williams RF, Mulrooney T, Voeller GR (2007) Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications. Hernia 12:379–383

    Article  Google Scholar 

  9. 9.

    Berrevoet F, de Hemptinne B (2009) Open intraperitoneal mesh repair for umbilical hernias. A technical note. Acta Chir Belg 109:555–558

    PubMed  CAS  Google Scholar 

  10. 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. 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. 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)

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Acknowledgements

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.

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Correspondence to F. E. Muysoms.

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Muysoms, F.E., Bontinck, J. & Pletinckx, P. Complications of mesh devices for intraperitoneal umbilical hernia repair: a word of caution. Hernia 15, 463–468 (2011). https://doi.org/10.1007/s10029-010-0692-x

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Keywords

  • Hernia repair
  • Mesh
  • Complications
  • Umbilical hernia
  • Ventral hernia
  • Epigastric hernia