Intraperitoneal Polypropylene Mesh Hernia Repair Complicates Subsequent Abdominal Surgery

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2006 Dec 21

PMID 17180562

Citations 63

Authors

J A Halm

L L de Wall

E W Steyerberg

J Jeekel

J F Lange

Affiliations

Soon will be listed here.

Abstract

Background: Prosthetic incisional hernia repair (PIHR) is superior to primary closure in preventing hernia recurrence. Serious complications have been associated with the use of prosthetic material. Complications of subsequent surgical interventions after prior PIHR in relation to its anatomical position were the objectives of this study.

Patients And Methods: Patients who underwent subsequent laparotomy/laparoscopy after PIHR between January 1992 and February 2005 at our institution were evaluated. Intraperitoneal and preperitoneal mesh was related to complication rates after subsequent surgical interventions.

Results: Sixty-six of 335 patients underwent re-laparotomy after PIHR. The perioperative course was complicated in 76% (30/39) of procedures with intraperitoneal placed grafts compared to 29% (8/27) of interventions with preperitoneally positioned meshes (P < 0.001). Small bowel resections were necessary in 21% of the intraperitoneal group (8/39) versus 0% in the preperitoneal group. Surgical site infection rates were higher in the intraperitoneal group (10/39, 26%, versus 1/27, 4%). Enterocutaneous fistula formation was rare and occurred in two patients after subsequent laparotomy (5%).

Conclusions: Re-laparotomy after PIHR with polypropylene meshes are associated with more preoperative and postoperative complications when the mesh is placed intraperitoneally. Therefore 0intraperitoneal positioning of polypropylene mesh at incisional hernia repair should be avoided if possible.

Citing Articles

Transabdominal Preperitoneal (TAPP) versus intraperitoneal onlay Mesh (IPOM) for ventral hernia repair - an updated systematic review and meta-analysis.

Rasador A, Balthazar da Silveira C, Ballecer C, Poli de Figueiredo S Hernia. 2025; 29(1):93.

PMID: 39954156 DOI: 10.1007/s10029-025-03271-5.

Minimally invasive intraperitoneal onlay mesh plus (IPOM +) repair versus enhanced-view totally extraperitoneal (e-TEP) repair for ventral hernias: a systematic review and meta-analysis.

Rasador A, Silveira C, Fernandez M, Dias Y, Martin R, Mazzola Poli de Figueiredo S Surg Endosc. 2024; 39(2):1251-1260.

PMID: 39548010 DOI: 10.1007/s00464-024-11377-7.

Open intraperitoneal onlay mesh repair with anterior component separation as a bail-out procedure in the management of complex hernias.

Vierstraete M, Molnar A, Berrevoet F Hernia. 2024; 28(3):887-893.

PMID: 38642316 DOI: 10.1007/s10029-024-03033-9.

Long-term mesh-related complications from minimally invasive intraperitoneal onlay mesh for small to medium-sized ventral hernias.

Maskal S, Ellis R, Mali O, Lau B, Messer N, Zheng X Surg Endosc. 2024; 38(4):2019-2026.

PMID: 38424284 PMC: 10978620. DOI: 10.1007/s00464-024-10716-y.

Are Surgeons Going to Be Left Holding the Bag? Incisional Hernia Repair and Intra-Peritoneal Non-Absorbable Mesh Implant Complications.

Kirkpatrick A, Coccolini F, Tolonen M, Minor S, Catena F, Celotti A J Clin Med. 2024; 13(4).

PMID: 38398318 PMC: 10889414. DOI: 10.3390/jcm13041005.

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