Mesh-related visceral complications following inguinal hernia repair: an emerging topic

Gossetti, Francesco; D'Amore, L; Annesi, Elena; Bruzzone, Paolo; Bambi, Lucia; Grimaldi, Maria Chiara; Ceci, Francesca; Negro, Paolo

doi:10.1007/s10029-019-01905-z

Cited by 50 publications

(32 citation statements)

References 31 publications

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“…Also, the UGF on the surface of the vas deferens and spermatic vessels must be protected to reduce the adhesion between the mesh and vas deferens. The previous studies have summarized the complications associated with the mesh, such as mesh migration [ 17 ], mesh erosion into the urinary bladder [ 18 ], and visceral injury [ 19 ]. Proper mesh placement is key to preventing these complications.…”

Section: Discussionmentioning

confidence: 99%

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Qin

Yan

et al. 2021

BMC Surg

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Purpose To investigate the urogenital fascia (UGF) anatomy in the inguinal region, to provide anatomical guidance for laparoscopic inguinal hernia repair (LIHR). Methods The anatomy was performed on 10 formalin-fixed cadavers. The peritoneum and its deeper fascial tissues were carefully dissected. Results The UGF’s bilateral superficial layer extended and ended in front of the abdominal aorta. At the posterior axillary line, the superficial layer medially reversed, with extension represented the UGF's deep layer. The UGF's bilateral deep layer medially extended beside the vertebral body and then continued with the transversalis fascia. The ureters, genital vessels, and superior hypogastric plexus moved between both layers. The vas deferens and spermatic vessels, ensheathed by both layers, moved through the deep inguinal ring. From the deep inguinal ring to the midline, the superficial layer extended to the urinary bladder’s posterior wall, whereas the deep layer extended to its anterior wall. Both layers ensheathed the urinary bladder and extended along the medial umbilical ligament to the umbilicus and in the sacral promontory, extended along the sacrum, forming the presacral fascia. The superficial layer formed the rectosacral fascia at S4 sacral vertebra, and the deep layer extended to the pelvic diaphragm, terminating at the levator ani muscle. Conclusion The UGF ensheaths the kidneys, ureters, vas deferens, genital vessels, superior hypogastric plexus, seminal vesicles, prostate, and urinary bladder. This knowledge of the UGF’s anatomy in the inguinal region will help find correct LIHR targets and reduce bleeding and other complications.

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Section: Discussionmentioning

confidence: 99%

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Qin

Yan

et al. 2021

BMC Surg

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“…In a review of literature from 1992 to 2018 by Gossetti et al ., the most common site of mesh migration after laparoscopic inguinal hernia repair was the sigmoid colon followed by the urinary bladder. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

Mesh migration into the sigmoid colon after total extraperitoneal hernioplasty – Report of a case and review of the literature

et al. 2020

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Over the past three decades, the practice laparoscopic inguinal hernioplasty has gained momentum. Mesh migration after laparoscopic inguinal hernia repair is an uncommon mesh-related delayed complication which is more common after transabdominal preperitoneal repair as compared to total extraperitoneal (TEP) repair. We report the first case of mesh migration into the sigmoid colon after TEP presenting 10 years after surgery. A 72-year-old male presented with left iliac fossa pain and diffuse lump. His computed tomogram scan showed sigmoid colon adherent to internal oblique at the site of hernia repair with a collection containing air specks and calcification. A colonoscopy revealed mesh within the sigmoid colon. He had to undergo a sigmoidectomy with Hartmann's surgery for the same. Here, we discuss the implicated pathophysiology, management and prevention of mesh migration after laparoscopic inguinal hernioplasty with literature review.

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“…However, non-porous meshes are preferred for intraperitoneal use [66]. MRVCs, which increase during the post-operative period, are observed after inguinal hernia repair [67,68] as well as after CAWR [69], and are more frequent and severe after intraperitoneal placement, even for composite meshes. Different surgical techniques have been developed to partially solve the problem, such as covering the intraperitoneal mesh with a peritoneal flap or with other tissue, but such techniques have not shown optimal results, and, therefore, this topic is still under discussion [70].…”

Section: Future In Clinical Applicationmentioning

confidence: 99%

Biological Scaffolds for Abdominal Wall Repair: Future in Clinical Application?

et al. 2019

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Millions of abdominal wall repair procedures are performed each year for primary and incisional hernias both in the European Union and in the United States with extremely high costs. Synthetic meshes approved for augmenting abdominal wall repair provide adequate mechanical support but have significant drawbacks (seroma formation, adhesion to viscera, stiffness of abdominal wall, and infection). Biologic scaffolds (i.e., derived from naturally occurring materials) represent an alternative to synthetic surgical meshes and are less sensitive to infection. Among biologic scaffolds, extracellular matrix scaffolds promote stem/progenitor cell recruitment in models of tissue remodeling and, in the specific application of abdominal wall repair, have enough mechanical strength to support the repair. However, many concerns remain about the use of these scaffolds in the clinic due to their higher cost of production compared with synthetic meshes, despite having the same recurrence rate. The present review aims to highlight the pros and cons of using biologic scaffolds as surgical devices for abdominal wall repair and present possible improvements to widen their use in clinical practice.

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Mesh-related visceral complications following inguinal hernia repair: an emerging topic

Cited by 50 publications

References 31 publications

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Mesh migration into the sigmoid colon after total extraperitoneal hernioplasty – Report of a case and review of the literature

Biological Scaffolds for Abdominal Wall Repair: Future in Clinical Application?

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