Totally Extraperitoneal (TEP) Removal of an Infected Mesh by Laparoscopy after Open Preperitoneal Repair: Initial Case Report

Abstract

Prosthetic mesh infection after open or laparoscopic hernia repair is a rare complication. Superficial wound infection can be resolved by treatment with a combination of antibiotics and wound drainage, whereas deep-seated mesh infection, which can lead to chronic groin sepsis, usually requires removal of the mesh. A 56-year-old Japanese man was admitted to our hospital for the treatment of deep-seated mesh infection. The patient had undergone inguinal hernia repair at another hospital 18 months earlier. The operation was prosthetic mesh repair via an anterior approach. The patient developed deep-seated mesh infection despite conservative treatment for infection, such as abscess drainage and antibiotic therapy. Since the patient eventually developed chronic groin sepsis, he was referred to our hospital, and infected mesh was removed successfully by laparoscopic surgery via a totally extraperitoneal approach. The laparoscopic approach provides several advantages, including less postoperative pain, a shorter hospital stay, and earlier rehabilitation. Furthermore, seeding of the abdominal cavity with pus never occurs with this approach unlike the laparoscopic transabdominal preperitoneal approach.