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. 2018 Aug 16;100(8):e1-e4.
doi: 10.1308/rcsann.2018.0135. Online ahead of print.

Laparoscopic inguinal hernia repair: a rare case of colonic mesh migration

K Narang  1 , A Krishan  1 , B Pisavadia  1 , A Wadood  1 , M Budhoo  1 , S Zaman  1
Affiliations

Laparoscopic inguinal hernia repair: a rare case of colonic mesh migration

K Narang et al. Ann R Coll Surg Engl. .

Abstract

Inguinal hernia repair can be performed via either an open or laparoscopic technique. Use of a mesh to repair the abdominal wall defect is now common practice, leading to a reduction in hernia recurrence but also associated with a number of complications. We report a rare case of a 49-year old man who presented 3 years after laparoscopic hernia repair with right-sided abdominal pain and loose stools. Colonoscopy and computed tomography revealed a mesh and fixation devices within the lumen of the caecum and ascending colon. The mesh was successfully excised with primary closure of the bowel defect. This case highlights the importance of recognising mesh migration as a complication of hernia repair, a phenomenon which can lead to serious morbidity. We suggest that patients should be informed of this risk during the consent process, while further research is needed to investigate how this occurrence can be prevented.

Keywords: Inguinal hernia; Laparoscopic; Mesh migration; Totally extraperitoneal; Transabdominal preperitoneal.

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Figures

Figure 1
Figure 1
Colonoscopy: polypropylene mesh and fixation devices noted within the caecum.
Figure 2
Figure 2
Colonoscopy: polypropylene mesh with faecal matter found next to the ileocaecal valve.
Figure 3
Figure 3
Non-contrast computed tomography: sagittal oblique view, showing an intraluminal high density material consistent with migrated mesh and fixation devices, with associated bowel wall thickening.
Figure 4
Figure 4
Non-contrast computed tomography: axial view, confirming the presence of intraluminal mesh within the caecum.
Figure 5
Figure 5
Non-contrast computed tomography: coronal view, demonstrating normal mesh fixation in left iliac fossa.
See this image and copyright information in PMC

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