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. 2021 Apr;25(2):435-440.
doi: 10.1007/s10029-020-02225-3. Epub 2020 Jun 3.

Re-do surgery after prosthetic abdominal wall repair: intraoperative findings of mesh-related complications

F Ceci  1 , L D'Amore  2 , M R Grimaldi  2 , L Bambi  2 , E Annesi  2 , P Negro  2 , F Gossetti  2
Affiliations

Re-do surgery after prosthetic abdominal wall repair: intraoperative findings of mesh-related complications

F Ceci et al. Hernia. 2021 Apr.

Abstract

Introduction: Mesh repair is one of the most popular technique for the treatment of abdominal wall hernias, resulting in lower recurrence rates. However, it is associated with a high risk of mesh-related complications. The aim of the present study is to assess the impact of biomaterials on the intra-abdominal organs, in terms of adhesions and visceral complications, in a series of patients undergoing re-do surgery at our abdominal wall unit.

Materials and methods: We reviewed the clinical records of 301 patients who undergone laparotomy between June 2008 and May 2018, selecting 67 patients with one or more previous prosthetic abdominal wall repair (AWR).

Results: The average number of previous repairs was 1.6 with a mean time interval of 66 months from the last repair. Clinical presentation included hernia recurrence (69%), mesh infection (26%), infection and recurrence (10%), and fistula (1%). Adhesions were intraoperatively observed in all patients, except for eight cases. Mesh was completely removed in 43 patients, partially in four. Postoperative complications were observed in 39% of cases, including wound dehiscence, hematoma, seroma, and mesh infection.

Conclusions: Long-term implant results in abdominal wall repair and are not completely known, and literature is still lacking on this topic. Re-do surgery for subsequent pathological events may represent a way to increase our knowledge.

Keywords: Abdominal wall hernia; Mesh adhesions; Mesh complications; Re-do surgery.

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