Surgical Treatment of Purulent Complications and Widespread Paraprosthetic Infection in the Area of the Mesh Prosthesis After Laparoscopic Transabdominal Preperitoneal Hernioplasty on the Right with Involvement of Abdominal Organs Using Laparoscopic Access
https://doi.org/10.23934/2223-9022-2024-13-3-528-533
Abstract
Laparoscopic transabdominal, preperitoneal hernioplasty for inguinal hernia using a synthetic mesh prosthesis is the most common operation in modern surgical practice. Given the minimally invasive approach, infectious complications are rare. Despite the rarity of infectious complications, their development requires additional use of medications, long-term use of antibiotics, repeated traumatic surgical interventions, which leads to prolonged pain syndrome, hernia recurrence and is accompanied by a serious deterioration in the mental and physical condition of patients. Ultrasound and computed tomography with contrast are quite informative research methods for diagnosing abscesses associated with the implantation of a synthetic mesh prosthesis. In this article, we consider a clinical observation: a 36-year-old man with an abscess in the area of a synthetic mesh prosthesis after laparoscopic prosthetic preperitoneal hernioplasty on the right for inguinal hernia 4 months after the initial operation. The infectious process spread from the area of the infected prosthesis into the abdominal cavity, was limited by internal organs with the formation of an abscess. The resulting complication was treated by laparoscopic access. The purpose of our article is to draw the attention of surgeons to the possibility of a rare infectious complication in the area of the synthetic mesh prosthesis after right laparoscopic preperitoneal hernioplasty for inguinal hernia 4 months after the initial operation, after which the infectious process may spread from the area of the infected prosthesis into the abdominal cavity. The emphasis is placed on the difficulties of preoperative diagnosis of the complication and its surgical correction by laparoscopic access.
About the Authors
H.M.H. KarkhaniRussian Federation
Hiwa M.H. Karkhani, Postgraduate Student, Department of General Surgery, N.V. Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
E. A. Gallyamov
Russian Federation
Eduard A. Gallyamov, Doctor of Medical Sciences, Professor, Head of the Department of General Surgery, N.V. Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
A. S. Vorotyntsev
Russian Federation
Alexander S. Vorotyntsev, Candidate of Medical Sciences, Associate Professor, Department of General Surgery, Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
A. Yu. Emelyanov
Russian Federation
Andrey Yu. Emelyanov, Candidate of Medical Sciences, Associate Professor, Department of General Surgery, N.V. Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
D.M.E. Henein
Russian Federation
David M.E. Henein, 6th Grade Student, Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
A. B. Shalygin
Russian Federation
Anton B. Shalygin, Candidate of Medical Sciences, Deputy Chief Physician
Yauzskaya Str. 11, Moscow, 109240
B. Sharma
Russian Federation
Bhawna Sharma 6th Grade Student, Sklifosovsky Institute of Clinical Medicine
Bolshaya Pirogovskaya Str. 19, bldg. 1, Moscow, 119146
References
1. Oorzhak O.V., Shost S.Y., Mozes V.G., Mozes K.B., Pavlenko V.V. Inguinal hernia – epidemiology, risk factors, treatment methods (literature review). Acta Biomedica Scientifica. 2021;6(4):230–242. (In Russ.) https://doi.org/10.29413/ABS.2021-6.4.21
2. O’Brien WJ, Dipp Ramos R, Gupta K, Itani KMF. Risk of Hernia Mesh Explantation following Early Versus Late Onset Skin and Soft Tissue Infection. Ann Surg Open. 2021;2(4):e098. PMID: 34957470 https://doi.org/10.1097/as9.0000000000000098
3. Ito H, Matsumoto K, Terauchi T, Kimata M, Lefor AK, Shinozaki H. Delayed mesh infection after inguinal hernia repair: a case report. J Surg Case Rep. 2021;(9):rjab399. PMID: 34567517 https://doi.org/10.1093/jscr/rjab399
4. Sazhin AV, Klimiashvili AD, Ivakhov GB, Kotchiay E. The laparoscopic trans-abdominal pre-peritoneal hernioplasty in case of inguinal-scrotal hernia. Rossiiskii meditsinskii zhurnal. 2016; 22(4):177—179. (In Russ.) https://doi.org/10.18821/0869-2106-2016-22-4-177-179
5. Chen T, Zhang YH, Wang HL, Chen W, Wang J. Late-onset deep mesh infection: A study of eight cases detected from 2666 consecutive patients with abdominal wall hernia repairs. Chin Med J (Engl). 2016;129(15):1870–1872. PMID: 27453240 https://doi.org/10.4103/0366-6999.186651
6. Gachabayov M, Latifi R. Different etiopathogeneses in early-onset and late-onset inguinal hernia mesh infections in a prospectively evaluated cohort. Acta Chir Belgica. 2021;121(3):164–169. PMID: 31690215 https://doi.org/10.1080/00015458.2019.1689648
7. Aggarwal S, Praneeth K, Rathore Y, Waran V, Singh P. Laparoscopic management of mesh erosion into small bowel and urinary bladder following total extra-peritoneal repair of inguinal hernia. J Min Acc Surg. 2016;12(1):79–82. PMID: 26917927 https://doi.org/10.4103/0972-9941.169956
8. Jin C, Shen Y, Chen J. Laparoscopic evaluation and management of 47 patients with late-onset mesh infection after inguinal hernioplasty. Hernia. 2020;24(2):381–385. PMID: 32096089 https://doi.org/10.1007/s10029-020-02141-6
9. Parshikov VV. Inflammatory Complications of the Abdominal Wall Prosthetic Repair: Diagnostics, Treatment, and Prevention (Review). Sovremennye tehnologii v medicine. 2019;11(3):158 (In Russ.). https://doi.org/10.17691/stm2019.11.3.19
10. Tazaki T, Sasaki M, Kohyama M, Sugiyama Y, Shintakuya R, Hirano T, et al. Laparoscopic plug removal for chronic pain after inguinal hernia repair using the plug-and-patch technique: A case report. Int J Surg Case Rep. 2019;65:107–110. PMID: 31704659 https://doi.org/10.1016/j.ijscr.2019.10.057
Review
For citations:
Karkhani H., Gallyamov E.A., Vorotyntsev A.S., Emelyanov A.Yu., Henein D., Shalygin A.B., Sharma B. Surgical Treatment of Purulent Complications and Widespread Paraprosthetic Infection in the Area of the Mesh Prosthesis After Laparoscopic Transabdominal Preperitoneal Hernioplasty on the Right with Involvement of Abdominal Organs Using Laparoscopic Access. Russian Sklifosovsky Journal "Emergency Medical Care". 2024;13(3):528-533. (In Russ.) https://doi.org/10.23934/2223-9022-2024-13-3-528-533