Laparoscopic management of infected mesh after laparoscopic inguinal hernia repair.

Purpose: We present our experience with 10 patients with infected meshes after laparoscopic inguinal hernia repair in whom we explanted infected meshes laparoscopically. Methods: On retrospective analysis over 5 years (2007 to 2012), we identified 10 patients (6 TAPP/4 TEP) with localized deep-seated mesh infections in whom infected meshes were explanted laparoscopically. Peritoneum was incised, associated abscesses were drained, meshes were identified, separated, and extracted through 10/12 mm port. Results: Nine patients experienced resolution of symptoms after 3 weeks of surgical intervention and remained asymptomatic at mean follow-up of 20 months (range, 4 to 42 mo). One patient with recurrent abscess required surgical drainage twice. Mean hospital stay was 2.2 days (range, 1 to 9 d). Two patients developed recurrent hernia at 6 and 8 months after mesh explantation. Conclusions: Laparoscopic explantation of infected meshes after laparoscopic hernia repair leads to less scarring and early recovery. Contamination of anterior abdominal wall after cutaneous drainage of deep-seated abscess is avoided.