Successful conservative treatment of a candida albicans intraperitoneal mesh infection following laparoscopic ventral hernia repair

Seroma formation has been documented as a common complication in laparoscopic ventral herniorraphy. However, there are no recent studies documenting the incidence of or protective strategies against seroma-related cellulitis. The purpose of this study was to evaluate 65 laparoscopic ventral herniorraphies and to determine if seroma-related cellulitis can be prevented by the routine use of postoperative prophylactic antibiotics. A retrospective case review of 65 laparoscopic ventral herniorraphies was done at our institution from February 2002 to January 2004. All were performed using either Gore-Tex DualMesh or Bard Composix mesh and performed under the direct supervision of a single surgeon. Twenty patients received only preoperative third-generation cephalosporins or fluoroquinolones. All other patients received either 7 days of postoperative oral cephalosporins or fluoroquinolones in addition to preoperative antibiotics. Sixty-five patients underwent laparoscopic ventral hernia repair. There were 45 patients in the postoperative antibiotic group and 20 patients in the preoperative-only antibiotic group. Twenty-one patients developed seromas. Twelve of these developed cellulitis. The rates of seroma formation were similar in the two groups with 30 per cent in the preoperative only group and 33 per cent in the postoperative antibiotic group. However, 100 per cent of the seromas in the preoperative antibiotic group developed seroma-related cellulitis. Only 40 per cent of seromas in the postoperative antibiotic group developed cellulitis. In addition, two seromas in the preoperative antibiotics–only group progressed to frank mesh infection necessitating operative removal. There were no complications related to antibiotic administration. Laparoscopic ventral hernia repair is a safe and effective procedure. Our seroma rate is 30 per cent and compares equally with prior reported studies. Seroma-related cellulitis is a common problem that can lead to mesh infection, postoperative morbidity, and further need for operative care. The administration of 7 days of postoperative prophylactic antibiotics appears to be a safe and effective means to limit seroma-related cellulitis.

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Robotic versus Laparoscopic Ventral Hernia Repair: A Multicenter, Blinded Randomized Controlled Trial

SSRN Electronic Journal ◽

10.2139/ssrn.3453330 ◽

2019 ◽

Author(s):

Oscar Olavarria ◽

Karla Bernardi ◽

Shinil K. Shah ◽

Todd D. Wilson ◽

Shuyan Wei ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Controlled Trial ◽

Laparoscopic Ventral Hernia Repair ◽

Randomized Controlled

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Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽

10.1007/s10029-021-02486-6 ◽

2021 ◽

Author(s):

P. J. O’Dwyer ◽

C. Chew ◽

H. Qandeel

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Ct Scans ◽

Unique Problem ◽

Polyester Mesh

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

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