Polypropylene “in vivo” Implantation in Inguinal Hernia Repair - Adverse Reactions

Polypropylene mesh is the preferred biomaterial used in iguinal hernia repair due to its flexibility, strength, rapid integration by surrounding tissues and resistance to infection. Despite being rare, adverse reaction to polypropylene mesh “in vivo” implantation are still a reality in clinical practice. Infections of an implanted mesh are extremely rare, with an incidence lower than 0,1% in laparoscopic inguinal hernia repair, respectively 1,5% in the open approach. However, when this complication occurs, managing it can be extremely difficult. This paper presents the case study of a 41-year-old male patient operated for right inguinal hernia, using a polypropylene mesh implanted laparososcopically. As a delayed postoperative complication, he developed mesh infection, which could not be treated with conservative measures. Definitive treatment consisted in surgical excision of the mesh and one titanium clip, using a hybrid technique, which combined the laparoscopic approach and open surgery. The postoperative course was favourable, with resolution of the symptoms. No recurrent abscess or hernia were noted during 18 months follow-up. In conclusion, removal of the mesh using the hybrid approach, can be a solution for polypropylene mesh infection. Keywords: polypropylene mesh infection, hernia repair, mesh excision, hybrid approach.