Van Besien Jeroen, Vindevoghel Koen, Sommeling Casper
a Department of General Surgery , OLV van Lourdes , Waregem , Belgium.
Acta Chir Belg. 2016 Oct;116(5):313-315. doi: 10.1080/00015458.2016.1159427. Epub 2016 May 26.
Central mesh failure after laparoscopic repair of a ventral hernia is a rare finding. We present a case of a 42-year-old man with clear umbilical hernia recurrence 4 years after IPOM procedure with an oxidized cellulose composite polypropylene mesh, using the double crown technique. Laparoscopy showed that a segment of small intestine herniated through a central defect in the prosthesis. A primary repair of the umbilical hernia recurrence was performed through a small transverse infraumbilical incision suturing both the fascia and mesh with interrupted non-resorbable monofilament sutures. A plausible explanation for this type of recurrence might be that the center of the mesh was further torn after an initial (micro) trauma induced by the tackers used for fixation.
腹腔镜修补腹疝后中央补片失败是一种罕见的情况。我们报告一例42岁男性患者，在采用氧化纤维素复合聚丙烯补片并使用双冠技术进行腹腔内补片植入修补术（IPOM）4年后，脐疝明显复发。腹腔镜检查显示一段小肠通过假体中央的缺损处疝出。通过脐下小横切口，用间断不可吸收单丝缝线缝合筋膜和补片，对脐疝复发进行了一期修补。对于这种类型的复发，一个合理的解释可能是，用于固定的钉合器造成初始（微小）创伤后，补片中央进一步撕裂。
