Central mesh failure after laparoscopic IPOM procedure.

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.