Louis Mena, Grabill Nathaniel, Fang Jerrell, Okunlola Oluwasemilore, Chambers James
General Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
General Surgery, Northeast Georgia Medical Center Braselton, Braselton, USA.
Cureus. 2024 Nov 22;16(11):e74204. doi: 10.7759/cureus.74204. eCollection 2024 Nov.
Mesh plugs are commonly used in inguinal hernia repair due to their perceived efficacy in reducing recurrence rates. However, their use has been associated with significant complications, including mesh migration, chronic pain, infection, hernia recurrence, adhesions, and erosion into adjacent organs. This case series presents three patients who experienced complications from mesh plug migration post-hernia repair. The patients, aged 63, 82, and 90, presented with symptoms ranging from chronic pain and groin bulging to acute-onset pain and recurrent hernias. Diagnostic imaging revealed migrated mesh plugs adhered to critical structures such as the spermatic cord and small bowel. The surgical intervention involved robotic-assisted laparoscopic techniques to excise the migrated mesh plugs and place the new mesh in the preperitoneal space. Postoperative outcomes were stable. A review of the literature supports our findings, emphasizing the multifactorial mechanisms behind mesh migration and its severe clinical implications. Given these risks, we recommend generally avoiding the use of mesh plugs in hernia repair, if possible. Instead, other mesh alternatives and improved fixation techniques should be considered to enhance patient outcomes and reduce the incidence of these complications.
由于网塞在降低腹股沟疝修补术后复发率方面被认为有效，因此常用于腹股沟疝修补术。然而，其使用与严重并发症相关，包括网塞移位、慢性疼痛、感染、疝复发、粘连以及侵蚀相邻器官。本病例系列介绍了三名患者，他们在疝修补术后因网塞移位而出现并发症。这三名患者年龄分别为63岁、82岁和90岁，症状从慢性疼痛和腹股沟隆起至急性疼痛和复发性疝不等。诊断性影像学检查显示移位的网塞附着于精索和小肠等关键结构。手术干预采用机器人辅助腹腔镜技术切除移位的网塞，并将新的网片置于腹膜前间隙。术后结果稳定。文献综述支持我们的发现，强调了网塞移位背后的多因素机制及其严重的临床影响。鉴于这些风险，我们建议如果可能，一般应避免在疝修补术中使用网塞。相反，应考虑其他网片替代方案和改进的固定技术，以提高患者的治疗效果并降低这些并发症的发生率。
