Large bowel obstruction: a postoperative complication after laparoscopic bilateral inguinal hernia repair

Late-Onset Ileocutaneous Fistula Eight Years After Plug Repair With Polypropylene Mesh: A Case Report

Introduction: As one of the short-term complications after inguinal hernia repair, mesh infection frequently occurs but rarely leads to ileocutaneous fistula. We present a rare case of ileocutaneous fistula 8 years after inguinal hernia plug repair with polypropylene mesh.

Case Presentation: The patient was a 67-year-old male who underwent a plug repair with polypropylene mesh of the right inguinal hernia. Eight years after the primary repair, skin ulceration with pus presented in the right groin area, and the final diagnosis was enterocutaneous fistula. According to laparoscopic exploration, the ileum below the fistula closely adhered to the abdominal wall. After gently separating the bowel loop, a defect area of about 2 × 3 cm was observed on the surface of the ileum. In laparotomy, the plug was found embedded in the ileum and then was completely removed, and an ileum side-to-side anastomosis was performed. The patient was discharged 2 weeks after the surgery, and follow-up at the sixth month revealed complete healing of the wound and no evidence of hernia recurrence.

Conclusion: Late-onset ileocutaneous fistula should be considered in the differential diagnosis in patients who present inflammation and abscess formation after hernia repair. Besides, for patients with suspected intestinal fistula after hernia repair, laparoscopic exploration should be given priority, and the mesh removal approach should be tailored according to the results of laparoscopic exploration.

Sigmoid colon fistula following totally extraperitoneal hernioplasty: an improper treatment for mesh infection or iatrogenic injury?

BACKGROUND

There are only a few reports of severe mesh-related complications, and major bowel complications after totally extraperitoneal (TEP) hernioplasty are also rare.

CASE REPORT

A 75-year-old male patient, who had undergone TEP hernioplasty for a left inguinal hernia 2 months previously, presented with a left inguinal swelling that was found to be due to sigmoid colon-related mesh complications following TEP hernioplasty.

CONCLUSIONS

Infection is an accepted complication of hernia operation; however, it may be more serious following laparoscopic techniques. Successful TEP hernioplasty requires adequate dissection and complete exposure and coverage of all potential sites that cause inguinal hernia. If infection and suppuration are resistant to conservative methods or occur in the early postoperative period, aggressive imaging study and treatment provides definitive treatment and reduces the burden of complications.

Laparoscopic closure of patent canal of Nuck for female indirect inguinal hernia

STUDY OBJECTIVE

To determine the efficacy of concomitant laparoscopic closure of the patent canal of Nuck in treatment of indirect inguinal hernias in women.

DESIGN

Prospective clinical trial (Canadian Task Force classification II-2).

SETTING

University-associated tertiary care referral center.

PATIENTS

Six women scheduled for laparoscopy for gynecologic indications. Intervention. Concomitant simple closure of the patent canal of Nuck from the peritoneal cavity during laparoscopic surgery.

MEASUREMENTS AND MAIN RESULTS

Inguinal hernias were repaired in all six patients, with no recurrence.

CONCLUSION

l Laparoscopic closure of the patent canal of Nuck is an easy, safe, and effective treatment of indirect inguinal hernias in women. (J Am Assoc Gynecol Laparosc 8(1):143-146, 2001)