• Mesh Migration

  Posted by Good intentions on March 17, 2023 at 9:17 am

  Here is an interesting new paper about mesh migration. It uses a case study to introduce a review of mesh migration cases in general.

  It has some interesting comments about fixation. The mesh producers have many products that describe “fixation-free” methods. The authors of the paper describe foreign body induced migration. A person has to wonder about migration that does not lead to problems worthy of surgical intervention. That zone of discomfort and pain while still being physically healthy. Alive but suffering.

  The patient had the repair in 2015 and the problem in 2018.

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014169/

  Cecum perforation by plug migration: an unexpected late complication of inguinal hernia mesh repair

  Filipa Policarpo,corresponding author Ana Alves Rafael, Miguel Fróis Borges, and Fernando Azevedo

  “… Secondary migration occurs due to foreign body reaction and subsequent erosion of the nearby structures, allowing slow and gradual mesh displacement through the different anatomic planes [1, 3]. This process is mostly related to the mesh material and the type of fixation used, being more frequent with polypropylene meshes. However, some authors argue that this association is because these meshes are the type most used.

  A mixed mechanism is also found in which, after a primary migration, the erosion of tissues was not initially in contact with the mesh [3].

  In the case described, considering the intra-operatory visualization of two non-absorbable (Prolene) fixation points of the mesh, the origin of the mesh migration was interpreted as a foreign body reaction. This reaction induced erosion of the posterior wall of the inguinal canal, enabling plug migration to the peritoneal cavity and subsequent cecum adhesion and perforation. …”

  Good intentions replied 1 year, 9 months ago 1 Member · 0 Replies
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