LAPAROSCOPIC MESH EXPLANTATION FOR DELAYED INTRAPERITONEAL ONLAY MESH (IPOM) INFECTION: A CASE REPORT

Abstract

Background: Intraperitoneal onlay mesh (IPOM) repair is a widely used minimal access technique for the repair of primary and incisional ventral hernias, valued for its low recurrence rates and short hospital stay.1 Mesh infection is an uncommon but serious complication of IPOM and can present acutely, within weeks of surgery, or as a delayed, chronic infection presenting months to years later. Here we present a case of a 30-year-old female who had delayed mesh infection four years after IPOM surgery done for umbilical hernia, presenting with pain and swelling for a short duration of one week. After investigations, she underwent laparoscopic IPOM mesh explantation. Conclusion: Delayed mesh infection, although rare, should be considered in any patient presenting with peri umbilical swelling even years after IPOM repair. Unlike acute mesh infection, in which the mesh typically lies loose within a purulent collection and is retrieved with relative ease, chronic infection is characterised by dense incorporation of the mesh into the abdominal wall, making laparoscopic explantation technically demanding, though still feasible and safe in experienced hands.