Неотложная медицинская помощь (Oct 2024)

Surgical Treatment of Purulent Complications and Widespread Paraprosthetic Infection in the Area of the Mesh Prosthesis After Laparoscopic Transabdominal Preperitoneal Hernioplasty on the Right with Involvement of Abdominal Organs Using Laparoscopic Access

  • H.M.H. Karkhani,
  • E. A. Gallyamov,
  • A. S. Vorotyntsev,
  • A. Yu. Emelyanov,
  • D.M.E. Henein,
  • A. B. Shalygin,
  • B. Sharma

DOI
https://doi.org/10.23934/2223-9022-2024-13-3-528-533
Journal volume & issue
Vol. 13, no. 3
pp. 528 – 533

Abstract

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Laparoscopic transabdominal, preperitoneal hernioplasty for inguinal hernia using a synthetic mesh prosthesis is the most common operation in modern surgical practice. Given the minimally invasive approach, infectious complications are rare. Despite the rarity of infectious complications, their development requires additional use of medications, long-term use of antibiotics, repeated traumatic surgical interventions, which leads to prolonged pain syndrome, hernia recurrence and is accompanied by a serious deterioration in the mental and physical condition of patients. Ultrasound and computed tomography with contrast are quite informative research methods for diagnosing abscesses associated with the implantation of a synthetic mesh prosthesis. In this article, we consider a clinical observation: a 36-year-old man with an abscess in the area of a synthetic mesh prosthesis after laparoscopic prosthetic preperitoneal hernioplasty on the right for inguinal hernia 4 months after the initial operation. The infectious process spread from the area of the infected prosthesis into the abdominal cavity, was limited by internal organs with the formation of an abscess. The resulting complication was treated by laparoscopic access. The purpose of our article is to draw the attention of surgeons to the possibility of a rare infectious complication in the area of the synthetic mesh prosthesis after right laparoscopic preperitoneal hernioplasty for inguinal hernia 4 months after the initial operation, after which the infectious process may spread from the area of the infected prosthesis into the abdominal cavity. The emphasis is placed on the difficulties of preoperative diagnosis of the complication and its surgical correction by laparoscopic access.

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