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Keywords = enteroprosthetic fistula

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16 pages, 835 KiB  
Review
Are Surgeons Going to Be Left Holding the Bag? Incisional Hernia Repair and Intra-Peritoneal Non-Absorbable Mesh Implant Complications
by Andrew W. Kirkpatrick, Federico Coccolini, Matti Tolonen, Samual Minor, Fausto Catena, Andrea Celotti, Emanuel Gois, Gennaro Perrone, Giuseppe Novelli, Gianluca Garulli, Orestis Ioannidis, Michael Sugrue, Belinda De Simone, Dario Tartaglia, Hanna Lampella, Fernando Ferreira, Luca Ansaloni, Neil G. Parry, Elif Colak, Mauro Podda, Luigi Noceroni, Carlo Vallicelli, Joao Rezende-Netos, Chad G. Ball, Jessica McKee, Ernest E. Moore and Jack Matheradd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(4), 1005; https://doi.org/10.3390/jcm13041005 - 9 Feb 2024
Cited by 7 | Viewed by 11454
Abstract
Ventral incisional hernias are common indications for elective repair and frequently complicated by recurrence. Surgical meshes, which may be synthetic, bio-synthetic, or biological, decrease recurrence and, resultingly, their use has become standard. While most patients are greatly benefited, mesh represents a permanently implanted [...] Read more.
Ventral incisional hernias are common indications for elective repair and frequently complicated by recurrence. Surgical meshes, which may be synthetic, bio-synthetic, or biological, decrease recurrence and, resultingly, their use has become standard. While most patients are greatly benefited, mesh represents a permanently implanted foreign body. Mesh may be implanted within the intra-peritoneal, preperitoneal, retrorectus, inlay, or onlay anatomic positions. Meshes may be associated with complications that may be early or late and range from minor to severe. Long-term complications with intra-peritoneal synthetic mesh (IPSM) in apposition to the viscera are particularly at risk for adhesions and potential enteric fistula formation. The overall rate of such complications is difficult to appreciate due to poor long-term follow-up data, although it behooves surgeons to understand these risks as they are the ones who implant these devices. All surgeons need to be aware that meshes are commercial devices that are delivered into their operating room without scientific evidence of efficacy or even safety due to the unique regulatory practices that distinguish medical devices from medications. Thus, surgeons must continue to advocate for more stringent oversight and improved scientific evaluation to serve our patients properly and protect the patient–surgeon relationship as the only rationale long-term strategy to avoid ongoing complications. Full article
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