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Introduction: Mesh repair is one of the most popular technique for the treatment of abdominal wall hernias, resulting in lower recurrence rates. However, it is associated with a high risk of mesh-related complications. The aim of the present study is to assess the impact of biomaterials on the intra-abdominal organs, in terms of adhesions and visceral complications, in a series of patients undergoing re-do surgery at our abdominal wall unit.Materials and Methods: We reviewed the clinical records of 301 patients who undergone laparotomy between June 2008 and May 2018, selecting 67 patients with one or more previous prosthetic abdominal wall repair (AWR).Results: The average number of previous repairs was 1.6 with a mean time interval of 66 months from the last repair. Clinical presentation included hernia recurrence (69%), mesh infection (26%), infection and recurrence (10%), and fistula (1%). Adhesions were intraoperatively observed in all patients, except for eight cases. Mesh was completely removed in 43 patients, partially in four. Postoperative complications were observed in 39% of cases, including wound dehiscence, hematoma, seroma, and mesh infection.Conclusions: Long-term implant results in abdominal wall repair and are not completely known, and literature is still lacking on this topic. Re-do surgery for subsequent pathological events may represent a way to increase our knowledge. [ABSTRACT FROM AUTHOR]

The use of meshes in inguinal hernia repair (IHR) has gained popularity but new complications have been observed. Mesh-related visceral complications (MRVCs) are generally considered rare and hence are not studied in depth. We carried out a thorough literature search and collected 101 clinical reports published from 1992 to 2018. The reported complications seem to have tripled in the last decade. Ninety-seven cases met the inclusion criteria and they were subdivided into four groups (group A-onlay IHR, group B-3-D IHR, group C-preperitoneal IHR, group D-laparoscopic IHR) to be analyzed, according to the herniorraphy technique. Every prosthetic IHR can be followed by MRVCs but, according to the present review, the highest incidence is related to laparoscopic repairs, the lowest to Lichtenstein technique. Time-to-event was shorter in case of preperitoneal position of the prosthesis than when the mesh was implanted over the transversalis fascia. Urinary bladder involvement predominantly occurred after laparosopic IHR. A pathogenic correlation between the most frequently complained clinical signs and the previous mesh herniorraphy was rarely reported. The diagnosis was generally made at laparotomy, which was usually performed as an emergency. Removing the infected mesh and resecting or suture repairing the involved viscera was the challenging surgical treatment. Prevention of MRVCs after inguinal hernia repair appears to be an important significant issue. It is important to pay attention to the choice of a proper implantation site, avoiding direct contact between the mesh and viscera, and to select a proper device. [ABSTRACT FROM AUTHOR]

Background: In ventral hernia repair, when prosthetic material is placed intraperitoneally, it may lead to an inflammatory reaction resulting in adhesions between the mesh and abdominal viscera. Several meshes have been developed to minimize this process. In this experimental study, the ability of different combined meshes to attenuate the adhesion formation was examined.Methods: Three commercially available lightweight porous combined meshes were placed intraperitoneally to repair an abdominal wall defect in rats: DynaMesh-IPOM (PVDF + PP), TiMesh (titanium-coated filament PP) and C-QUR/FX (omega-3 fatty acid-coated filament PP). The DynaMesh-CICAT (PVDF) was implanted in the control group. Adhesion formation was macroscopically evaluated and scored after 7 and 21 days.Results: All animals except two presented intra-abdominal adhesions. None of the meshes examined in the study demonstrated to prevent adhesions. C-QUR/FX reduced adhesion formation at 7 days' follow-up compared with all other meshes but by 21 days this effect was diminished. Between 7 and 21 days adhesion extension significantly decreased for TiMesh. TAS did not show significant modifications between 7 and 21 days' follow-up for each mesh.Conclusions: The combined porous meshes tested in the present study demonstrated to reduce but not to prevent the adhesion formation, even if with some differences. Combined porous meshes could be chosen instead of simple meshes for retro-rectus preperitoneal prosthetic ventral hernia repair. [ABSTRACT FROM AUTHOR]

All prosthetic inguinal hernia repairs can be followed by MRVCs but we observed that the rate of MRVCs after laparoscopic approach was almost double than after mesh-plug technique (51% vs. 41%). We read with great interest the paper "Intestinal erosions following inguinal hernia repair: a systematic review" by Koliakos et al. [[1]]. [Extracted from the article]

Plug repair actually represents one of most recommended procedures in open groin hernia repair. It is generally recognized that Lichtenstein in 1968 first introduced the plug technique for femoral and recurrent inguinal hernia. The present paper backdates more than 50 years the first application of a plug due to an ingenious Italian surgeon named Davide Fieschi. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Long-term outcomes (>5 year follow-up) with porcine acellular dermal matrix (Permacol™) in incisional hernias at risk for infection" by M. M. Abdelfatah, N. Rostambeigi, E. Podgaetz, and M. G. Sarr in the February 2015 issue.

A letter to the editor is presented in response to the article "A rare cause of mechanical bowel obstruction: mesh migration," by I. Yilmaz and colleagues in the 2012 issue.

A response by P. Negro and colleagues to a letter to the editor about their article "Open tension-free Lichtenstein repair of inguinal hernia: use of fibrin glue versus sutures for mesh fixation," is presented.

A letter to the editor is presented in response to the article on repairing patch hernia of young adults.

The article discusses a study that compares he three most commonly used mesh techniques. It shows that P repair is more user-friendly than the Prolene Hernia System (PHS) and Lichtenstein mesh (L), with comparable complication rates. It indicates that the overall surgeon's satisfaction was significantly greater for the patch (P) repair group.

A letter to the editor is presented in response to a case report about the late discomfort after inguinal hernia repair.

The article presents the abstract of a research paper on the use of macroporous meshes with adhesion barrier. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the results of the control study comparing the Lichtenstein patch, PerWx plug and ProLoop plug in the repair of primary inguinal hernia.