Laparoscopic Inguinal Hernia Repair and Mesh Infection: Does the Type of Mesh Used Matter
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It was Ger in 1982 who first described minimal access surgery for laparoscopic inguinal hernia repairs. Over the last two decades, laparoscopic repair has become one of the accepted standards of inguinal herniorrhaphy, notably the Trans abdominal pre-peritoneal repair (TAPP) and the total extra- peritoneal repair (TEP). In the Anglophone Caribbean, strides and leaps are being taken in this field. In addition to challenges in initiating and establishing these operative procedures in tertiary health institutions, there is the further burden of managing possible complications that may arise. Mesh infection is very uncommon post laparoscopic inguinal hernia repair–with rates of infection being noted as low as 0% in Caribbean literature. However, some authors have described rates as high as 0.5% -1% in other literature, and, despite the varied incidence of mesh infection-it is clear, that it is certainly not the common phenomena. Mesh infection can be categorised as either early or late/delayed onset mesh infection. Early mesh infection occurring more commonly, usually presenting within days or weeks post operation. At least fiÑ–\ percent (50%) of cases are expected to occur within the first month post operation. Several factors have been researched, in an attempt to find a likely causative factor. One of those recurrently highlighted, is not only the type of mesh used, but also its inherent biological properties. Understanding the dLوٴerent structural components of the plethora of mesh available, may give the surgeon better clarity when choosing his best option.
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