Recommended Citation
Hadjiloucas N, Armstrong N. Safely Placing Mesh in Multi-recurrent Right Inguinal Hernia Repair with Appendectomy. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Introduction/Background:
Patient is a 54-year-old male with a history of 5 prior inguinal hernia repairs with multiple layers of mesh who presented to our office with discomfort in his right groin, seeking elective repair. During our procedure multiple meshes were encountered, including a portion of Marlex mesh encompassing the appendix. A decision was made at the time to perform an appendectomy. Our case reviews the decision to place mesh for hernia repair, after performing appendectomy, and measures taken to limit infection. We have shown in this case that it is safe to place mesh even if the bowel is transected.
Description:
Given the patient’s complex abdominal history decision was made to repair hernia in a transabdominal approach to allow us to lyse adhesions and prevent bowel obstruction. Upon entering the abdomen, it was noted that there were many adhesions in the right lower quadrant tethering the colon and appendix to the anterior abdominal wall. On closer inspection it was found that the appendix was completely encased in previously placed Marlex mesh. We performed a no touch appendectomy, deploying a stapler at the base of the appendix. Given the number of adhesions and the multiple layers of mesh, the mesh was explained, and peritoneum was sacrificed.
Discussion:
After multiple months of observation, no signs of mesh infection have been noted. We believe our precautions intraoperatively with mesh choice, post-operative antibiotics and omental flap all led to successful mesh placement after transected bowels in an elective hernia repair.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Poster
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Available to all.
Safely Placing Mesh in Multi-recurrent Right Inguinal Hernia Repair with Appendectomy
Introduction/Background:
Patient is a 54-year-old male with a history of 5 prior inguinal hernia repairs with multiple layers of mesh who presented to our office with discomfort in his right groin, seeking elective repair. During our procedure multiple meshes were encountered, including a portion of Marlex mesh encompassing the appendix. A decision was made at the time to perform an appendectomy. Our case reviews the decision to place mesh for hernia repair, after performing appendectomy, and measures taken to limit infection. We have shown in this case that it is safe to place mesh even if the bowel is transected.
Description:
Given the patient’s complex abdominal history decision was made to repair hernia in a transabdominal approach to allow us to lyse adhesions and prevent bowel obstruction. Upon entering the abdomen, it was noted that there were many adhesions in the right lower quadrant tethering the colon and appendix to the anterior abdominal wall. On closer inspection it was found that the appendix was completely encased in previously placed Marlex mesh. We performed a no touch appendectomy, deploying a stapler at the base of the appendix. Given the number of adhesions and the multiple layers of mesh, the mesh was explained, and peritoneum was sacrificed.
Discussion:
After multiple months of observation, no signs of mesh infection have been noted. We believe our precautions intraoperatively with mesh choice, post-operative antibiotics and omental flap all led to successful mesh placement after transected bowels in an elective hernia repair.
Affiliations
Aurora St. Luke's Medical Center