Laparoscopic Removal of Inguinal Hernia Mesh Placed During a Robotic TAPP Hernia Repair in a Patient With Chronic Pain

Naif A Alenazi, MD, Jonathan B Yuval, MD, Alexandra Argiroff, MD, Brian P Jacob, MD, FACS. Mount Sinai Medical Center

An 18-year-old healthy male presented with acute-onset left lower quadrant pain. Extensive work up did not reveal source. He underwent a robotic TAPP inguinal hernia repair at another hospital assuming an incidentally discovered small left inguinal hernia may have been the culprit.

Post operatively, the pain continued to worsen. He developed systemic symptoms as well as psychological distress. Extensive workup failed to reveal the cause of these symptoms. The patient presented to our office requesting mesh removal after three months of worsening symptoms. 

He was admitted for laparoscopic excision of mesh. Intraoperative findings included: old mesh partially clam-shelled and a left inguinal lipoma. There was no intra-abdominal pathology deep to the area of pain. No adhesions, spigelian hernias or right inguinal pathologies were found.

Rarely patients may develop psychological distress and systemic symptoms following surgical insertion of a foreign body. Laparoscopic removal of inguinal RTAPP inserted mesh is both feasible and safe, when attempted by an experienced surgeon. Although removal may not improve the underlying pain, it alleviates the patient’s distress and improves their well-being.

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