Description

Laparoscopic removal of an infected surgical mesh is a technically demanding procedure that requires meticulous dissection, precise anatomical identification, and careful management of adhesions to minimize the risk of bowel, bladder, vascular, or abdominal wall injury. In this surgical video, Dr. R.K. Mishra demonstrates a systematic approach to the laparoscopic explantation of infected mesh, emphasizing safe surgical principles and effective management of mesh-related complications. Mesh infection following previous hernia repair can present with chronic pain, persistent wound or sinus discharge, abscess formation, recurrent infection, mesh migration, adhesions, or fistula formation. When conservative treatment fails or deep-seated mesh infection persists, complete or appropriately planned mesh explantation may become necessary. The procedure begins with careful laparoscopic access away from the suspected area of adhesions. A detailed inspection of the abdominal cavity is performed to assess the relationship of the infected mesh with the omentum, bowel, abdominal wall, and surrounding structures. Adhesiolysis is undertaken gradually, maintaining continuous awareness of bowel proximity and avoiding unnecessary thermal injury. The infected prosthetic material is then identified and progressively separated from surrounding tissues. Dense adhesions and incorporated portions of the mesh require controlled dissection with appropriate traction and counter-traction. Particular attention is given to preventing inadvertent enterotomy while achieving adequate removal of infected or nonviable prosthetic material. The operative field is subsequently inspected for bleeding, bowel injury, residual infected material, collections, and other complications. This video provides an educational demonstration of the principles involved in managing infected mesh after hernia surgery, including laparoscopic adhesiolysis, mesh explantation, infection control, complication avoidance, and assessment of the abdominal wall following removal. The presentation is particularly useful for general surgeons, laparoscopic surgeons, hernia surgeons, surgical residents, fellows, and trainees interested in advanced minimally invasive management of complex mesh-related complications.