Mesh Plug Migration After a Robotic Inguinal Hernia Repair

Abstract

Even though inguinal hernia repairs are one of the most common surgery but the techniques have been evolving over the years. The evolution has been from open to minimally invasive surgery. Recently robotic surgery has gained popularity and is now well accepted for surgeries of the pelvis and the prostate. Inguinal hernias are detected in 20-30% of patients undergoing robotic radical prostatectomy, and are concomitantly repaired. A 50-year-old male presented with a non reducible groin mass. He had a prior history of a robotic prostatectomy with a concurrent mesh plug repair of direct inguinal hernia repair three years ago. Preoperative workup revealed mesh plug migration and intra operatively, it was noted that the robotically placed pre-peritoneal mesh plug had migrated through the internal ring into the inguinal canal. Excision of the plug with an open mesh repair of the inguinal hernia was done. A high degree of suspicion helped in correct management of the patient. When dealing with a patient with a prior history of robotic pelvic surgery who presents with a groin mass, mesh migration should be a part of the differential diagnosis. Pre-operative imaging in this select group of patients can aid in making the correct diagnosis and management plan. To the best of our knowledge this is the first report of a mesh plug migration after a robotic inguinal hernia repair.




doi: http://dx.doi.org/10.4021/jcs186w