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December 1, 2004

Radiologic Images of Meshoma: A New Phenomenon Causing Chronic Pain After Prosthetic Repair of Abdominal Wall Hernias

Arch Surg. 2004;139(12):1297-1298. doi:10.1001/archsurg.139.12.1297

Hernia surgery has been fundamentally affected by the use of prosthetic meshes, which have dramatically lowered the rate of recurrence after hernia repair. This revolutionary development, however, may lead to certain complications. Depending on the chosen procedure and the approach, the mesh is implanted in front of or behind the transversalis fascia; in the latter case, this is done through an open or laparoscopic approach. Furthermore, depending on the surgeon’s choice, the mesh is implanted without fixation or is fixed by sutures, metallic staples and tacks, or a variety of tissue glues. Nonfixation, insufficient fixation, or insufficient dissection to make adequate room for the prosthesis, however, can lead to folding and wrinkling of the mesh, a process that continues until the mesh is wadded up into a ball, which elsewhere I have referred to as “meshoma.”1Figure 1, Figure 2, Figure 3, and Figure 4 show computed tomographic and magnetic resonance images of this phenomenon and the corresponding explanted surgical specimens.