Ventral hernia mesh tack causes liver hemorrhage.
BACKGROUND
The laparoscopic approach is an increasingly popular option for ventral hernia repair. In the wake of this new technology, unexpected complications have been reported.


METHODS
We present the case of a patient who developed a liver laceration and hemorrhage after a mesh tacking device partially dislodged subsequent to ventral hernia repair. The patient underwent exploratory laparotomy, liver hemostasis and removal of the offending tack.


CONCLUSIONS
Our patient partially dislodged a mesh tacking device likely after violent coughing during a bout of pneumonia. The exposed blade caused a liver laceration and hemorrhage. Few other unexpected complications of the use of mesh tacking devices have been noted in the literature. Tackless hernia repair has also been described.


CONCLUSIONS
Laparoscopic ventral hernia repair with tacks may have unexpected complications of which the surgeon should be aware and advise patients. Our patient developed a liver laceration and symptomatic hemorrhage after partially dislodging a hernia mesh tack. Further research into tackless hernia repair may be beneficial. A low long-term recurrence rate would demonstrate if tackless hernia repair is a viable option.
Department of Surgery, Wyckoff Heights Medical Center, Brooklyn, NY, USA.
G
G
Baltazar
K
K
Coakley
A
A
Badiwala
A
A
Chendrasekhar
D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008099:Liver / Q000293:injuries*; D009765:Obesity / Q000150:complications; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome