title: Appendiceal adhesion to synthetic mesh after laparoscopic sacrocolpopexy: a case report.
abstract: Minimally invasive alternatives to abdominal sacrocolpopexy have been shown to be equivalent with low overall complication rates. A small number of direct mesh-related gastrointestinal complications have been reported in the literature. Sacrocolpopexy with mesh retroperitonealization is recommended to minimize bowel adhesions. A 53-year-old nulligravid woman presented with persistent right lower-quadrant pain 1 year after laparoscopic sacrocolpopexy. The polypropylene mesh used during the case was retroperitonealized. Computed tomography (CT) prior to surgical exploration revealed no obvious pathology. On diagnostic laparoscopy, appendiceal adhesion to mesh requiring an appendectomy was observed. The patient's symptoms resolved after surgical intervention. Appendiceal adhesion to surgical mesh leading to chronic discomfort is a potential complication of intraperitoneal synthetic mesh placement. Our case emphasizes that bowel adhesions may occur even after proper mesh retroperitonealization. Appendiceal adhesion to the surgical site is a potential complication of retroperitonealized synthetic mesh placement at the time of sacrocolpopexy.
authors.affiliation: Department of Urogynecology, Brigham and Women's Hospital, 500 Brookline Ave 500B-Suite E, Boston, MA, 02114, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vargas
authors.forename: Anna
authors.initials: A
authors.lastname: Keryan
authors.forename: Vatche A
authors.initials: VA
authors.lastname: Minassian
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery; D001062:Appendectomy; D002429:Cecal Diseases / Q000209:etiology* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D000267:Tissue Adhesions / Q000209:etiology* / Q000601:surgery