title: Inflammatory reaction to fish oil coated polypropylene mesh used for laparoscopic incisional hernia repair: a case report.
abstract: BACKGROUND
  Polypropylene meshes are widely used in hernia repairs. Hernia meshes have been developed incorporating coatings of active agents. One commercially available mesh has a fish oil coating which is promoted as having anti-inflammatory properties. We report a case, a symptomatic foreign body granuloma reaction associated with a fish oil coated polypropylene mesh, which required eventual mesh explantation.
  
  
  METHODS
  A 61-year old lady with previous peptic ulcer disease underwent a laparoscopic intraperitoneal placement of mesh for incisional hernia utilising a fish oil coated polypropylene mesh. The patient presented 3 months after the procedure complaining of dyspepsia and pain at the operative site. There was no discharge. The patient was managed conservatively. She presented 10 months post-operatively with progressively worsening symptoms and a hard palpable mass in the epigastrium. Abdominal laparoscopy revealed dense adhesive disease around the mesh with exudates. Adhesiolysis, mesh explantation and a partial gastrectomy was performed. Histopathological examination revealed a foreign body granuloma formation to the mesh.
  
  
  CONCLUSIONS
  In-vivo studies looking at intraperitoneal mesh placement with fish oil coatings including data on surgical outcomes such as fistula and adhesive characteristics are scarce in the literature. Further monitoring and studies are required to investigate the safety and efficacy profile of this mesh type in in-vivo models.
authors: School of Medicine, University of Glasgow, Wolfson Medical School Building, University Avenue, Glasgow, G12 8QQ, Scotland, UK. 2054397K@student.gla.ac.uk.
authors: Chia Yew
authors: CY
authors: Kong
authors: Department of Nursing Science, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
authors: Lee Lee
authors: LL
authors: Lai
authors: The University of Queensland Mayne Medical School, 288 Herston Road, Herston, Brisbane, QLD, 4006, Australia.|Redland Hospital, Weippin Street, Cleveland, QLD, Australia.
authors: Amanda Yin Yen
authors: AYY
authors: Khoo
authors: Department of Pathology, University of Malaya, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
authors: Nazarina Abdul
authors: NA
authors: Rahman
authors: Department of Surgery, University of Malaya, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.|Department of Surgery, Tunku Abdul Rahman University, Sungai Long Campus, Jalan Sungai Long, Bandar Sungai Long, Cheras, 43000, Kajang, Selangor, Malaysia.
authors: Kin Fah
authors: KF
authors: Chin
mesh_terms: D005260:Female; D005395:Fish Oils / Q000009:adverse effects*; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology / Q000601:surgery*; D007249:Inflammation; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation*; D008875:Middle Aged; D011126:Polypropylenes / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects*
chemical_list: D005395:Fish Oils; D011126:Polypropylenes