• 1 School of Medicine, University of Glasgow, Wolfson Medical School Building, University Avenue, Glasgow, G12 8QQ, Scotland, UK.
  • 2 Department of Nursing Science, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Malaysia
  • 3 The University of Queensland Mayne Medical School, 288 Herston Road, Herston, Brisbane, QLD, 4006, Australia
  • 4 Department of Pathology, University of Malaya, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia
  • 5 Department of Surgery, University of Malaya, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia
BMC Surg, 2016 Feb 11;16:8.
PMID: 26864939 DOI: 10.1186/s12893-016-0123-8


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.

CASE PRESENTATION: 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.

CONCLUSION: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.