Infected surgical mesh is a challenging complication following hernia repair and may present with persistent pain, chronic discharging sinus, recurrent abscess, mesh erosion, adhesions, or failure of conservative treatment. When mesh infection becomes established, complete removal of the infected prosthetic material may be required to achieve definitive source control.

In this surgical video, Dr. R.K. Mishra demonstrates the laparoscopic removal of an infected surgical mesh, highlighting a systematic and minimally invasive approach to this technically demanding procedure. Careful laparoscopic exploration allows assessment of the infected mesh, surrounding adhesions, bowel involvement, and the relationship of the prosthesis to the abdominal wall and adjacent structures.

The procedure emphasizes meticulous adhesiolysis and controlled mesh dissection, with particular attention to avoiding inadvertent bowel injury. The mesh is progressively separated from surrounding tissues while maintaining precise hemostasis and protecting adherent viscera. In cases of chronic infection, dense fibrosis and tissue incorporation can make explantation particularly difficult, requiring patience, anatomical orientation, and advanced laparoscopic skills.

This operative demonstration focuses on important surgical principles including safe abdominal access, identification of adhesions, careful bowel separation, recognition of potentially involved structures, complete removal of infected foreign material when appropriate, contamination control, and thorough inspection of the operative field following mesh explantation.

Laparoscopic management can provide excellent visualization of the abdominal cavity and may reduce the morbidity associated with a large open incision in appropriately selected patients. However, the operative strategy must always be individualized according to the location and type of mesh, extent of infection, presence of fistula or bowel involvement, previous operations, and abdominal wall condition.

This educational video is intended for surgeons and trainees interested in advanced laparoscopic surgery, hernia surgery, management of mesh-related complications, and minimally invasive surgical techniques. It demonstrates the importance of precise dissection, sound surgical judgment, and patient-specific planning when managing infected prosthetic mesh.