Page 326 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 16
mesh can be partly excised to tighten the repair or the mesh can be removed and replaced. In this case however, bulging was an ongoing process, that nally resulted in mesh explantation and placement of a new mesh. In asymptomatic patients a watchful waiting approach seems justi ed(2).
Conclusion
A swelling after abdominal wall repair can be caused by bulging of the mesh. A progressive bulging might be the result of failure of the mesh implant due to elongation. The distinction between a recurrence and bulging of the mesh remains di cult even with radiological examinations but is therapeutically irrelevant in symptomatic patients.
324