After reading the comment from Gachabayov M on our published study [1, 2], I do not think that our laparoscopic method of mesh removal was understood clearly. Therefore, I would like to explain this in detail, and this method has been addressed clearly in our previously published paper [3]. The first step was to explore the abdominal cavity thoroughly and to identify the infection. After the abscess of the abdominal wall was identified, a small incision was made at its lateral margin using endoscopic scissors. The pus from the abscess was aspirated completely to avoid contamination of the abdominal cavity and a pus sample was sent for cul-turing. Then, the peritoneum was developed approximately 2 cm above the internal inguinal ring to explore the infected mesh. The mesh was divided away with the laparoscopic grasper and suction. Separation of the mesh, especially from the pubic bone, can be difficult, and great care was taken to avoid injury to the bladder, inferior epigastric vessels, or iliac vessels. After thorough irrigation of the preperito-neal pocket, a drain with flushing function was inserted. The peritoneal flap was closed with 3/0 absorbable consecutive suture. If an abdominal wall sinus was present, an additional open excision was performed after methylene blue injection through the sinus. I hope the above explanation made it clear.
展开▼
