Two Rare Cases of Mesh Infection Due to Mycobacterium abscessus Following Laparoscopic Inguinal Hernia Repair

Background: Mesh infections after laparoscopic inguinal hernia repair are rare, particularly those caused by Mycobacterium abscessus , a multi-drug-resistant nontuberculous mycobacterium. Case Presentation: We describe two cases of M. abscessus infection following total extraperitoneal inguinal hernia repairs. Both patients developed delayed groin pain and fluid collections. Cultures confirmed M. abscessus , requiring mesh explanation and prolonged multi-drug antibiotic therapy. Despite complications, both achieved infection resolution after approximately 12 months. Discussion: Investigation suggested contamination of laparoscopic instrument sheaths as the infection source, prompting changes in sterilization protocols. The pathogen’s biofilm formation and resistance to sterilization contributed to persistence. Conclusion: Early recognition, mesh removal, and multi-disciplinary care are essential for successful management of M. abscessus mesh infections. Strict adherence to sterilization protocols is critical in preventing such rare but serious complications.