Absorbable synthetic mesh (polyglactin 910) for the formation of a pelvic "lid" after radical pelvic resection.

Isolation of the abdominal contents from the denuded, potentially infected pelvis after radical pelvic surgery has been advocated. Of the many materials evaluated, omentum is usually chosen. In six patients in whom omentum was unsuitable, we have substituted polyglactin 910 (Vicryl, Ethicon, Sommerville, New Jersey) mesh to form a pelvic "lid." In these patients, omentum was either densely adherent in the upper abdomen because of prior surgery or was removed as part of surgical treatment for recurrent cancer. Vicryl mesh formed a "lid" across the true pelvis. No gastrointestinal complications occurred in these patients. Four patients developed pelvic infections that resolved after surgical drainage and antibiotic therapy. No patients developed peritonitis above the pelvis. No chronic infections have been found in more than 12 to 48 months of follow-up. In this preliminary experience, Vicryl mesh appears to be useful for the formation of a pelvic "lid" after exenterative pelvic surgery when the omentum is unavailable.