, Volume 16, Issue 1, pp 69-76

Comparison of contracture, adhesion, tissue ingrowth, and histologic response characteristics of permanent and absorbable barrier meshes in a porcine model of laparoscopic ventral hernia repair

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Abstract

Purpose

The objective of this study was to determine the mesh contracture, adhesion, tissue ingrowth, and histologic characteristics of a novel absorbable barrier mesh (Ventrio ST Hernia Patch) compared to existing permanent (Ventrio Hernia Patch) and absorbable barrier meshes (Sepramesh IP Composite and PROCEED Surgical Mesh).

Methods

Standard laparoscopic technique was utilized to bilaterally implant meshes in 20 female Yorkshire pigs (n = 5 pigs/group). Meshes were fixated to the intact peritoneum with SorbaFix absorbable fixation devices. Mesh contracture, adhesion coverage, and adhesion tenacity were evaluated after 4 weeks. T-Peel testing and hematoxylin and eosin (H&E) staining were utilized to assess tissue ingrowth and host response.

Results

A significantly greater percent area contracture was demonstrated for PROCEED (26.9%) compared to Ventrio ST (8.8%), Ventrio (14.5%) and Sepramesh (9.2%). Ventrio ST demonstrated similar adhesion area, tenacity, and tissue ingrowth compared to all other meshes. Histological scoring revealed a comparable host inflammatory response for all meshes, with a few exceptions. A greater number of giant cells were observed in Ventrio ST and Sepramesh near the multifilament polyglycolic acid (PGA) fibers; a greater number of macrophages were observed in PROCEED compared to Ventrio; and a greater number of neutrophils were observed in PROCEED, compared to Sepramesh (P < 0.05). Focal areas of hemorrhage were also observed on the visceral surface of PROCEED™.

Conclusions

Ventrio ST Hernia Patch demonstrated comparable contracture, adhesion, tissue ingrowth, and histologic characteristics compared to existing permanent and absorbable barrier meshes. Host inflammatory and fibrotic responses for all four meshes were minimal and representative of a biocompatible response.

Presented as a poster at the 14th Annual Hernia Repair meeting of the American Hernia Society, March 2011, San Francisco, CA.