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Surgical Endoscopy

, Volume 8, Issue 7, pp 812–816 | Cite as

Bursting strength evaluation

Comparison of 0-Prolene sutures and endoscopic staples in an experimental prosthetic patch repair of abdominal wall defect
  • Y. -M. Dion
  • J. Charara
  • R. Guidoin
Technique

Abstract

Recently, titanium staples have been designed to stabilize a small prosthetic mesh used for laparoscopic herniorrhaphy. Unlike the giant prosthesis employed by Stoppa, the small mesh must be fixed to the surrounding musculo-aponeurotic defect. The strength of these titanium staples has never been evaluated and was compared to 0-Prolene sutures. In an ex vivo study, we evaluated the maximal stress (bursting strength [BS]) a repair performed with 0-Prolene sutures or staples can bear. Bilateral abdominal-wall defects were created in 16 piglets. A Prolene mesh was fixed preperitoneally on one side of the abdomen with 0-Prolene sutures and on the other side with the Endopath EMS stapler or the Endo Hernia stapler. The mean BS of meshes attached with 0-Prolene was 1,461.7 mmHg. The mean BS of meshes fixed with Endopath EMS staples was 885.5 mmHg and that of meshes fixed with Endo Hernia staples was 665.2 mmHg. A repair with 0-Prolene sutures is stronger (P<0.05) than one with staples (Endopath EMS or Endo Hernia). Also, repair with an Endopath EMS stapler has a significantly higher BS (P<0.05) than one with the Endo Hernia stapler. In the second part of the study, evaluation of the longitudinal tensile strength also showed that 0-Prolene sutures are stronger (P<0.05) than staples. Endopath EMS staples are stronger (P<0.05) than Endo Hernia staples.

Key words

Abdominal wall defect Bursting strength Polypropylene mesh Endoscopic staples 

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References

  1. 1.
    Bassini E (1889) Nuovo metodo per la cura radicale dellernia inguinale. Prosperini, PaduaGoogle Scholar
  2. 2.
    Bendavid R (1989) New techniques in hernia repair. World J Surg 13: 522–531Google Scholar
  3. 3.
    Grew ND (1980) Intraabdominal pressure response to loads applied to the torso in normal subjects. Spine 5(2): 149–154Google Scholar
  4. 4.
    Hemborg B, Moritz U, Hamberg J, Holmstrom E, Lowing H, Akesson I (1985) Intra-abdominal pressure and trunk muscle activity during lifting. Scand J Rehab Med 17: 15–24Google Scholar
  5. 5.
    Lazorthes F, Browne AF (1984) Cure de hernie inguinale selon la technique de Shouldice. J Chir (Paris) 121(12): 765–770Google Scholar
  6. 6.
    Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension free hernioplasty. Am J Surg 157(2): 188–193Google Scholar
  7. 7.
    McVay CB, Chapp JD (1958) Inguinal and femoral hernioplasty. Evaluation of a basic concept. Ann Surg 148: 499–512Google Scholar
  8. 8.
    Nachemson AL, Andersson GBJ, Schultz AB (1986) Valsalva manuever biomechanics. Effects on lumbar trunk loads of elevated intraabdominal pressures. Spine 11(5): 476–479Google Scholar
  9. 9.
    Neufang T (1993) Laparoscopic repair of recurrent hernias—the German experience. Proceedings from Hernia 93: Advances or controversies. Indianapolis, USAGoogle Scholar
  10. 10.
    Nyhus LM (1989) The recurrent groin hernia: therapeutic solutions. World J Surg 13: 541–544Google Scholar
  11. 11.
    Nyhus LM, Klein MS, Rogers FB (1991) Inguinal hernia. Curr Probl Surg 28(6): 401–450Google Scholar
  12. 12.
    Peacock EE (1978) Biology of hernia. In: Hernia, 2nd ed. JB Lippincott, Philadelphia, pp 79–93Google Scholar
  13. 13.
    Read RC (1968) Preperitoneal exposure of inguinal herniation. Am J Surg 116: 653–658Google Scholar
  14. 14.
    Rignault DP (1986) Properitoneal prosthetic inguinal hernioplasty through a Pfannenstiel approach. Surg Gyn Obstet 163: 465–468Google Scholar
  15. 15.
    Rives J, Fortesa F, Drouard J, Hibon J, Flament JB (1976) La voie d'abord abdominale sous-péritonéale dans le traitement des hernies de l'aine. Ann Chir 32(3–4): 245–253Google Scholar
  16. 16.
    Rives J, Lardennois B, Flament JB, Convers G (1973) La pièce en tulle de dacron, traitement de chox des hernies de l'aine de l'adulte. Chirurgie 99: 564–575Google Scholar
  17. 17.
    Stoppa R (1989) The treatment of complicated groin and incisional hernias. World J Surg 13(5): 545–554Google Scholar
  18. 18.
    Stoppa R (1993) The pathogenic mechanism of groin hernias. Proceedings from Hernia 93: Advances or controversies. Indianapolis, USAGoogle Scholar
  19. 19.
    Stoppa R (1993) Giant prosthetic reinforcement of the visceral sac (G.P.R.V.S.). Proceedings from Hernia 93: Advances or controversies. Indianapolis, USAGoogle Scholar
  20. 20.
    Stoppa R, Henry X, Verhaeghe P, Odimba BBK (1981) La place des prosthèses réticulées non résorbables dans le traitement chirurgical des hernies de l'aine. Chirurgie (Mémoires de l'Académie) 107(5): 333–341Google Scholar
  21. 21.
    Stoppa R, Petit J, Abourachid H, Henry X, Duclaye C, Monchaux G, Hillebrant JP (1973) Procédé original de plastie des hernies de l'aine: L'interposition sans fixation d'une prothèse en tulle de Dacron par voie médiane sous péritonéale. Chirurgie 99(2): 119–124Google Scholar
  22. 22.
    Stoppa R, Petit J, Henry X (1975) Unsutured Dacron prosthesis in groin hernias. Int Surg 60(8): 411–412Google Scholar
  23. 23.
    Stoppa R, Verhaeghe P, Marasse E (1987) Mécanisme des hernies de l'aine. J Chir (Paris) 124(2): 125–131Google Scholar
  24. 24.
    Stoppa R, Warlaumont C, Verhaeghe P. (1987) Comment se constitute une hernie de l'aine? La Revue du Praticien 37(45): 2337–2742Google Scholar
  25. 25.
    Stoppa R, Warlaumont C, Verhaeghe P, Henry X (1983) Tulle de dacron et cure chirurgicale des hernies de l'aine. Chirurgie 109: 847–854Google Scholar
  26. 26.
    Odlaug TO (1966) Laboratory anatomy of the fetal pig, 3rd ed. WMC Brown, Dubuque, IA, USA, pp 8–19Google Scholar
  27. 27.
    Twardowski ZJ, Khanna R, Nolph KD, Scalamogna A, Metzler MH, Schneider TW, Prowant BF, Ryan LP (1986) Intraabdominal pressures during natural activities in patients treated with continuous ambulatory peritoneal dialysis. Nephron 44: 129–135Google Scholar

Copyright information

© Springer-Verlag New York Inc 1994

Authors and Affiliations

  • Y. -M. Dion
    • 1
    • 2
  • J. Charara
    • 2
  • R. Guidoin
    • 2
  1. 1.Department of SurgeryLaval University, Saint-François d'Assise HospitalQuebec CityCanada
  2. 2.Quebec Biomaterials InstituteSaint-François d'Assise HospitalQuebec CityCanada

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