Skip to main content
SpringerLink
Log in

Laparoscopic transabdominal preperitoneal approach to place a polypropylene mesh on the abdominal wall: an experimental swine model of a technique that can be used for incisional hernia repair

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

The placement of intraabdominal polypropylene mesh entails risks of adhesions and fistulas that can be avoided by preperitoneal placement.

Methods

This comparative, open, experimental, prospective, randomized, and transversal study randomized pigs into two groups of 11 each for intraperitoneal (IPOM) or preperitoneal (TAPP) polypropylene mesh placement by laparoscopy. Diagnostic laparoscopy and tissue en-bloc resection was performed 28 days postoperatively for histopathologic analysis.

Results

The following data were observed for the two study groups: surgical time (IPOM: 35.73 ± 4.22 min; TAPP: 58.09 ± 6.28 min; p = <0.0001); adhesions (IPOM: 81.81%; TAPP: 27.27%; p = 0.032), grade III for IPOM and grade II for TAPP (p = 0.001); and interloop adhesions (IPOM: 81.81%; TAPP: 9.09%; p = 0.003). No fistulas were found in either group. The TAPP procedure showed better integration of mesh, without lesion to abdominal organs. Two complications, occurred with IPOM, and one with TAPP (p = 1.0, not significant).

Conclusions

The perperitoneal technique requires more time, but has fewer adhesions and less intraabdominal inflammatory response. It is a feasible technique that may diminish risks in the laparoscopic treatment of incisional hernias with polypropylene mesh.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others

References

  1. Abrahamson, J (1997) “Hernias” In: Schwartz, SI, Ellis, H (eds.), Maingot’s abdominal operations, Appleton & Lange, Stamford, CT, pp 479–580

  2. PK Amid AG Shulman IL Lichtenstein S Sostrin J Young M Hakakha (1994) ArticleTitleExperimental evaluation of a new composite mesh with selective property of incorporation to the abdominal wall without adhering to the intestines J Biomed Mater Res 28 373–375 Occurrence Handle10.1002/jbm.820280312 Occurrence Handle8077252

    Article  PubMed  Google Scholar 

  3. PK Amid (2000) ArticleTitleIntraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula Br J Surg 87 1436–1437 Occurrence Handle10.1046/j.1365-2168.2000.0870101436.x

    Article  Google Scholar 

  4. ML Baptista ME Bonsack JP Delaney (2000) ArticleTitleSeprafilm reduces adhesions to polypropylene mesh Surgery 128 86–92 Occurrence Handle10.1067/msy.2000.106810 Occurrence Handle10876190

    Article  PubMed  Google Scholar 

  5. JJ Bauer BA Salky IM Gelernt L Kreel (1987) ArticleTitleRepair of large abdominal defects with expanded polytetrafluoroethylene (PTFE) Ann Surg 206 765–769 Occurrence Handle3689012

    PubMed  Google Scholar 

  6. T Billroth (1881) Clinical surgery: extracts from reports of surgical practice between the years 1860–1876 New Sydenham Society London

    Google Scholar 

  7. CP Brandt CR McHenry DG Jacobs JJ Piotrowski PP Priebe (1995) ArticleTitlePolypropylene mesh closure after emergency laparotomy: morbidity and outcome Surgery 118 736–740 Occurrence Handle7570330

    PubMed  Google Scholar 

  8. EJ De Maria ParticleDe JM Moss HJ Sugerman (2000) ArticleTitleLaparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia: prospective comparison to open prefascial polypropylene mesh repair Surg Endosc 14 326–329 Occurrence Handle10.1007/s004640020013 Occurrence Handle10790548

    Article  PubMed  Google Scholar 

  9. GM Eid JM Prince SG Mattar G Hamad S Ikrammudin PR Schauer (2003) ArticleTitleMedium term follow-up confirms the safety and durability of laparoscopic ventral hernia repair with PTFE Surgery 134 599–603 Occurrence Handle10.1016/S0039-6060(03)00283-6 Occurrence Handle14605620

    Article  PubMed  Google Scholar 

  10. S Langner J Christiansen (1985) ArticleTitleLong-term results after incisional hernia repair Acta Chir Scand 151 217–219 Occurrence Handle4013599

    PubMed  Google Scholar 

  11. RW Luijendijk DCD Lange Particlede CCAP Wauters WCJ Hop JJ Duron JL Pailler BR Camprodon L Holmdahl HJ Geldrop Particlevan J Jeekel (1996) ArticleTitleForeign material in postoperative adhesions Ann Surg 223 242–248 Occurrence Handle10.1097/00000658-199603000-00003 Occurrence Handle8604903

    Article  PubMed  Google Scholar 

  12. RW Luijendijk WCJ Hop MP Tol Particlevan den DCD de Lange Particlede MMJ Braaksma JNM Ijzermans RU Boelhouwer BC de Vries Particlede MKM Salu JCJ Wereldsma CMA Bruijninckx J Jeekel (2000) ArticleTitleA comparison of suture repair with mesh repair for incisional hernia N Engl J Med 343 392–398 Occurrence Handle10.1056/NEJM200008103430603 Occurrence Handle10933738

    Article  PubMed  Google Scholar 

  13. BV MacFadyen ME Arregui JD Corbitt CJ Filipi RJ Fitzgibbons ME Franklin JB McKernan DO Olsen EH Phillips D Rosenthal (1993) ArticleTitleComplications of laparoscopic herniorrhaphy Surg Endosc 7 155–158 Occurrence Handle10.1007/BF00594097 Occurrence Handle8503070

    Article  PubMed  Google Scholar 

  14. K Miller W Junger (1997) ArticleTitleIleocutaneous fistula formation following laparoscopic polypropylene mesh hernia repair Surg Endosc 11 772–773 Occurrence Handle10.1007/s004649900448 Occurrence Handle9214331

    Article  PubMed  Google Scholar 

  15. R Schneider JL Herrington SuffixJr AM Granada (1979) ArticleTitleMarlex mesh repair of a diaphragmatic defect later eroding into the distal esophagus and stomach Am Surg 45 337–339 Occurrence Handle378054

    PubMed  Google Scholar 

  16. RS Smith (1971) ArticleTitleThe use of prosthetic materials in the repair of hernias Surg Clin North Am 51 1387–1389 Occurrence Handle4256971

    PubMed  Google Scholar 

  17. HH Stone TC Fabian ML Turkleson MJ Jurkiewicz (1981) ArticleTitleManagement of acute full-thickness losses of abdominal wall due to infection Ann Surg 193 612–618 Occurrence Handle6263197

    PubMed  Google Scholar 

  18. FC Usher (1963) ArticleTitleHernia repair with knitted polypropylene mesh Surg Gynecol Obstet 17 239–240

    Google Scholar 

  19. WW Vrijland J Jeekel EW Steyerberg PT Den Hoed ParticleDen HJ Bonjer (2000) ArticleTitleIntraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula Br J Surg 87 348–352 Occurrence Handle10.1046/j.1365-2168.2000.01364.x Occurrence Handle10718806

    Article  PubMed  Google Scholar 

  20. HV Zühlke EMP Lorenz EM Straub V Savvas (1990) ArticleTitlePathophysiologie und klassifikation von adhäsionen Langenbecks Arch Chir Suppl II . IssueIDKongressbericht 1009–1016

    Google Scholar 

Download references

Acknowledgments

The authors acknowledge the assistance of Act. Yolanda Perdomo Jiménez in the statistical analysis.

Author information

Authors and Affiliations

  1. Division of Endoscopic Surgery, Hospital General “Dr. Manuel Gea González”, Calzada de Tlalpan 4800. Col. Toriello Guerra, C.P. 14000, Tlalpan, Mexico D.F., Mexico

    J. I. Díaz-Pizarro Graf & M. Moreno Portillo

  2. Division of Experimental Surgery, Hospital General “Dr. Manuel Gea González”, Calzada de Tlalpan 4800. Col. Toriello Guerra, C.P. 14000, Tlalpan, Mexico D.F., Mexico

    L. E. Cárdenas Lailson

  3. Division of General Surgery, Hospital General “Dr. Manuel Gea González”, Calzada de Tlalpan 4800. Col. Toriello Guerra, C.P. 14000, Tlalpan, Mexico D.F., Mexico

    M. E. Ramírez Solís & J. A. Palacios Ruiz

  4. Divsion of Pathology, Hospital General “Dr. Manuel Gea González”, Calzada de Tlalpan 4800. Col. Toriello Guerra, C.P. 14000, Tlalpan, Mexico D.F., Mexico

    S. Parraguirre Martínez

Authors
  1. J. I. Díaz-Pizarro Graf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Moreno Portillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. E. Cárdenas Lailson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. E. Ramírez Solís
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. A. Palacios Ruiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Parraguirre Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. I. Díaz-Pizarro Graf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Graf, J.I.DP., Moreno Portillo, M., Lailson, L.E.C. et al. Laparoscopic transabdominal preperitoneal approach to place a polypropylene mesh on the abdominal wall: an experimental swine model of a technique that can be used for incisional hernia repair. Surg Endosc 19, 990–995 (2005). https://doi.org/10.1007/s00464-003-8291-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-8291-x

Keywords

Search

Navigation