Adhesion prevention in ventral hernia repair: an experimental study comparing three lightweight porous meshes recommended for intraperitoneal use
- 657 Downloads
In ventral hernia repair, when prosthetic material is placed intraperitoneally, it may lead to an inflammatory reaction resulting in adhesions between the mesh and abdominal viscera. Several meshes have been developed to minimize this process. In this experimental study, the ability of different combined meshes to attenuate the adhesion formation was examined.
Three commercially available lightweight porous combined meshes were placed intraperitoneally to repair an abdominal wall defect in rats: DynaMesh-IPOM (PVDF + PP), TiMesh (titanium-coated filament PP) and C-QUR/FX (omega-3 fatty acid-coated filament PP). The DynaMesh-CICAT (PVDF) was implanted in the control group. Adhesion formation was macroscopically evaluated and scored after 7 and 21 days.
All animals except two presented intra-abdominal adhesions. None of the meshes examined in the study demonstrated to prevent adhesions. C-QUR/FX reduced adhesion formation at 7 days’ follow-up compared with all other meshes but by 21 days this effect was diminished. Between 7 and 21 days adhesion extension significantly decreased for TiMesh. TAS did not show significant modifications between 7 and 21 days’ follow-up for each mesh.
The combined porous meshes tested in the present study demonstrated to reduce but not to prevent the adhesion formation, even if with some differences. Combined porous meshes could be chosen instead of simple meshes for retro-rectus preperitoneal prosthetic ventral hernia repair.
KeywordsExperimental ventral hernia Intraperitoneal adhesions IPOM Omega-3-fatty acids PVDF Titanized polypropylene mesh
Compliance with ethical standards
Conflict of interest
LD declares no conflict of interest. FC declares no conflict of interest. SM declares no conflict of interest. MF declares no conflict of interest. PN declares no conflict of interest. FG declares no conflict of interest.
This study was conducted using personal academic funds.
All procedures performed in the present study involving animals were in accordance with the ethical standards of national research commitee and with the 1964 Helsinki daclaration and its later amendments or comparable ethical standards. All applicable international, national and institutional guidelines for the care and use of animals were followed.
Informed consent was obtained from all individual partecipants included in the study.
- 2.Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 16(3):CD007781Google Scholar
- 4.Coda A, Lamberti R, Martorana S (2012) Classification of prosthetics used in hernia repair based on weight and biomaterial. Hernia 1:15–21Google Scholar
- 23.Pierce RA, Perrone JM, Nimeri A, Sexon JA, Walcutt J, Frisella M, Matthews BD (2009) 120-Day comparative analysis of adhesion grade and quality, mesh contraction and tissue response to a novel omega-3 fatty acid bioabsorbable barrier macroporous mesh after intraperitoneal placement. Surg Inn 16:45–54Google Scholar
- 24.Schug-Pass C, Sommerer F, Tannapfel A, Lippert H, Kockerling R (2008) Does the additional application of a polylactide film (SurgiWrap) to a lightweight mesh (TiMesh) reduce adhesion after laparoscopic intraperitoneal implantation procedures? Experimental results obtained with the laparoscopic porcine model. Surg Endosc 22:2433–2439CrossRefPubMedGoogle Scholar