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Hernia

, Volume 21, Issue 1, pp 115–123 | Cite as

Adhesion prevention in ventral hernia repair: an experimental study comparing three lightweight porous meshes recommended for intraperitoneal use

  • L. D’AmoreEmail author
  • F. Ceci
  • S. Mattia
  • M. Fabbi
  • P. Negro
  • F. Gossetti
Original Article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Experimental ventral hernia Intraperitoneal adhesions IPOM Omega-3-fatty acids PVDF Titanized polypropylene mesh 

Notes

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.

Funding

This study was conducted using personal academic funds.

Ethical approval

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

Informed consent was obtained from all individual partecipants included in the study.

References

  1. 1.
    Conze J, Binnebosel M, Junge K, Schumpelick V (2010) Incisional hernia. How do I do it? Standard surgical approach. Chirurg 81:192–200CrossRefPubMedGoogle Scholar
  2. 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
  3. 3.
    Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF (2007) Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 31:423–429 (discussion 430) CrossRefPubMedGoogle Scholar
  4. 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
  5. 5.
    Robinson TN, Clarke JH, Schoen J, Walsh MD (2005) Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc 19:1556–1560CrossRefPubMedGoogle Scholar
  6. 6.
    Eriksen JR, Gogenur I, Rosenberg J (2007) Choice of mesh for laparoscopic ventral hernia repair. Hernia 11:481–492CrossRefPubMedGoogle Scholar
  7. 7.
    Gaertner WB, Bonsack ME, Delany JP (2010) Visceral adhesions to hernia prostheses. Hernia 14:375–381CrossRefPubMedGoogle Scholar
  8. 8.
    Vogels RRM, van Barneveld KWY, Bosman JWAM, Bets G, Gijbels MJJ, Schreinemacher MHF, Bouvy ND (2015) Long-term evaluation of adhesion formation and foreign body response to three new meshes. Surg Endosc 29:2251–2259CrossRefPubMedGoogle Scholar
  9. 9.
    Dilege E, Coskun H, Gunduz B, Sakiz D, Mihmanli M (2006) Prevention of adhesion to prosthetic mesh in incisional ventral hernias: comparison of different barriers in an experimental model. Eur Surg Res 38:358–364CrossRefPubMedGoogle Scholar
  10. 10.
    Schreinemacher MHF, Emans PJ, Gijbels MJJ, Greve JWM, Beets GL, Bouvy ND (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96:305–313CrossRefPubMedGoogle Scholar
  11. 11.
    Konerding MA, Chanterau P, Delventhal V, Holste JL, Ackermann M (2012) Biomechanical and histologic evaluation of abdominal wall compliance with intraperitoneal onlay mesh implants in rabbits: a comparison of six different state-of-the-art meshes. Med Eng Phys 34:806–816CrossRefPubMedGoogle Scholar
  12. 12.
    Schreinemacher MHF, van Barneveld KWY, Dikmans REG, Gijbels MJJ, Greve JWM, Bouvy ND (2013) Coated meshes for hernia repair provide comparable intraperitoneal adhesion prevention. Surg Endosc 27:4202–4209CrossRefPubMedGoogle Scholar
  13. 13.
    Klinge U, Klosterhalfen B (2012) Modified classification of surgical meshes for hernia repair based on the analyses of 1,000 explanted meshes. Hernia 16:251–258CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gaertner WB, Bonsack ME, Delaney JP (2007) Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 11:1275–1285CrossRefPubMedGoogle Scholar
  15. 15.
    Garrard CL, Clement RH, Nannej L, Davidson JM, Richards WO (1999) Adhesion formation is reduced after laparoscopic surgery. Surg Endosc 13:10–13CrossRefPubMedGoogle Scholar
  16. 16.
    Baptista ML, Bonsack ME, Felemovicious I, Delaney JP (2000) Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy. J Am Coll Surg 190:271–280CrossRefPubMedGoogle Scholar
  17. 17.
    Matthews BD, Pratt BL, Backus CL, Kerche KW, Heniford BT (2002) Comparison of adhesion formation to the intra-abdominal mesh after laparoscopic adhesiolysis in the New Zealand white rabbit. Am Surg 68:936–940PubMedGoogle Scholar
  18. 18.
    Conze J, Junge K, Weiss C, Oettinger A, Schumpelick V (2008) New polymer for intra-abdominal meshes—PVDF copolymer. J Biomed Mater Res B Appl Biomater 87:321–328CrossRefPubMedGoogle Scholar
  19. 19.
    Scheidbach H, Tannapfel A, Schmidt U, Lippert H, Kockerling F (2004) Influence of titanium coating on the biocompatibility of a heavyweight polypropylene mesh. Eur Surg Res 36:313–317CrossRefPubMedGoogle Scholar
  20. 20.
    Boutros C, Somasundar P, Razzak A, Helton S, Espat NJ (2010) Omega-3 fatty acids: investigations from cytokines regulation to pancreatic cancer gene suppression. Arch Surg 145:515–520CrossRefPubMedGoogle Scholar
  21. 21.
    Junge K, Binnebosel M, Rosch R, Jansen M, Kammer D, Otto J, Schumpelick V, Klinge U (2009) Adhesion formation on polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg Endosc 23:327–333CrossRefPubMedGoogle Scholar
  22. 22.
    Bellon JM, Jurado F, Garcia-Honduvilla N, Lopez R, Carrera-Sanmartin A, Bujan J (2002) The structure of a biomaterial rather than its chemical composition modulates the repair process at the peritoneal level. Am J Surg 184:154–159CrossRefPubMedGoogle Scholar
  23. 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. 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
  25. 25.
    Berger D, Bientzle M (2007) Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients. Dis Colon Rectum 50:1668–1673CrossRefPubMedGoogle Scholar
  26. 26.
    Berger D, Bientzle M (2009) Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia 13:167–172CrossRefPubMedGoogle Scholar
  27. 27.
    Fortenly RH, Petter-Puchner AH, Glaser KS, Offner F, Benesch T, Rohr M (2010) Adverse effects of polyvinylidene fluoride-coated polypropylene mesh used for laparoscopic intraperitoneal onlay repair of incisional hernia. Br J Surg 97:1140–1145CrossRefGoogle Scholar
  28. 28.
    Klosterhalfen B (2011) Letter2: adverse effects of polyvinylidene fluoride-coated polypropylene mesh used for laparoscopic intraperitoneal onlay repair of incisional hernia. Br J Surg 98:159–160CrossRefPubMedGoogle Scholar
  29. 29.
    Jamry A, Jalynski M, Piskorz L, Brocki M (2013) Assessment of adhesion formation after laparoscopic intraperitoneal implantation of Dynamesh IPOM mesh. Arch Med Sci 20:487–492CrossRefGoogle Scholar
  30. 30.
    Sommer T, Friis-Andersen H (2013) DynaMesh in the repair of laparoscopic ventral hernia. A prospective study. Hernia 17:613–618CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • L. D’Amore
    • 1
    Email author
  • F. Ceci
    • 1
  • S. Mattia
    • 2
  • M. Fabbi
    • 2
  • P. Negro
    • 1
  • F. Gossetti
    • 1
  1. 1.Department of Surgery P.StefaniniSapienza University of RomeRomeItaly
  2. 2.School of SurgerySapienza University of RomeRomeItaly

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