Skip to main content
Top
Published in: Hernia 3/2021

01-06-2021 | Inguinal Hernia | Original Article

Magnetic resonance visualization of iron-loaded meshes in patients with pain after inguinal hernia repair

Authors: E. Özveri, D. E. T. Şanlı, D. Yıldırım, H. Gök, M. Ertem

Published in: Hernia | Issue 3/2021

Login to get access

Abstract

Purpose

Chronic post-operative inguinal pain (CPIP) is defined as pain lasting more than 3 months and the incidence is less than 4% after laparoscopic hernia repair. CPIP can have several causes. In this study, we aimed to show that 3D-iron loaded mesh preparations are useful in radiological evaluation of post-operative complications, especially patients with chronic pain and the mesh status of operated inguinal hernia cases.

Methods

A total of 450 cases who had been operated for inguinal hernia with 3D-iron loaded mesh and who had ongoing pain at the post-operative period were included in this study. MRI (Magnetic Resonance Imaging) was performed at the post-operative 90th day of the seven symptomatic (groin pain, limitation of movement) cases which were operated using a 3D-iron loaded mesh, 10 × 15 cm in size, (DynaMeshEndolap visible with 25% MRI-visible filaments, FEG TextiltechnikmbH, Aachen, Germany) for inguinal hernia repair to evaluate mesh status, localization, and local complications. Gradient echo sequences in the sagittal, axial, and coronal sections on MRI were discussed by two radiologists. Mesh localizations, their relationship with surrounding structures and their complications related with mesh were evaluated by two radiologists (D.Y, D.E.T.Ş).

Results

No significant radiological findings related to defined anatomical structures were found in the MRI images of the study group. The dimensions measured on the sagittal, axial and coronal images were correlated with original mesh sizes and no significant shrinkage was detected.

Conclusion

Mesh position and deformation as shrinkage can be the mesh-related cause of pain. The incidence of CPIP in our patients is less than 2%. 3D-iron loaded meshes were monitored with MRI in CPIP patients and there was no mesh-related changes found in our study. The use of MRI-visible meshes will most likely help us to monitor mesh preparations and show potential time-dependent changes in mesh characteristics and consequent complications. In case of doubtful clinical postoperative hernia recurrence or chronic groin pain, mesh position can be identified by MRI and unnecessary surgical intervention can be avoided.
Literature
1.
go back to reference Primatesta P, Goldacre MJ (1996) Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 25:835–839CrossRef Primatesta P, Goldacre MJ (1996) Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 25:835–839CrossRef
2.
go back to reference Kingsnorth AN, LeBlanc KA (2003) Management of abdominal hernias, 3rd edn. Edward Arnold, London, pp 40–47 Kingsnorth AN, LeBlanc KA (2003) Management of abdominal hernias, 3rd edn. Edward Arnold, London, pp 40–47
3.
go back to reference Aasvang EK, Gmaehle E, Hansen JB et al (2010) Predictive risk factors for persistent postherniotomy pain. Anesthesiology 112(4):957–969CrossRef Aasvang EK, Gmaehle E, Hansen JB et al (2010) Predictive risk factors for persistent postherniotomy pain. Anesthesiology 112(4):957–969CrossRef
4.
go back to reference Andresen K, Burcharht J, Fonnes S et al (2017) Chronic pain after inguinal hernia repair with the ONSTEP versus the Lichtenstein technique, results of a double-blinded multicenter randomized clinical trial. Langenbecks Arch Surg 402(2):213–218CrossRef Andresen K, Burcharht J, Fonnes S et al (2017) Chronic pain after inguinal hernia repair with the ONSTEP versus the Lichtenstein technique, results of a double-blinded multicenter randomized clinical trial. Langenbecks Arch Surg 402(2):213–218CrossRef
5.
go back to reference Andersen K, Fenger AQ, Burchharth J, Pommergaard HC, Rosenberg J (2017) Mesh fixation methods and chronic pain after transabdominal preperitoneal (TAPP) inguinal hernia surgery: a comparison between fibrin sealant and tacks. SurgEndosc 31(10):4077–4084 Andersen K, Fenger AQ, Burchharth J, Pommergaard HC, Rosenberg J (2017) Mesh fixation methods and chronic pain after transabdominal preperitoneal (TAPP) inguinal hernia surgery: a comparison between fibrin sealant and tacks. SurgEndosc 31(10):4077–4084
6.
go back to reference Amid PK (2004) Radiologic images of meshoma a new phenomenon causing chronic pain after prosthetic repair of abdominal wall hernias. JAMA Surg 139(12):1297–1298 Amid PK (2004) Radiologic images of meshoma a new phenomenon causing chronic pain after prosthetic repair of abdominal wall hernias. JAMA Surg 139(12):1297–1298
7.
go back to reference Kraemer NA, Donker HC, Otto J et al (2010) A concept formagnetic resonance visualisation of surgical textile implants. Invest Radiol 45:477–483CrossRef Kraemer NA, Donker HC, Otto J et al (2010) A concept formagnetic resonance visualisation of surgical textile implants. Invest Radiol 45:477–483CrossRef
8.
go back to reference Donker HC, Kraemer NA, Otto J et al (2012) Mapping of proton relaxation near superparamagnetic iron oxide particle-loaded polymer threads for magnetic susceptibility difference quantification. Invest Radiol 47:359–367CrossRef Donker HC, Kraemer NA, Otto J et al (2012) Mapping of proton relaxation near superparamagnetic iron oxide particle-loaded polymer threads for magnetic susceptibility difference quantification. Invest Radiol 47:359–367CrossRef
9.
go back to reference Slabu I, Guentheradt G, Schmitz-Rode T et al (2012) Investigation of superparamagnetic iron oxide nanoparticles for MR-visualization of surgical implants. Curr Pharm Biotechnol 13:545–551CrossRef Slabu I, Guentheradt G, Schmitz-Rode T et al (2012) Investigation of superparamagnetic iron oxide nanoparticles for MR-visualization of surgical implants. Curr Pharm Biotechnol 13:545–551CrossRef
10.
go back to reference Ciritsis A, Hansen NL, Barabasch A et al (2014) Time-dependent changes of magnetic resonance imaging-visible mesh implants in patients. Invest Radiol 49:439–444CrossRef Ciritsis A, Hansen NL, Barabasch A et al (2014) Time-dependent changes of magnetic resonance imaging-visible mesh implants in patients. Invest Radiol 49:439–444CrossRef
11.
go back to reference Kraemer NA, Donker HC, Kuehnert N, Otto J, Schrading S, Krombach GA et al (2013) In vivo visualization of polmer-based mesh implants using conventional magnetic resonance imaging and positive contrast susceptibility imaging. Invest Radiol 48:200–205CrossRef Kraemer NA, Donker HC, Kuehnert N, Otto J, Schrading S, Krombach GA et al (2013) In vivo visualization of polmer-based mesh implants using conventional magnetic resonance imaging and positive contrast susceptibility imaging. Invest Radiol 48:200–205CrossRef
12.
go back to reference Olsson A, Sandblom G, Franneby U, Sonden A, Gunnarsson U, Dahlstrand U (2019) The short-form inguinal pain questionnaire (sf-IPQ): An instrument for rating groin pain after inguinal hernia surgery in daily clinical practice. World J Surg 43(3):806–881CrossRef Olsson A, Sandblom G, Franneby U, Sonden A, Gunnarsson U, Dahlstrand U (2019) The short-form inguinal pain questionnaire (sf-IPQ): An instrument for rating groin pain after inguinal hernia surgery in daily clinical practice. World J Surg 43(3):806–881CrossRef
13.
go back to reference EU Hernia Trialists Collaboration (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trails. Br J Surg 87:854–859CrossRef EU Hernia Trialists Collaboration (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trails. Br J Surg 87:854–859CrossRef
14.
go back to reference Page B, Paterson C, Young D et al (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89:1315–1318CrossRef Page B, Paterson C, Young D et al (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89:1315–1318CrossRef
15.
go back to reference Burgmans JP, Voorbrood CE, Simmermacher RK et al (2016) Long term results of a randomized double-blinded prospective trial of a lightweight (Ultrapro) versus a heavyweight mesh (prolene) in laparoscopic total extraperitoneal inguinal hernia repair (TULP-trial). Ann Surg 263(5):862–866CrossRef Burgmans JP, Voorbrood CE, Simmermacher RK et al (2016) Long term results of a randomized double-blinded prospective trial of a lightweight (Ultrapro) versus a heavyweight mesh (prolene) in laparoscopic total extraperitoneal inguinal hernia repair (TULP-trial). Ann Surg 263(5):862–866CrossRef
16.
go back to reference HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1–165CrossRef HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1–165CrossRef
17.
go back to reference Wermer MU, Kongsgaard UEI (2014) Defining persistent post-surgical pain:is an update required. Br J Anaesth 113(1):1–4CrossRef Wermer MU, Kongsgaard UEI (2014) Defining persistent post-surgical pain:is an update required. Br J Anaesth 113(1):1–4CrossRef
18.
go back to reference Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long term pain after hernia surgery. Ann Surg 244:212–219CrossRef Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long term pain after hernia surgery. Ann Surg 244:212–219CrossRef
19.
go back to reference Olsson A, Sandblom G, Franneby U, Sonden A, Gunnarsson U, Dahlstrand U (2017) Impact of postoperative complications on the risk of chronic groin pain after open inguinal hernia repair. Surgery 161:509–516CrossRef Olsson A, Sandblom G, Franneby U, Sonden A, Gunnarsson U, Dahlstrand U (2017) Impact of postoperative complications on the risk of chronic groin pain after open inguinal hernia repair. Surgery 161:509–516CrossRef
20.
go back to reference Poobalan AS, Bruce J, King PM et al (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88:1122CrossRef Poobalan AS, Bruce J, King PM et al (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88:1122CrossRef
21.
go back to reference Aasvang EK, Mohl B, Bay-Nielsen M, Kehlet H (2006) Pain related sexual dysfunction after inguinal herniorrhaphy. Pain 122:258CrossRef Aasvang EK, Mohl B, Bay-Nielsen M, Kehlet H (2006) Pain related sexual dysfunction after inguinal herniorrhaphy. Pain 122:258CrossRef
22.
go back to reference Hawn MT, Itani KM, Giobbie-Hurder A et al (2006) Patient-reported outcomes after inguinal herniorrhaphy. Surgery 140:198CrossRef Hawn MT, Itani KM, Giobbie-Hurder A et al (2006) Patient-reported outcomes after inguinal herniorrhaphy. Surgery 140:198CrossRef
23.
go back to reference Hakeem A, Shanmugam V (2011) Current trends in the diagnosis and management of post-herniorraphy chronic groin pain. World J Gastrointest Surg 3:73CrossRef Hakeem A, Shanmugam V (2011) Current trends in the diagnosis and management of post-herniorraphy chronic groin pain. World J Gastrointest Surg 3:73CrossRef
24.
go back to reference Köhler G, Pallwein-Prettner L, Koch OO, Luketina RR, Lechner M, Emmanuel K (2015) Magnetic resonance-visible meshes for laparoscopic ventral hernia repair. JSLS 19(1):00175CrossRef Köhler G, Pallwein-Prettner L, Koch OO, Luketina RR, Lechner M, Emmanuel K (2015) Magnetic resonance-visible meshes for laparoscopic ventral hernia repair. JSLS 19(1):00175CrossRef
25.
go back to reference Otto J, Kuehnert N, Busch D, Lambertz A, Klink C, Hansen NL, Ciritsis A, Kuhl C, Klinge U, Neumann UP, Conze J, Kraemer NA (2014) MR-visualization of surgical textile implants. BioNanomaterials 15(1–2):3–8 Otto J, Kuehnert N, Busch D, Lambertz A, Klink C, Hansen NL, Ciritsis A, Kuhl C, Klinge U, Neumann UP, Conze J, Kraemer NA (2014) MR-visualization of surgical textile implants. BioNanomaterials 15(1–2):3–8
26.
go back to reference Hansen NL, Barabasch A, Distelmaier M et al (2013) First in human magnetic resonance visualization of surgical mesh implants for inguinal hernia treatment. Invest Radiol 48:770–778CrossRef Hansen NL, Barabasch A, Distelmaier M et al (2013) First in human magnetic resonance visualization of surgical mesh implants for inguinal hernia treatment. Invest Radiol 48:770–778CrossRef
27.
go back to reference Novitsky Y, Harel AG, Cristiano JA et al (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prostetic meshes after lon-term intra-abdominal implantation in a rabbit. Surg Res 140:6–11CrossRef Novitsky Y, Harel AG, Cristiano JA et al (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prostetic meshes after lon-term intra-abdominal implantation in a rabbit. Surg Res 140:6–11CrossRef
28.
go back to reference McGinty JJ, Hogle NJ, McCarty H et al (2005) A comparative study of adhesion formation and abdominal wall ingrowth after laparoscopic ventral hernia repair in a pocine model using multiple types of mesh. Surg Endosc 19:786–790CrossRef McGinty JJ, Hogle NJ, McCarty H et al (2005) A comparative study of adhesion formation and abdominal wall ingrowth after laparoscopic ventral hernia repair in a pocine model using multiple types of mesh. Surg Endosc 19:786–790CrossRef
29.
go back to reference Burger JW, Halm JA, Wijsmuller AR et al (2006) Evaluation of new prosthetic meshes for ventral hernia repair. Surg Endosc 20:1320–1325CrossRef Burger JW, Halm JA, Wijsmuller AR et al (2006) Evaluation of new prosthetic meshes for ventral hernia repair. Surg Endosc 20:1320–1325CrossRef
30.
go back to reference Schoenmaeckers EJP, van der Valk SBA, van den Hout HW, Raymakers JFTJ, Rakic S (2009) Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc 23:1620–1623CrossRef Schoenmaeckers EJP, van der Valk SBA, van den Hout HW, Raymakers JFTJ, Rakic S (2009) Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc 23:1620–1623CrossRef
31.
go back to reference Kirchhoff S, Ladurner R, Kirchhoff C, Mussack T, Reiser MF, Lienemann A (2009) Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: a functional cine MRI-study. Abdom Imaging 35:224–231CrossRef Kirchhoff S, Ladurner R, Kirchhoff C, Mussack T, Reiser MF, Lienemann A (2009) Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: a functional cine MRI-study. Abdom Imaging 35:224–231CrossRef
Metadata
Title
Magnetic resonance visualization of iron-loaded meshes in patients with pain after inguinal hernia repair
Authors
E. Özveri
D. E. T. Şanlı
D. Yıldırım
H. Gök
M. Ertem
Publication date
01-06-2021
Publisher
Springer Paris
Keyword
Inguinal Hernia
Published in
Hernia / Issue 3/2021
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-020-02168-9

Other articles of this Issue 3/2021

Hernia 3/2021 Go to the issue