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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2018

01-07-2018

Comparison of mesh fixation devices for laparoscopic ventral hernia repair: an experimental study on human anatomic specimens

Authors: Yi-Wei Chan, Zacaria Sow, Dobrica Lukic, Matthias Monschein, Elisabeth Calek, Michael Pretterklieber, Christian Hollinsky

Published in: Surgical Endoscopy | Issue 7/2018

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Abstract

Background

As there is a lack of clarity in terms of the tensile strength of mesh fixation for laparoscopic ventral hernia repair (LVHR), our aim was to investigate the immediate tensile strength of currently available mesh fixation devices on human anatomic specimens.

Methods

Sixteen recently deceased body donators (mean body mass index of 24.4 kg/m2) were used to test the immediate tensile strength (Newton) of 11 different LVHR mesh fixation devices.

Results

Each of the 11 different laparoscopic fixation devices was tested 44 times. Non-articulating tackers provided higher fixation resistance to tensile stress in comparison to articulating tackers (5.1-mm ReliaTack™: 16.9 ± 8.7 N vs. 12.2 ± 5.6 N, p = 0.013; 7-mm ReliaTack™: 19.8 ± 9.4 N vs. 15.0 ± 7.0 N, p = 0.007). Absorbable tacks with a greater length, i.e. ≥6 mm (7-mm ReliaTack™, 6-mm SorbaFix™ and 7.2-mm SecureStrap™) had significantly higher fixation tensile strength than tacks with a shorter length, i.e. < 6 mm (5.1-mm ReliaTack™ and 5.1-mm AbsorbaTack™) (p < 0.001). Furthermore, transfascial sutures (PDS 2-0 sutures 26.3 ± 5.6 N) provided superior fixation tensile strength than 5.1-mm AbsorbaTack™ (13.6 ± 7.3 N) and cyanoacrylate glues such as LiquiBand FIX8™ (3.5 ± 2.4 N) (p < 0.001, respectively). There was a significant deterioration in fixation capacity in obese body donators with a body mass index > 30 kg/m2 (13.8 ± 8.0 vs. 17.9 ± 9.7 N, p = 0.044).

Conclusions

Although articulating laparoscopic tackers improve accessibility and facilitate the utilization of tacks within the fixation weak spot adjacent to the trocar placement, an articulating shaft that is not ergonomic to use may limit mechanisms of force transmission. For mesh fixation in LVHR, transfascial sutures and tacks with a longer length provide better immediate fixation tensile strength results.
Literature
1.
Tobler WD Jr, Itani KM (2016) Current status and challenges of laparoscopy in ventral hernia repair. J Laparoendosc Adv Surg Tech A 26:281–289CrossRefPubMed
2.
Earle D, Roth JS, Saber A, Haggerty S, Bradley JF, 3rd, Fanelli R, Price R, Richardson WS, Stefanidis D, Committee SG (2016) SAGES guidelines for laparoscopic ventral hernia repair. Surg Endosc 30:3163–3183CrossRefPubMed
3.
Berler DJ, Cook T, LeBlanc K, Jacob BP (2016) Next generation mesh fixation technology for hernia repair. Surg Technol Int 29:109–117PubMed
4.
Muysoms F, Vander Mijnsbrugge G, Pletinckx P, Boldo E, Jacobs I, Michiels M, Ceulemans R (2013) Randomized clinical trial of mesh fixation with “double crown” versus “sutures and tackers” in laparoscopic ventral hernia repair. Hernia 17:603–612CrossRefPubMed
5.
Hollinsky C, Kolbe T, Walter I, Joachim A, Sandberg S, Koch T, Rulicke T, Tuchmann A (2010) Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair. Surg Endosc 24:1318–1324CrossRefPubMed
6.
Reynvoet E, Berrevoet F (2014) Pros and cons of tacking in laparoscopic hernia repair. Surg Technol Int 25:136–140PubMed
7.
Christoffersen MW, Brandt E, Helgstrand F, Westen M, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T (2015) Recurrence rate after absorbable tack fixation of mesh in laparoscopic incisional hernia repair. Br J Surg 102:541–547CrossRefPubMed
8.
Colak E, Ozlem N, Kucuk GO, Aktimur R, Kesmer S, Yildirim K (2015) Prospective randomized trial of mesh fixation with absorbable versus nonabsorbable tacker in laparoscopic ventral incisional hernia repair. Int J Clin Exp Med 8:21611–21616PubMedPubMedCentral
9.
Liang MK, Clapp ML, Garcia A, Subramanian A, Awad SS (2012) Mesh shift following laparoscopic ventral hernia repair. J Surg Res 177:e7–e13CrossRefPubMed
10.
Rastegarpour A, Cheung M, Vardhan M, Ibrahim MM, Butler CE, Levinson H (2016) Surgical mesh for ventral incisional hernia repairs: understanding mesh design. Plast Surg (Oakv) 24:41–50CrossRef
11.
Zihni AM, Cavallo JA, Thompson DM Jr, Chowdhury NH, Frisella MM, Matthews BD, Deeken CR (2015) Evaluation of absorbable mesh fixation devices at various deployment angles. Surg Endosc 29:1605–1613CrossRefPubMed
12.
Moore AM, Chen DC (2016) Articulating and reloadable fixation devices for hernia repair. Surg Technol Int 28:133–138CrossRefPubMed
13.
Kakizoe S, Kakizoe Y, Matsuoka I, Kakizoe K (2011) Flexible tack for ventral hernia repair. Surg Today 41:1024–1025CrossRefPubMed
14.
Jeong CW, Kim SH, Kim HT, Jeong SJ, Hong SK, Byun SS, Lee SE (2013) Insufficient joint forces of first-generation articulating instruments for laparoendoscopic single-site surgery. Surg Innov 20:466–470CrossRefPubMed
15.
Elazary R, Kedar A, Abu-Gazala M, Mintz Y (2013) Comparing laparoscopic mesh fixation strength between articulated and non-articulated tack devices. Minim Invasive Ther Allied Technol 22:288–290CrossRefPubMed
16.
Bansal VK, Asuri K, Panaiyadiyan S, Kumar S, Subramaniam R, Ramachandran R, Sagar R, Misra MC (2016) Comparison of absorbable versus nonabsorbable tackers in terms of long-term outcomes, chronic pain, and quality of life after laparoscopic incisional hernia repair: a randomized study. Surg Laparosc Endosc Percutaneous Tech 26:476–483CrossRef
17.
Ching SS, Sarela AI, Dexter SP, Hayden JD, McMahon MJ (2008) Comparison of early outcomes for laparoscopic ventral hernia repair between nonobese and morbidly obese patient populations. Surg Endosc 22:2244–2250CrossRefPubMed
18.
Froylich D, Segal M, Weinstein A, Hatib K, Shiloni E, Hazzan D (2016) Laparoscopic versus open ventral hernia repair in obese patients: a long-term follow-up. Surg Endosc 30:670–675CrossRefPubMed
19.
Varghese TK, Denham DW, Dawes LG, Murayama KM, Prystowsky JB, Joehl RJ (2002) Laparoscopic ventral hernia repair: an initial institutional experience. J Surg Res 105:115–118CrossRefPubMed
20.
Costi R, Randone B, Cinieri GF, Sarli L, Violi V (2009) Early strangulated recurrence of incisional hernia after laparoscopic repair: an old complication for a new technique. J Laparoendosc Adv Surg Tech A 19:397–400CrossRefPubMed
21.
Chowbey PK, Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M (2006) Laparoscopic repair of ventral/incisional hernias. J Minimal Access Surg 2:192–198CrossRef
22.
Greenstein AJ, Nguyen SQ, Buch KE, Chin EH, Weber KJ, Divino CM (2008) Recurrence after laparoscopic ventral hernia repair: a prospective pilot study of suture versus tack fixation. Am Surg 74:227–231PubMed
23.
Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25:749–755CrossRefPubMed
Metadata
Title
Comparison of mesh fixation devices for laparoscopic ventral hernia repair: an experimental study on human anatomic specimens
Authors
Yi-Wei Chan
Zacaria Sow
Dobrica Lukic
Matthias Monschein
Elisabeth Calek
Michael Pretterklieber
Christian Hollinsky
Publication date
01-07-2018
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6031-5

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