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Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment

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Summary

Background

Funnel mesh implants can be used for both prevention and repair of parastomal hernia (PSH). We aimed to prove the practice of such implants as well as the magnetic resonance (MR) presentability in humans.

Methods

Five patients were surgically treated for laparoscopic PSH prevention, and five patients underwent laparoscopic repair of manifest and symptomatic PSH with iron-loaded 3-D funnel meshes in an intraperitoneal onlay technique. MR investigation was performed on postoperative day 7 to assess mesh delineation, and additionally 6 and 12 months postoperatively to evaluate hernia recurrences and biocompatibility of mesh integration.

Results

We could demonstrate precise mesh depiction and delineation with MR in all 10 cases, as well as accurate assessment of the surrounding tissue. No funnel alterations and no functional change of the stoma bowel patency occurred due to the tightly fitting funnel implant. We documented no mesh-related complications, no PSH formation, and no stoma prolapse occurrence during the follow-up period of 1 year comprising all ten cases.

Conclusion

The pilot use of a new method of MR investigation using a mesh with enhanced signal through the addition of iron particles into the polyvinylidene fluoride base material provides detailed mesh depiction. Furthermore, funnel mesh implantation seems to offer a safe and promising surgical alternative for both PSH prevention and treatment.

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Abbreviations

PSH:

Parastomal hernia

MRI:

Magnetic resonance investigation/imaging

PVDF:

Polyvinylidene fluoride

PP:

Polypropylene

IPOM:

Intraperitoneal onlay mesh

GRE:

Gradient echo sequence

TSE:

Turbo spin-echo sequence

MRT:

Magnetic resonance tomography

STI:

Surgical textile implants

CT:

Computed tomography

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Acknowledgments

The kind statistical support by Mag. Christian Steinlechner is greatly acknowledged

Conflict of interest

G. Köhler, H. Wundsam, L. Pallwein-Prettner, O.O. Koch, and K. Emmanuel have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Sisters of Charity Hospital, 4010, Linz, Austria

    G. Köhler MD,  H. Wundsam MD,  O.O. Koch MD &  K. Emmanuel MD

  2. Department of Diagnostic and Interventional Radiology, Sisters of Charity Hospital, Linz, Austria

    L. Pallwein-Prettner MD

  3. Department of Surgery, Paracelsus Medical University, Salzburg, Austria

    G. Köhler MD &  O.O. Koch MD

  4. Academic Teaching Hospital, Medical University of Graz, Graz, Austria

    L. Pallwein-Prettner MD

  5. Academic Teaching Hospital, Medical University of Innsbruck, Innsbruck, Austria

    L. Pallwein-Prettner MD

Authors
  1. G. Köhler MD
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  2. H. Wundsam MD
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  3. L. Pallwein-Prettner MD
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  4. O.O. Koch MD
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  5. K. Emmanuel MD
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Corresponding author

Correspondence to G. Köhler MD.

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Köhler, G., Wundsam, H., Pallwein-Prettner, L. et al. Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment. Eur Surg 47, 127–132 (2015). https://doi.org/10.1007/s10353-015-0319-7

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  • DOI: https://doi.org/10.1007/s10353-015-0319-7

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