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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2015

01-08-2015

Long-term evaluation of adhesion formation and foreign body response to three new meshes

Authors: R. R. M. Vogels, K. W. Y. van Barneveld, J. W. A. M. Bosmans, G. Beets, M. J. J. Gijbels, M. H. F. Schreinemacher, N. D. Bouvy

Published in: Surgical Endoscopy | Issue 8/2015

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Abstract

Introduction

Mesh-related adhesions are a significant clinical problem following intraperitoneal mesh placement. In this study, we evaluated adhesion formation to three relatively new meshes for intraperitoneal use.

Methods

Three new meshes for intraperitoneal use (Omyra® mesh, Physiomesh®, and Hi-Tex Endo-IP®) were implanted intraperitoneally in rats and compared with a polypropylene control mesh (Parietene®) after 7 or 90 days. Adhesion formation, incorporation (tensile strength), shrinkage, and foreign body reaction were scored.

Results

Hi-Tex Endo-IP and Physiomesh® showed significantly less adhesion formation when compared to Parietene at both time points (p < 0.05). Shrinkage was highest in Omyra mesh after 90 days, which was significantly more compared to Parietene® (p < 0.001). Physiomesh® only showed a significant reduction in craniocaudal mesh length, compared to Parietene and Hi-Tex Endo-IP (p < 0.05). After 90 days, Hi-Tex Endo-IP® showed significantly higher and Physiomesh® significantly lower incorporation strengths compared to all other groups (p < 0.05). Microscopic evaluation revealed massive foreign body reaction to Hi-Tex Endo-IP®, leading to an extensive and thick collagenous scar adherent to the abdominal wall. Fractioning of the Physiomesh® coating over time led to an increase in interfilamentary granuloma formation, leading to scar plate formation, but with only minimal to no abdominal wall adherence. Both Parietene® and Omyra® showed a mild foreign body response.

Conclusion

Although clear distinctions can be made between meshes and some meshes excel, none of the meshes are superior in all aspects required for effective and safe incisional hernia repair.
Literature
1.
Kingsnorth A, LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 8(362):1561–1571CrossRef
2.
Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D et al (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16:179–183PubMedCrossRef
3.
Burger JWA, Luijendijk RW, Hop WCJ, Halm JA, Verdaasdonk EGG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583 discussion 583–585PubMedCentralPubMed
4.
Dumanian GA (2012) Discussion: adhesions and meshes: synthetic versus bioprosthetic. Plast Reconstr Surg 130:214S–215SPubMedCrossRef
5.
Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Bisgaard T (2013) Nationwide prospective study of outcomes after elective incisional hernia repair. J Am Coll Surg 216:217–228PubMedCrossRef
6.
Huang C-C, Lien H-H, Huang C-S (2013) Long-term follow-up of laparoscopic incisional and ventral hernia repairs. J Laparoendosc Adv Surg Tech A 23:199–203PubMedCrossRef
7.
Jenkins ED, Yom V, Melman L, Brunt LM, Eagon JC, Frisella MM et al (2010) Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysis-related complications during laparoscopic re-exploration after prior ventral hernia repair. Surg Endosc 24:3002–3007PubMedCrossRef
8.
Demir U, Mihmanli M, Coskun H, Dilege E, Kalyoncu A, Altinli E et al (2005) Comparison of prosthetic materials in incisional hernia repair. Surg Today 35:223–227PubMedCrossRef
9.
Turza KC, Butler CE (2012) Adhesions and meshes: synthetic versus bioprosthetic. Plast Reconstr Surg 130:206S–213SPubMedCrossRef
10.
Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D et al (1999) Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 1(353):1476–1480CrossRef
11.
Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, Reijnen MMPJ, Schaapveld M, van Goor H (2000) Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg 87:467–471CrossRef
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 27:4202–4209PubMedCrossRef
13.
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 96:305–313PubMedCrossRef
14.
Conze J, Rosch R, Klinge U, Weiss C, Anurov M, Titkowa S et al (2004) Polypropylene in the intra-abdominal position: influence of pore size and surface area. Hernia 8:365–372PubMedCrossRef
15.
Novitsky YW, Harrell AG, Cristiano JA, Paton BL, Norton HJ, Peindl RD et al (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intra-abdominal implantation in a rabbit. J Surg Res 140:6–11PubMedCrossRef
16.
Sanders DL, Kingsnorth AN (2012) Prosthetic mesh materials used in hernia surgery. Expert Rev Med Devices 9:159–179PubMedCrossRef
17.
18.
19.
Greca F, Paula J, Biondo-Simões M, Costa F, Silva A, Time S et al (2001) The influence of differing pore sizes on the biocompatibility of two polypropylene meshes in the repair of abdominal defects. Hernia 5:59–64PubMedCrossRef
20.
Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63–69PubMedCrossRef
21.
Sanders DL, Waydia S (2013) A systematic review of randomised control trials assessing mesh fixation in open inguinal hernia repair. Hernia 18:165–176
22.
Hollinsky C, Kolbe T, Walter I, Joachim A, Sandberg S, Koch T et al (2010) Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair. Surg Endosc Interv Tech 24:1318–1324CrossRef
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 25:749–755PubMedCrossRef
24.
Zogbi L, Trindade EN, Trindade MRM (2013) Comparative study of shrinkage, inflammatory response and fibroplasia in heavyweight and lightweight meshes. Hernia 17:765–772
25.
Eriksen JR, Gogenur I, Rosenberg J (2007) Choice of mesh for laparoscopic ventral hernia repair. Hernia 11:481–492PubMedCrossRef
26.
Fortelny 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 97:1140–1145PubMedCrossRef
27.
Schreinemacher MHF, Henatsch D, van Barneveld K, Bouvy N (2010) The need for standardised animal models and scoring systems in assessing mesh biocompatibility. Hernia 14:335–336PubMedCentralPubMedCrossRef
28.
Dubay DA, Wang X, Adamson B, Kuzon WM Jr, Dennis RG, Franz MG (2005) Progressive fascial wound failure impairs subsequent abdominal wall repairs: a new animal model of incisional hernia formation. Surgery 137:463–471PubMedCrossRef
29.
Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH et al (2014) Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)—part 1. Surg Endosc 28:2–29PubMedCentralPubMedCrossRef
Metadata
Title
Long-term evaluation of adhesion formation and foreign body response to three new meshes
Authors
R. R. M. Vogels
K. W. Y. van Barneveld
J. W. A. M. Bosmans
G. Beets
M. J. J. Gijbels
M. H. F. Schreinemacher
N. D. Bouvy
Publication date
01-08-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3936-5

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