A J Duffy1, N J Hogle, K M LaPerle, D L Fowler. 1. Minimal Access Surgery Center Department of Surgery, Weill Medical College of Cornell University, New York, NY, USA.
Abstract
INTRODUCTION: Laparoscopic ventral hernia repair uses tacks to secure mesh. The mesh is designed to maximize tissue ingrowth while minimizing adhesions. We hypothesized: (1) a collagen-coated polyester mesh (PCO) will form fewer adhesions than an ePTFE-polypropylene composite (BC) and (2) absorbable tacks are equivalent to metal tacks. METHODS: In a porcine model of adhesion formation, three pieces of 10x15-cm mesh were placed on the anterior abdominal wall. PCO was secured with absorbable (PLA) or metal tacks (PT), BC with PT. At 28 days, adhesion formation, abdominal-wall adherence, and tissue ingrowth were analyzed. RESULTS: PCO induced fewer adhesions (14.5% vs 53.4%, P = 0.007). On an adhesion scale (0 5), BC scored 3.6 vs 1.75 for PCO (P < 0.03). There was no difference in adhesion strength, tack adhesions, or abdominal-wall peel force. Histology showed equal ingrowth. CONCLUSIONS: PCO induces fewer adhesions than BC. There is no difference in the ingrowth of the two mesh types. The PLA achieves equivalent mesh incorporation to the PT.
INTRODUCTION: Laparoscopic ventral hernia repair uses tacks to secure mesh. The mesh is designed to maximize tissue ingrowth while minimizing adhesions. We hypothesized: (1) a collagen-coated polyester mesh (PCO) will form fewer adhesions than an ePTFE-polypropylene composite (BC) and (2) absorbable tacks are equivalent to metal tacks. METHODS: In a porcine model of adhesion formation, three pieces of 10x15-cm mesh were placed on the anterior abdominal wall. PCO was secured with absorbable (PLA) or metal tacks (PT), BC with PT. At 28 days, adhesion formation, abdominal-wall adherence, and tissue ingrowth were analyzed. RESULTS: PCO induced fewer adhesions (14.5% vs 53.4%, P = 0.007). On an adhesion scale (0 5), BC scored 3.6 vs 1.75 for PCO (P < 0.03). There was no difference in adhesion strength, tack adhesions, or abdominal-wall peel force. Histology showed equal ingrowth. CONCLUSIONS: PCO induces fewer adhesions than BC. There is no difference in the ingrowth of the two mesh types. The PLA achieves equivalent mesh incorporation to the PT.
Authors: B J Ramshaw; P Esartia; J Schwab; E M Mason; R A Wilson; T D Duncan; J Miller; G W Lucas; J Promes Journal: Am Surg Date: 1999-09 Impact factor: 0.688
Authors: Juan M Bellón; Francisca Jurado; Francisca García-Moreno; Celia Corrales; Antonio Carrera-San Martín; Julia Buján Journal: J Biomed Mater Res Date: 2002
Authors: George M Eid; Jose M Prince; Samer G Mattar; Giselle Hamad; Sayeed Ikrammudin; Philip R Schauer Journal: Surgery Date: 2003-10 Impact factor: 3.982
Authors: Alfredo M Carbonell; Kristi L Harold; Aida J Mahmutovic; Reem Hassan; Brent D Matthews; Kent W Kercher; Ronald F Sing; B Todd Heniford Journal: Am Surg Date: 2003-08 Impact factor: 0.688
Authors: J M McGreevy; P P Goodney; C M Birkmeyer; S R G Finlayson; W S Laycock; J D Birkmeyer Journal: Surg Endosc Date: 2003-09-10 Impact factor: 4.584
Authors: J F Byrd; N Agee; R Z Swan; K N Lau; J J Heath; I H Mckillop; D Sindram; J B Martinie; D A Iannitti Journal: Hernia Date: 2011-05-19 Impact factor: 4.739