In vivo study of meshes implanted over the inguinal ring and external iliac vessels in uncastrated pigs.
BACKGROUND
The effects of placing a prosthesis directly on the internal inguinal ring and external iliac vessels in inguinal hernia repair are unknown. We compared tissue responses to five prostheses implanted in this position in uncastrated male pigs.


METHODS
Three types of polypropylene and two types of expanded polytetrafluoroethylene (ePTFE) mesh were implanted in 20 pigs (n = 8 for each prosthesis type). Specimens of the implants and surrounding tissue were obtained 30 and 90 days after implantation and assessed histologically.


RESULTS
The polypropylene implants had more adhesions, more surface area covered by adhesions, and more tenacious adhesions than did the ePTFE implants. Perivascular cuffing was observed in eight polypropylene and one ePTFE specimen; ossification, necrosis, and testicular venous congestion were seen in polypropylene specimens.


CONCLUSIONS
Abnormal healing processes after implantation of polypropylene mesh may increase complications of the transabdominal preperitoneal and total extraperitoneal approaches in laparoscopic inguinal hernia repair, whereas the minimal response to ePTFE meshes may make them safer for use in the preperitoneal space.
LeBlanc
K A
KA
Surgical Specialty Group, Inc., Medical Plaza, Suite 612, 777 Hennessy Boulevard, Baton Rouge, LA 70808, USA.
Booth
W V
WV
Whitaker
J M
JM
Baker
D
D
D000818:Animals; D006119:Groin / Q000473:pathology / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh / Q000009:adverse effects*; D013552:Swine; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology
D011126:Polypropylenes; D011138:Polytetrafluoroethylene