Is mesh fixation necessary in abdominal hernia repair? Results of an experimental study in the rat.
BACKGROUND
Abdominal hernia repair with implantation of synthetic meshes using the sublay technique has resulted in low recurrence rates and high patient satisfaction.


OBJECTIVE
The purpose of this experimental animal study was to investigate whether mesh fixation is necessary in abdominal hernia repair using a polypropylene mesh in the sublay technique.


METHODS
Forty-five rats were divided into three groups after creating an abdominal wall defect (CG control group, no mesh implantation; NoFixG mesh implantation without fixation group; SG mesh with suture fixation group) with 15 animals in each group. End-points were clinical herniation pressure, hydroxyproline (HP) concentration, mesh shape and number of fibroblasts/collagen fibres of the anchor zone 7, 14 and 90 days after implantation.


RESULTS
Herniation pressure, HP content and number of fibroblasts were similar between NoFixG and SG, although significantly higher in these groups than in the CG (P<0.05). Both mesh groups had significantly higher counts of fibroblasts and collagen fibres than the CG. Mesh shrinking occurred in both groups but was less in the SG.


CONCLUSIONS
Mesh fixation was not mandatory in abdominal hernia repair using this animal model.
Zieren
J
J
Klinik und Poliklinik für Chirurgie, Universitätsklinikum Charité, Berlin, Germany. zieren@rz.charite.hu-berlin.de
Castenholz
E
E
Jacobi
C A
CA
Zieren
H U
HU
Müller
J M
JM
D000818:Animals; D002452:Cell Count; D005347:Fibroblasts / Q000166:cytology; D006555:Hernia, Ventral / Q000601:surgery*; D006909:Hydroxyproline / Q000032:analysis; D017060:Patient Satisfaction; D011126:Polypropylenes; D019919:Prosthesis Implantation; D051381:Rats; D017208:Rats, Wistar; D012008:Recurrence; D013526:Surgical Mesh
D011126:Polypropylenes; D006909:Hydroxyproline