Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy.
BACKGROUND
Most adhesion experiments involve observations at a single time point. We developed a method to evaluate abdominal adhesions to surgical mesh by sequential laparoscopy.


METHODS
An abdominal wall defect was created in rats and repaired with polypropylene mesh. Sequential laparoscopic evaluation of adhesion formation was performed in each animal. The percentage of mesh area involved was scored (0% to 100%). At various time intervals animals were sacrificed and samples were obtained for light and scanning electron microscopy.


RESULTS
Adhesions were already present on day 1, increased by day 7, and did not progress thereafter. Mesh surfaces free of adhesions were covered with a confluent mesothelial cell layer, first seen by scanning electron microscopy on day 5 and complete by day 7.


CONCLUSIONS
Intraabdominal adhesions are best studied by sequential laparoscopy. Adhesions develop within 1 day of prosthesis placement. Adhesion-free surfaces are carpeted with mesothelial cells by day 7 and remain free thereafter, for duration of study.
Baptista
M L
ML
Department of Surgery, University of Minnesota Medical School, Minneapolis 55455, USA.
Bonsack
M E
ME
Felemovicius
I
I
Delaney
J P
JP
D000005:Abdomen; D000818:Animals; D005260:Female; D010535:Laparoscopy; D008855:Microscopy, Electron, Scanning; D009852:Omentum / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology* / Q000473:pathology