Effect of prosthetic material on adhesion formation after laparoscopic ventral hernia repair in a porcine model.
Intraperitoneal placement of prosthetic mesh causes adhesion formation after laparoscopic incisional hernia repair. A prosthesis that prevents or reduces adhesion formation is desirable. In this study, 21 pigs were randomized to receive laparoscopic placement of plain polypropylene mesh (PPM), expanded polytetrafluoroethylene (ePTFE), or polypropylene coated on one side with a bioresorbable adhesion barrier (PPM/HA/CMC). The animals were sacrificed after 28 days and evaluated for adhesion formation. Mean area of adhesion formation was 14% (SD+/-15) in the PPM/HA/CMC group, 40% (SD+/-17) in the PPM group, and 41% (SD+/-39) in the ePTFE group. The difference between PPM/HA/CMC and PPM was significant ( P=0.013). A new visceral layer of mesothelium was present in seven out of seven PPM/HA/CMC cases, six out of seven PPM cases, and two out of seven ePTFE cases. Thus, laparoscopic placement of PPM/HA/CMC reduces adhesion formation compared to other mesh types used for laparoscopic ventral hernia repairs.
Borrazzo
E C
EC
Minimal Access Surgery Center Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical Center, F763 Box 203, New York, NY 10021, USA.
Belmont
M F
MF
Boffa
D
D
Fowler
D L
DL
D034861:Abdominal Wall / Q000473:pathology; D000818:Animals; D001672:Biocompatible Materials; D002266:Carboxymethylcellulose Sodium; D020099:Coated Materials, Biocompatible; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006820:Hyaluronic Acid; D007422:Intestines / Q000473:pathology; D010535:Laparoscopy; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh / Q000009:adverse effects*; D013552:Swine; D000267:Tissue Adhesions
D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D011126:Polypropylenes; C118198:Seprafilm; D011138:Polytetrafluoroethylene; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium