Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits.
OBJECTIVE
Compare, in a rabbit model, the inflammatory response and adhesions formation following surgical fixation of polypropilene and Vypro mesh in the inguinal preperitoneal space.


METHODS
Fourteen male New Zealand rabbits, weighing between 2.000 to 2.500 g were used. A midline incision was made and the peritoneal cavity was exposed. The 2.0 x 1.0 cm polypropylene mesh was fixed in the left flank and secured to the margins with 3-0 prolene in a separate pattern. In the right flank, a 2.0 x 1.0 cm Vypro II mesh was sewn in the same way. After the post surgical period, the animals were again anesthetized and underwent laparoscopic approach, in order to identify and evaluate adhesions degree. Both fixed prosthesis were excised bilaterally with the abdominal wall segment, including peritoneum, aponeurosis and muscle and sent to a pathologist.


RESULTS
Operative time ranged from 15 to 25 minutes and no difficulties in applying the mesh were found. From the 14 polypropylene meshes fixed to the intact peritoneum, 11 had adhesions to the abdominal cavity (78.6%). Concerning Vypro mesh, 12 animals developed adhesions from the 14 with mesh fixation (85.7%). Histological examination of tissues harvested revealed fibroblasts, collagen, macrophages and lymphocytes between the threads of the mesh.


CONCLUSIONS
Polypropylene and Vypro mesh, when implanted in the peritoneal cavity of rabbits provoke similar amount of adhesions. Vypro mesh tissues had higher fibrosis resulting in better mesh incorporation to the abdominal wall.
Goldenberg
Alberto
A
Gastrointestinal Division, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil. goldenb@terra.com.br
Matone
Jacques
J
Marcondes
Wagner
W
Herbella
Fernando Augusto Mardiros
FA
Farah
José Francisco de Mattos
JF
D000818:Animals; D004195:Disease Models, Animal; D006552:Hernia, Inguinal / Q000473:pathology / Q000601:surgery; D007249:Inflammation / Q000473:pathology*; D010535:Laparoscopy; D008297:Male; D011098:Polyglactin 910 / Q000009:adverse effects; D011126:Polypropylenes / Q000009:adverse effects*; D011183:Postoperative Complications / Q000473:pathology; D019736:Prostheses and Implants / Q000009:adverse effects; D011817:Rabbits; D013526:Surgical Mesh / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000473:pathology*
D011126:Polypropylenes; D011098:Polyglactin 910