A lightweight, partially absorbable mesh (Ultrapro) for endoscopic hernia repair: experimental biocompatibility results obtained with a porcine model.
BACKGROUND
A meticulous surgical technique, a mesh of adequate dimensions, and use of a mesh with good biocompatibility properties are decisively important for minimizing the development of recurrences after endoscopic hernia repair surgery. Mesh "shrinkage" is a function of the mesh's biocompatibility, that is, the properties of the mesh. Large-pore, lightweight polypropylene meshes possess the best biocompatibility, and the newly developed meshes meet these requirements.


METHODS
Using a totally extraperitoneal technique in an experimental animal model, 10 domestic pigs were implanted with a lightweight, large-pore polypropylene mesh containing an absorbable component consisting of poliglecaprone (Ultrapro). After a period of 91 days, diagnostic laparoscopy followed by explantation of the specimens for macroscopic, histologic, and immunohistochemical evaluation was performed.


RESULTS
The mean mesh shrinkage was a mere 1.9%. The partial volume of the inflammatory cells was a low 15.8%. The markers of cell turnover, namely Ki67 and the apoptosis index, were, at 5.8 and 2.1, respectively, also very low. The extracellular matrix showed a low value of transforming growth factor-beta (TGF-beta) (50.8). The mean value of collagen 1 was 136.9.


CONCLUSIONS
As a result of its good biocompatibility and elastic properties, the lightweight, large-pore Ultrapo mesh showed only a very slight tendency to "shrink." This renders it extremely well suited for clinical use in hernia repair surgery, and its minimal shrinkage characteristic should help in achieving low complication and recurrence rates.
Schug-Pass
C
C
Department of Surgery and Center for Minimally Invasive Surgery, Hanover Hospital, Roesebeckstrasse 15 (Siloah), 30449, Hanover, Germany. christine.schug-pass.siloah@klinikum-hannover.de
Tamme
C
C
Sommerer
F
F
Tannapfel
A
A
Lippert
H
H
Köckerling
F
F
D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D004548:Elasticity; D004797:Enzyme-Linked Immunosorbent Assay; D059685:Herniorrhaphy; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D010535:Laparoscopy; D008422:Materials Testing; D011126:Polypropylenes; D013526:Surgical Mesh; D013552:Swine
D001672:Biocompatible Materials; D011126:Polypropylenes