title: Comparison of a new self-gripping mesh with other fixation methods for laparoscopic hernia repair in a rat model.
abstract: BACKGROUND
  Microhooks are small structures on the surface of the Progrip (PG; Sofradim Corp) mesh to ensure its anchorage in tissue. Additional fixation is not required. The aim of this animal study was to compare the strength of incorporation, foreign body reaction, and changes in material after implantation of this novel mesh with the current fixation alternatives, namely the hernia stapler (HS) and fibrin glue (FG).
  
  
  METHODS
  Forty Sprague-Dawley rats were used in this two-phase, prospective randomized study. Polypropylene meshes (Parietene light; Sofradim Corp) were positioned bilaterally on the abdominal muscle. The randomized mesh fixation groups were named HS, FG, PG, and UM (unfixed mesh). Half of the rats in each group were sacrificed and analyzed 5 days after implantation, and the second half were sacrificed and analyzed after 2 months. Measured parameters were strength of incorporation, foreign-body reaction to, and potential degradation of, mesh and fixation systems.
  
  
  RESULTS
  After 5 days, strength of incorporation was substantially higher for PG (3.2 N/cm(2)) and HS (2.7 N/cm(2)) compared with FG (0.9 N/cm(2)) or UM (1.5 N/cm(2)). After 2 months, PG had a much greater strength of incorporation (14.8 N/cm(2)) compared with all other groups (HS 11.7 N/cm(2); FG 11.4 N/cm(2); UM 8.7 N/cm(2)). Inflammatory reactions were considerably more severe after 5 days than after 2 months. No significant differences in foreign-body reactions were found between groups. At neither time point were signs of degradation detected by scanning electron microscopy.
  
  
  CONCLUSIONS
  PG demonstrated a substantially stronger strength of incorporation in muscle tissue compared with other fixation systems and is an economic alternative to HS or FG. Laparoscopic mesh placement of PG requires some practice because of the microhooks. Clinical studies will have to be performed before the value of this mesh can be established for laparoscopic application.
authors.affiliation: Department of Surgery, Kaiserin Elisabeth Hospital, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Hollinsky
authors.forename: Thomas
authors.initials: T
authors.lastname: Kolbe
authors.forename: Ingrid
authors.initials: I
authors.lastname: Walter
authors.forename: Anja
authors.initials: A
authors.lastname: Joachim
authors.forename: Simone
authors.initials: S
authors.lastname: Sandberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Koch
authors.forename: Thomas
authors.initials: T
authors.lastname: Rülicke
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D059685:Herniorrhaphy; D010535:Laparoscopy; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh; D017792:Surgical Stapling; D014014:Tissue Adhesives / Q000627:therapeutic use
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives