First in vivo visualization of MRI-visible IPOM in a rabbit model.
BACKGROUND
Application of a mesh in presence of pneumoperitoneum may cause deformation or wave formation when gas is released. Moreover, mesh shrinkage during subsequent wound healing cannot be detected in vivo without invasive diagnostics. Using MRI-visible polyvinylidene fluoride (PVDF) mesh, the extend of mesh deformation and shrinkage could be objectified by MRI for the first time.


METHODS
Laparoscopic intraperitoneal onlay mesh (IPOM) implantation was performed in 10 female rabbits using ferro-oxide loaded PVDF meshes. MRI measurements were performed postoperatively at days 1 and 90. After three-dimensional reconstruction of all MRI images the total surface and the effective surface of the implanted mesh were explored and calculated computer-assisted.


RESULTS
In all cases, the mesh could be identified in MRI. The subsequent three-dimensional reconstruction always allowed a calculation of the mesh area. In relation to the original size of the used textile implant, we found neither a significant reduction of the effective mesh surface after release of the pneumoperitoneum at day 1 after laparoscopic surgery nor a significant change of the total surface of this large pore mesh by the end of the observation period.


CONCLUSIONS
In vivo investigation of mesh surface via MRI could exclude a significant initial reduction of the effective mesh surface after release of pneumoperitoneum, in this IPOM rabbit model. A further subsequent shrinkage of these large pore PVDF meshes could be excluded, as well. Imaging of MRI-visible IPOM mesh turned out to be a sufficient tool to objectify mesh configuration and position in vivo.
Department for General, Visceral and Transplant Surgery at the University Hospital, RWTH Aachen University, Aachen, Germany.
Jens
J
Otto
Nicolas
N
Kuehnert
Nils A
NA
Kraemer
Alexander
A
Ciritsis
Nienke Lynn
NL
Hansen
Christiane
C
Kuhl
Daniel
D
Busch
Ulf
U
Peter Neumann
Uwe
U
Klinge
Klaus-Joachim
KJ
Conze
D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D008279:Magnetic Resonance Imaging; D008422:Materials Testing; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging* / Q000601:surgery*; D011145:Polyvinyls; D011817:Rabbits; D011859:Radiography; D013526:Surgical Mesh; D005465:Fluorocarbon Polymers
D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers
IPOM; laparoscopy; mesh surface; pneumoperitoneum; shrinkage