title: Assessment of gel-coated delayed self-gripping mesh.
abstract: BACKGROUND
  Mesh hernia repair is one of the most frequently performed procedures in general surgery. Recently, use of the self-gripping mesh demonstrated a beneficial effect on postoperative pain in inguinal hernia repairs. However, in intra-abdominal placement, the use of this novel mesh requires greater laparoscopic skill and dexterity because of the mesh's tendency to fold and adhere to itself and to any surrounding tissues. We hypothesized that gel-like coverage of a self-gripping mesh with a water-soluble film would allow delaying the immediate surface adhesion of the mesh to the tissue, which may allow greater freedom and ease in mesh placement for laparoscopic surgeons.
  
  
  METHODS
  In this ex vivo animal study, gel-coated self-gripping mesh (ProGrip) was compared with a control uncoated mesh in bovine and porcine tissue specimens and assessed for dislodgement shear forces before and after dissolving of the gel.
  
  
  RESULTS
  Gel coating of the mesh reduced preperitoneal dislodgement forces in a porcine abdominal wall specimen by 81% (8.05 ± 0.66 vs 1.53 ± 0.82 N, P < .01). Dissolving the gel markedly increased the anchoring forces (10.62 ± 3.70 vs 1.53 ± 0.82 N, P < .0001), and after dissolving the gel, the mesh shear dislodgement forces were similar and noninferior to the control mesh (8.05 ± 0.66 vs 10.62 ± 3.70 N, P = NS).
  
  
  CONCLUSIONS
  We believe that water-soluble gel coating does not impair the adhesive features of the self-gripping mesh and may simplify its use in open and laparoscopic procedures by allowing controlled activation of the self-gripping mechanism.
authors.affiliation: Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel (affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel).
authors.forename: Avinoam
authors.initials: A
authors.lastname: Nevler
authors.affiliation: Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel (affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel).
authors.forename: Mordechai
authors.initials: M
authors.lastname: Gutman
authors.affiliation: Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel (affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel).
authors.forename: Alexander
authors.initials: A
authors.lastname: Lebedyev
mesh_terms: D000818:Animals; D002417:Cattle; D020099:Coated Materials, Biocompatible; D004195:Disease Models, Animal; D005260:Female; D005782:Gels; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D011474:Prosthesis Design; D013526:Surgical Mesh; D013552:Swine
chemical_list: D020099:Coated Materials, Biocompatible; D005782:Gels
keywords: Animal study; Biomaterials; Biomechanical testing; Hernia repair; Self-gripping mesh