title: Endoscopic and histological evaluations of a newly designed inguinal hernia mesh implant: Experimental studies on porcine animal model and human cadaver.
abstract: OBJECTIVE
  Conventional prostheses used for inguinal hernia repair are static and passive. This feasibility-study shows the features of a new 3D tension-free prosthesis in an experimental model.
  
  
  METHODS
  This study was divided into two-phases: 1) aimed to test the physics intrinsic features and the anatomical adaptability of a new 3D designed mesh, and 2) aimed to evaluate the inflammatory reaction associated with different materials used. On phase-1 implantations were performed in pigs. During the first trial phase, the prostheses were also implanted on human cadavers. On phase-2, implantation was carried out on large swine. Follow-up was of 60-days, after which the animals were anaesthetized for laparoscopic assessment, and for sample collection of mesh implantation site for histological analysis.
  
  
  RESULTS
  All animals showed good 3D mesh tolerance, and the follow-up period was uneventful. The laparoscopy showed no inflammatory lesions on the internal surface of the peritoneum. Macroscopic observation of implantation site revealed some local fibrosis and reorganization of tissue, no signs of infection, and no changes on original implant positioning. Histological analysis on phase-1 showed in most sample segments the deferent duct maintaining its central position and surrounded by vascular and nervous structures. On phase-2 differences in inflammatory lesion score could be found between subjects.
  
  
  CONCLUSIONS
  This new 3D mesh can be placed appropriately and from this preliminary animal study no untoward complications were noted over a 60 day period.
authors.affiliation: Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Panaro
authors.affiliation: Laparoscopy Unit-Minimally Invasive Surgery, Centre Jesús Usón, Carretera N-521, 10071, Cáceres, Spain.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Matos-Azevedo
authors.affiliation: Department of General Surgery, Hospital Royo Villanova, Avenida San Gregorio 30, 50015, Zaragoza, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Fatas
authors.affiliation: Department of General Surgery, Valme University Hospital, Crta Cádiz s/n, 41014, Sevilla, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Marin
authors.affiliation: Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
authors.affiliation: Department of General Surgery, Hôpital Général Universitaire de Valence, Valencia, Spain.
authors.forename: Cristobal
authors.initials: C
authors.lastname: Zaragoza-Fernandez
keywords: 3D mesh; Dynamic design; Experimental feasibility-study; Inguinal hernia