TY - JOUR
T1 - Tissue attachment strength and adhesion formation of intraabdominal fixed meshes with cyanoacrylat glues
AU - Ladurner, Roland
AU - Drosse, I.
AU - Seitz, S.
AU - Plitz, W.
AU - Barbaryka, G.
AU - Siebeck, M.
AU - Bürklein, D.
AU - Kirchhoff, C.
AU - Buhman, S.
AU - Mutschler, W.
AU - Schieker, M.
AU - Mussack, T.
PY - 2008/5/26
Y1 - 2008/5/26
N2 - Objective: The aim of this study was to evaluate the technique of prosthetic mesh fixation in laparoscopic intraperitoneal incisional and ventral hernia repair using cyanoacrylat glue (Glubran® GEM, Viareggio, Italy) in comparison with fixation methods using spiral tacks (Protack 5mm, Tyco) or transabdominal Prolene® 4/0 sutures respectively. Method: Through a midline laparotomy 3 pieces (3 x 3cm) of mesh (n = 60) where fixed onto the intact peritoneum on either side of a midline laparotomy in 10 New Zealand White rabbits. Two types of meshes where compared: ePTFE meshes (Gore-Tex Dual Mesh W.L. Gore & Associates, Inc. Medical Products Division, Flagstaff, Arizona, USA) and polypropylene/polyvinylfluorid meshes (Dyna Mesh® - IPOM P.J. Dahlhausen & Co. GmbH, Germany). All animals were killed after 12 weeks. Upon scoring of the adhesions the prosthetic materials were excised en bloc with the anterior abdominal wall for tensile strength analysis and histologic evaluation. Results: In contrast to ePTFE meshes fixed with cyanoacrylat glue, PP meshes fixed with transabdominal sutures as well as with spiral tacks showed the highest percentage and tenacity of adhesions (p <0.033). Independent of the method of fixation, ePTFE meshes revealed a significantly higher shrinkage than PP prosthesis (41% vs 17% related to original mesh surface; p <0.033). The strength of the mesh incorporation was significantly higher in PP meshes (p <0.033). Fixation of PP meshes with cyanoacrylat glue showed an equivalent tensile strength as ePTFE meshes fixed with spiral tacks (6.6 ± 2.7 N vs 6.6 ± 3.1N). Conclusion: In this rabbit model, intraabdominal fixation of PP composite meshes with cyanoacrylat glue was equivalent to ePTFE mesh fixation with spiral tacks concerning tensile strength analysis. Adhesions between mesh and abdominal wall were found more frequently after PP fixation. In contrast, mesh shrinkage was more evident after ePTFE mesh implantation.
AB - Objective: The aim of this study was to evaluate the technique of prosthetic mesh fixation in laparoscopic intraperitoneal incisional and ventral hernia repair using cyanoacrylat glue (Glubran® GEM, Viareggio, Italy) in comparison with fixation methods using spiral tacks (Protack 5mm, Tyco) or transabdominal Prolene® 4/0 sutures respectively. Method: Through a midline laparotomy 3 pieces (3 x 3cm) of mesh (n = 60) where fixed onto the intact peritoneum on either side of a midline laparotomy in 10 New Zealand White rabbits. Two types of meshes where compared: ePTFE meshes (Gore-Tex Dual Mesh W.L. Gore & Associates, Inc. Medical Products Division, Flagstaff, Arizona, USA) and polypropylene/polyvinylfluorid meshes (Dyna Mesh® - IPOM P.J. Dahlhausen & Co. GmbH, Germany). All animals were killed after 12 weeks. Upon scoring of the adhesions the prosthetic materials were excised en bloc with the anterior abdominal wall for tensile strength analysis and histologic evaluation. Results: In contrast to ePTFE meshes fixed with cyanoacrylat glue, PP meshes fixed with transabdominal sutures as well as with spiral tacks showed the highest percentage and tenacity of adhesions (p <0.033). Independent of the method of fixation, ePTFE meshes revealed a significantly higher shrinkage than PP prosthesis (41% vs 17% related to original mesh surface; p <0.033). The strength of the mesh incorporation was significantly higher in PP meshes (p <0.033). Fixation of PP meshes with cyanoacrylat glue showed an equivalent tensile strength as ePTFE meshes fixed with spiral tacks (6.6 ± 2.7 N vs 6.6 ± 3.1N). Conclusion: In this rabbit model, intraabdominal fixation of PP composite meshes with cyanoacrylat glue was equivalent to ePTFE mesh fixation with spiral tacks concerning tensile strength analysis. Adhesions between mesh and abdominal wall were found more frequently after PP fixation. In contrast, mesh shrinkage was more evident after ePTFE mesh implantation.
KW - Cyanoacrylat glue
KW - Fixation devices
KW - Intraabdominal adhesions
KW - Laparoscopic incisional hernia iepair
KW - Tensile strength
UR - http://www.scopus.com/inward/record.url?scp=45849149613&partnerID=8YFLogxK
M3 - Article
C2 - 18559298
AN - SCOPUS:45849149613
SN - 0949-2321
VL - 13
SP - 185
EP - 191
JO - European Journal of Medical Research
JF - European Journal of Medical Research
IS - 5
ER -