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The use of a mesh with good biocompatibility properties is of decisive importance for the avoidance of recurrences and chronic pain in endoscopic hernia repair surgery. As we know from numerous experiments and clinical experience, large-pore, lightweight polypropylene meshes possess the best biocompatibility. However, large-pore meshes of different polymers may be used as well and might be an alternative solution.
Utilizing a totally extraperitoneal technique in an established animal model, 20 domestic pigs were implanted with either a lightweight large-pore polypropylene (PP) mesh (Optilene® LP) or a medium-weight large-pore knitted polytetrafluorethylene (PTFE) mesh (GORE® INFINIT® mesh). After 94 days, the pigs were sacrificed and postmortem diagnostic laparoscopy was performed, followed by explantation of the specimens for macroscopic, histological and immunohistochemical evaluation.
The mean mesh shrinkage rate was 14.2% for Optilene® LP vs. 24.7% for INFINIT® mesh (p = 0.017). The partial volume of the inflammatory cells was 11.2% for Optilene® LP vs. 13.9% for INFINIT (n.s.). CD68 was significantly higher for INFINIT (11.8% vs. 5.6%, p = 0.007). The markers of cell turnover, namely Ki67 and the apoptotic index, were comparable at 6.4% vs. 12.4% (n.s.) and 1.6% vs. 2.0% (n.s.). In the extracellular matrix, TGF-β was 35.4% for Optilene® LP and 31.0% for INFINIT® (n.s.). Collagen I (pos/300 μm) deposits were 117.8 and 114.9, respectively.
In our experimental examinations, Optilene® LP and INFINIT® showed a comparable biocompatibility in terms of chronic inflammatory reaction; however, the shrinkage rate was significantly higher for INFINIT® after 3 months. The higher shrinkage rate of INFINIT® should be taken into account when choosing the mesh size for an adequate hernia overlap.
Department of Surgery and Center for Minimally Invasive Surgery, Vivantes Hospital Spandau, Neue Bergstr. 6, 13585, Berlin, Germany, firstname.lastname@example.org.
This article was published in the following journal.
Name: Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie
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Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal.
Proteins involved in the process of transporting molecules in and out the cell nucleus. Included here are: NUCLEOPORINS, which are membrane proteins that form the NUCLEAR PORE COMPLEX; KARYOPHERINS, which carry molecules through the nuclear pore complex; and proteins that play a direct role in the transport of karyopherin complexes through the nuclear pore complex.
The pore-forming subunits of large-conductance calcium-activated potassium channels. They form tetramers in CELL MEMBRANES.
An opening through the NUCLEAR ENVELOPE formed by the nuclear pore complex which transports nuclear proteins or RNA into or out of the CELL NUCLEUS and which, under some conditions, acts as an ion channel.
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