Weight and biomaterial classifications were proposed after an extensive analysis of commercially available prosthetics. The need for a common terminology is important to avoid misunderstandings among clinicians and technicians.

No abstract

NCT02001844.

Complications involving the abdominal wall, particularly incisional hernias, were not expected when laparoscopic procedures were first introduced. With the increasing number of laparoscopies in abdominal surgery, more incisional hernias are observed. The authors report 13 cases of umbilical incisional hernia, which occurred late after laparoscopic cholecystectomy, and one case of omental procidentia through a lateral port, which occurred early after laparoscopic hernia repair with the transabdominal preperitoneal technique. There are 4 men and 10 women (mean age, 59.8 years; range, 40-74 years). Between March 1991 and December 1997, a total of 1,287 patients underwent laparoscopic operations at the Surgical Department of the Gradenigo Hospital in Turin, Italy. Incisional hernia incidence is 1%. Risk factors, such as chronic bronchitis or weight increase, which give rise to endoabdominal pressure, are present in some cases. Malnutrition may have a major role in many cases. Calculi larger than 15 mm are also seen frequently. Postlaparoscopy incisional hernia is generally a minor complication--only once did its occurrence cause a strangulated hernia. All precautions, including fascial suturing, must be taken to reduce the 1% incidence of postoperative incisional hernias.

For the first time, by scanning electron microscopy (SEM), polypropylene (PP) excised meshes (ethylene oxide sterilized) for abdominal wall hernia repair have been shown to be greatly damaged physically, independently of the implantation time, while the polyethylene terephthalate (PET), or Dacron, ones (gamma radiation sterilized), did not undergo alterations due to the sterilization process and were not damaged, even after long implantation periods. Fourier-Transform Infrared Spectroscopy (FTIR) study of PP and PET excised meshes, as well as of their extracts with cyclohexane, has shown the presence of species, such as squalene, palmitic and stearic acid, in some cases, cholesterol, transferred from the surrounding tissues to the polymer during the implantation period. In the case of PP meshes, these small organic molecules would reduce physical and mechanical properties of the material. A hypothesis is presented to account for the better behavior (not in the clinical sense) of PET meshes.