The failure of polypropylene surgical mesh in vivo

Taylor, David

doi:10.1016/j.jmbbm.2018.08.041

Cited by 30 publications

(19 citation statements)

References 25 publications

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“…An experimental study showed that mesh shrank to up to 55% of its original size within 3 months after implantation with a considerable tissue integration force (ranging from 120 to 229 N) 8 . With the shrinkage of the mesh over time, the tensile stresses in mesh would increase 9 . Furthermore, permanent fixation of mesh may worsen the symptom.…”

Section: Discussionmentioning

confidence: 99%

Mesh shrinkage is the potential pathogenesis of chronic somatic pain following transabdominal preperitoneal repair: Report of two cases

Narita

Munekage

Yamaoka

et al. 2021

Asian J Endoscop Surgery

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Although mesh‐related pain, termed “somatic pain,” is a well‐known pain syndrome following Lichtenstein repair, few reports are available on somatic pain following transabdominal preperitoneal repair (TAPP) and its pathogenesis remains unclear. We report on two patients with refractory somatic chronic pain following TAPP. In the present two cases, both mesh fixation with rigid permanent metal tackers and mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP. The lessons learned from these two cases are: (a) mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP; (b) partial mesh removal would be an effective alternative to total mesh removal in those patients for remedial surgery.

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Section: Discussionmentioning

confidence: 99%

Mesh shrinkage is the potential pathogenesis of chronic somatic pain following transabdominal preperitoneal repair: Report of two cases

Narita

Munekage

Yamaoka

et al. 2021

Asian J Endoscop Surgery

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“…Over the past few years, the confusion of whether PP mesh is still suitable for implantation in human body has aroused a myriad of researchers' concern. Collecting data from a series of clinical case studies and biomechanics analysis, David Taylor 23 noted that when polypropylene mesh was tested for tensile strength, the researchers found that it was greater than the abdominal wall maximum tensile strength, approximately 16 N/cm, which was deduced from the human intra-abdominal pressure, so the leading causes of postoperative complications were not mechanical failure of mesh.…”

Section: Developments In Hernia Meshesmentioning

confidence: 99%

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

Fang

Wang

et al. 2021

ACS Appl. Bio Mater.

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Throughout the past few years, hernia incidence has remained at a high level worldwide, with more than 20 million people requiring hernia surgery each year. Synthetic hernia meshes play an important role, providing a microenvironment that attracts and harbors host cells and acting as a permanent roadmap for intact abdominal wall reconstruction. Nevertheless, it is still inevitable to cause not-so-trivial complications, especially chronic pain and adhesion. In long-term studies, it was found that the complications are mainly caused by excessive fibrosis from the foreign body reaction (FBR) and infection resulting from bacterial colonization. For a thorough understanding of their complex mechanism and providing a richer background for mesh development, herein, we discuss different clinical mesh products and explore the interactions between their structure and complications. We further explored progress in reducing mesh complications to provide varied strategies that are informative and instructive for mesh modification in different research directions. We hope that this work will spur hernia mesh designers to step up their efforts to develop more practical and accessible meshes by improving the physical structure and chemical properties of meshes to combat the increasing risk of adhesions, infections, and inflammatory reactions. We conclude that further work is needed to solve this pressing problem, especially in the analysis and functionalization of mesh materials, provided of course that the initial performance of the mesh is guaranteed.

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“…Several synthetic materials have been proposed and used in urogynecology. Polypropylene, which has more than a 60-year history of successful application in general surgery [10], seems to be the most prevalent one. Another increasingly used option is polyvinylidene fluoride (PVDF), which was shown to have excellent biocompatibility, low risk of bacterial colonization and superior tensile strength maintenance [11, 12].…”

Section: Mesh Repair – Yes or No?mentioning

confidence: 99%

Laparoscopic approach to pelvic organ prolapse - the way to go or a blind alley?

Malanowska

Šoltés

Starczewski

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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A b s t r a c tPelvic organ prolapse represents a relatively frequent diagnosis that requires attention due to its detrimental effect on quality of life. Not surprisingly, it is one of the commonest indications for surgery in premenopausal and postmenopausal women, often requiring a complex multidisciplinary approach. Traditional vaginal procedures are being gradually replaced by laparoscopic techniques, offering anticipated benefits in reduced recurrence and complication rates, while respecting the trend towards uterus sparing if desirable. Recently, questions about the safety of alloplastic materials used in pelvic organ prolapse surgery were raised, leading to official restrictions in their use, particularly for transvaginal application. As a result, laparoscopic procedures might appear slightly favored but caution must be taken to assure proper technique of mesh placement while maintaining high awareness of possible long-term mesh-related complications that require close surveillance. Therefore, adequate education and training becomes even more important to achieve optimal results and to avoid possible serious medico-legal charges.

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The failure of polypropylene surgical mesh in vivo

Cited by 30 publications

References 25 publications

Mesh shrinkage is the potential pathogenesis of chronic somatic pain following transabdominal preperitoneal repair: Report of two cases

Mesh shrinkage is the potential pathogenesis of chronic somatic pain following transabdominal preperitoneal repair: Report of two cases

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

Laparoscopic approach to pelvic organ prolapse - the way to go or a blind alley?

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