The Historical Development of Prosthetics in Hernia Surgery

DeBord, James R.

doi:10.1016/s0039-6109(05)70365-0

Cited by 104 publications

(74 citation statements)

References 72 publications

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“…Polypropylene meshes have been used in hernia surgery for decades [15,16] but its use has increased dramatically the last 10 years. The superiority of mesh repairs compared to conventional repairs regarding recurrence rate is now well documented [6,8].…”

Section: Discussionmentioning

confidence: 99%

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

Berndsen

Bjursten

Simanaitis³

et al. 2004

Eur Surg Res

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Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas deferens and s-testosterone from the spermatic vein were measured using the contralateral side as control. Light microscopy of the inguinal canal was performed and inflammation and fibrosis were graded. Results: Vasography revealed patent vas deferens in all animals. In group III, there was a lower s-testosterone in the spermatic vein and a reduced cross-sectional area of the vas deferens on the operated compared to the control side. However, there was no difference in the other groups and there was no significant difference in s-testosterone levels between the groups. There was significantly more inflammation and fibrosis after mesh repair compared to suture repair, but there was no difference between the two mesh groups. Unexpectedly, polyglactin fibres were still seen in specimens in group III after 90 days. Conclusion: In conclusion, the only effect on the spermatic cord structures in a rat model is seen as an impaired s-testosterone production and a reduced cross-sectional area of the vas deferens after use of a low-weight composite mesh compared to the control side. No difference in inflammation or fibrosis was found between heavyweight polypropylene mesh and low-weight composite mesh.

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Section: Discussionmentioning

confidence: 99%

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

Berndsen

Bjursten

Simanaitis³

et al. 2004

Eur Surg Res

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“…The material should be chemically inert, non-carcinogenic, and capable of resisting mechanical strains, not excited by an inflammatory or foreign body reaction. But it is unlikely that a single 'ideal' prosthesis could fit all these properties (3,12). The effect of prosthetic materials used in hernia repair on wound healing differs according to properties of the material.…”

Section: Discussionmentioning

confidence: 99%

Investigation into the optimal prosthetic material for wound healing of abdominal wall defects

2017

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Abstract. The purpose of this experimental study is to investigate and compare the effects of prosthetic materials used for wound healing of abdominal wall hernias. A total of 60 rats were divided into five equal groups: Group I, control subjected to laparotomy; group II, abdominal wall defect 3x2 cm+polypropylene (PP) mesh; group III, abdominal wall defect 3x2 cm+PP mesh+hyaluronate and carboxymethylcellulose (H-CMC; Seprafilm ® ); group IV, abdominal wall defect 3x2 cm+polytetrafluoroethylene (PTFE; Composix™); and group V, abdominal wall defect 3x2 cm+polyethylene terephthalate (PET; Dacron ® ). A total of 14 days after the surgery, rats were sacrificed and the meshes with the surrounding tissue were extracted in block. The breaking strength of the mesh from the fascia was recorded. The healing tissue was examined with the index of histopathology and the hydroxyproline value was analyzed using the Switzer method. Both the breaking strength and histopathological index of the wound healing were significantly improved in groups II and III compared with that in groups IV and V (P<0.001). Hydroxyproline values were the highest in group I (P<0.001). There was also a statistically significant difference between groups II and IV, and group V and the other groups (P<0.001). The present findings demonstrated that PP mesh and PP mesh+H-CMC had a superior breaking strength and improved histopathologic indices compared with PTFE and PET. Furthermore, hydroxyproline values were the lowest in the PET group. In conclusion, wound healing was improved in the PP mesh group and the PP mesh+H-CMC group compared with the PTFE and PET groups according to the present study parameters.

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“…This method is very simple, effective, and is associated with very low recurrence rates (ranging from 0-2% in the literature) and can be performed under local or regional anaesthesia 16,17 . As it is tension free, it causes minimal postoperative pain 10,13 . The technique used in this study is practical for our surgeons because there is virtually no learning curve.…”

Section: Discussionmentioning

confidence: 99%

Tension Free Mesh Repair is an Effective Treatment of Inguinal Hernia: An Observational Study

et al. 2013

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The Historical Development of Prosthetics in Hernia Surgery

Cited by 104 publications

References 72 publications

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

Investigation into the optimal prosthetic material for wound healing of abdominal wall defects

Tension Free Mesh Repair is an Effective Treatment of Inguinal Hernia: An Observational Study

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