P046 ATRAUMATIC AND CONSISTENT HERNIA MESH FIXATION: PERFORMANCE AND SAFETY IN A LAPAROSCOPIC IPOM PORCINE MODEL

Abstract Aim Demonstrate the performance and safety of TISSIUM on-demand activated adhesive for atraumatic hernia mesh fixation in a laparoscopic IPOM porcine model. Material and Methods Full thickness 4 cm in diameter excisional abdominal defects (n = 14) were created in pig (n = 8). The defects were repaired through laparoscopic intraperitoneal mesh placement using commercial composite meshes fixed with TISSIUM adhesive (n = 8) or resorbable tacks (n = 6). The animals were sacrificed after 28 and 90 days. An independent pathologist evaluated abdominal adhesion, mesh shrinkage, local tissue tolerance and tissue ingrowth through histological analysis (H&E and Movat Pentacrome) at sacrifice. Fixation strength of the explanted abdominal walls was also assessed via burst-ball. Results No adverse events were observed at implantation or during the survival period. All the meshes were in place at sacrifice. Mesh shrinkage and abdominal adhesion scores were similar between the two groups. Histological analysis of the mesh demonstrated equivalent quality of tissue ingrowth and excellent local tissue tolerance with minimal/mild foreign body response and mononuclear cells inflammation. The repair strength, evaluated through a burst ball method 90 days after implantation, showed no significant difference between the TISSIUM adhesive and tacks. Usability is currently being evaluated in clinically relevant models. Conclusions In this preclinical study the TISSIUM adhesive demonstrated similar fixation strength and quality of repair when compared to commercial tacks. This technology has the potential to impact hernia procedures standardization and reduce pain often associated with current fixation technologies.

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P044 ATRAUMATIC AND CONSISTENT HERNIA MESH FIXATION: PERFORMANCE AND SAFETY IN A LAPAROSCOPIC IPOM PORCINE MODEL

British Journal of Surgery ◽

10.1093/bjs/znab395.040 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Miguel Lopes ◽

Elisa Bitton ◽

Elise Devries ◽

Maria Pereira

Keyword(s):

Histological Analysis ◽

Porcine Model ◽

Mesh Fixation ◽

Fixation Strength ◽

Tissue Ingrowth ◽

Hernia Mesh ◽

Local Tissue ◽

Abdominal Adhesion ◽

Mesh Shrinkage

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Transcolonic ventral wall hernia mesh fixation in a porcine model

Endoscopy ◽

10.1055/s-2007-966916 ◽

2007 ◽

Vol 39 (10) ◽

pp. 865-869 ◽

Cited By ~ 55

Author(s):

D. Fong ◽

M. Ryou ◽

R. Pai ◽

A. Tavakkolizadeh ◽

D. Rattner ◽

...

Keyword(s):

Porcine Model ◽

Mesh Fixation ◽

Hernia Mesh ◽

Ventral Wall

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Developing a Hernia Mesh Tissue Integration Index Using a Porcine Model—A Pilot Study

Frontiers in Surgery ◽

10.3389/fsurg.2020.600195 ◽

2020 ◽

Vol 7 ◽

Author(s):

Paul Patiniott ◽

Brendan Stagg ◽

Alex Karatassas ◽

Guy Maddern

Keyword(s):

Pilot Study ◽

Hernia Repair ◽

Abdominal Wall ◽

Surgical Outcomes ◽

Porcine Model ◽

Biomechanical Analysis ◽

Tissue Ingrowth ◽

Hernia Mesh ◽

Tissue Integration

Introduction: With so many prosthetics available, it can be difficult for surgeons to choose the most appropriate hernia mesh. Successful hernia repair mandates an understanding of how the patient's inflammatory response influences surgical outcomes. Failure to appreciate the importance of the biological aspect of hernia repair can be very costly as emerging evidence supports that biofilm formation and reduction in effective mesh porosity gives rise to long-term mesh complications including fibrosis, chronic mesh infection, and pain. In this pilot study, we utilized a large animal (porcine) model to develop a numerical Mesh Tissue Integration (MTI) Index focused on visible tissue ingrowth, fibrosis, adhesion formation and resorption of mesh. The aim is to help surgeons adopt an evidence-based approach in selecting the most appropriate mesh according to its tissue ingrowth characteristics, matched to the patient to achieve improved surgical outcomes and optimal patient-centered care.Methods: Two forty kg female Landrace pigs were recruited for this pilot study. A total of eight commonly used hernia mesh products and two controls measuring 5 × 5cm were surgically implanted in subrectus and intraperitoneal planes. The pigs were euthanised at 2 and 4 weeks, respectively. The abdominal wall was explanted, and the mesh specimens underwent macroscopic, histologic and biomechanical analysis, with engineering and pathology teams blinded to the mesh.Results: Significant differences between the degrees of MTI were observed at 2 weeks and the distinctions were even more apparent at 4 weeks. One of the interesting incidental findings we observed is that mesh products placed in the subrectus plane displayed greater degrees of adhesion strength and integration than those placed intraperitoneally.Conclusion: This pilot study is one of the first to propose a functional, biological standardized model for comparing hernia mesh products. The results are encouraging and demonstrate that this is a robust and transferrable model for assessing MTI in hernia mesh. The intention for this model is that it will be utilized synergistically with long term mesh/patient outcome registries and databases to inform improved matching of mesh to patient, particularly in the setting of the complex hernia repair and abdominal wall reconstruction.

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Transcolonic Ventral Wall Hernia Mesh Fixation in a Porcine Model

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.03.024 ◽

2007 ◽

Vol 65 (5) ◽

pp. AB109

Author(s):

Derek G. Fong ◽

Marvin Ryou ◽

Reina D. Pai ◽

Ali Tavakkolizadeh ◽

David W. Rattner ◽

...

Keyword(s):

Porcine Model ◽

Mesh Fixation ◽

Hernia Mesh ◽

Ventral Wall

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A Clinical Study to Evaluate the Clinical Performance and Safety of LiquiBand FIX8® Versus AbsorbaTack™ for Hernia Mesh Fixation and Peritoneal Closure in Groin Hernia Repair

Case Medical Research ◽

10.31525/ct1-nct04009213 ◽

2019 ◽

Author(s):

Keyword(s):

Clinical Study ◽

Hernia Repair ◽

Groin Hernia ◽

Clinical Performance ◽

Mesh Fixation ◽

Groin Hernia Repair ◽

Hernia Mesh ◽

Peritoneal Closure

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Infl uence of crossbreeding and level of feeding on microstructural indicators of lamb

Glavnyj zootehnik (Head of Animal Breeding) ◽

10.33920/sel-03-2009-04 ◽

2020 ◽

pp. 32-40

Author(s):

I. I. Dmitrik

Keyword(s):

Muscle Tissue ◽

Nutritional Value ◽

Histological Analysis ◽

Meat Industry ◽

North Caucasus ◽

Marbling Score ◽

Sheep Meat ◽

Histological Method ◽

Meat Productivity

When studying indicators that characterize the quality of meat and its nutritional value as part of the development and improvement of existing research methods, histological analysis of the tissues included in it becomes increasingly important. Histological method has been used to study the microstructure of muscle tissue (m. longissimus dorsi) and chemical composition in sheep of diff erent genotypes and reared at diff erent feeding levels. It has been found that the muscle tissue of sheep obtained from crossbreeding of breeds North Caucasus (SC) with Texel (T) has been characterized by a large amount of muscle fi bers by 5,0 and 11,3 % (P < 0,05), the smaller amount by 5,7 and 18,6 % (P < 0,05) in diameter, a higher “marbling” score by 5,2 and 8,3 points, and the lower content of connective tissue by 0,8 and 1,3 abs.% compared to purebreds North Caucasian and from crossbreeding North Caucasian with Poll Dorset breed (PD). Chemical analysis of meat revealed a tendency to increase the content of dry matter and fat by 1,1 and 0,1 abs. % in lamb genotype T×SC and less than the amount by 1,1 and 0,1 abs.% moisture compared to purebreds and PD×SC. Increasing the energy supply of sheep, regardless of breed affi liation, contributes to the formation by 10 % more number of muscle fi bers per unit area and the decrease in their diameter, which increases the “marbling” of lamb and increases its consumer quality. The results have been obtained indicate the feasibility of using morphometric indicators of muscle tissue in the development of criteria for assessing the quality of sheep meat productivity, intended for practical use in agriculture and the meat industry.

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HISTOLOGICAL ANALYSIS AND PERFORMANCE OF SOUR PASSION FRUIT POPULATIONS UNDER DIFFERENT ROOTSTOCKS RESISTANT TO Fusarium spp

Revista Brasileira de Fruticultura ◽

10.1590/0100-29452018274 ◽

2018 ◽

Vol 40 (1) ◽

Author(s):

Moisés Ambrósio ◽

Willian Krause ◽

Celice Alexandre Silva ◽

Laís Alves Lage ◽

Natan Ramos Cavalcante ◽

...

Keyword(s):

Histological Analysis ◽

Block Design ◽

Welding Process ◽

Anatomical Study ◽

Optical Microscope ◽

Passion Fruit ◽

Randomized Block Design ◽

Physical And Chemical ◽

Sour Passion Fruit

ABSTRACT The present study aimed to describe histological traits of the graft welding process and evaluate the effect of rootstocks on the physical and chemical traits and the productivity of sour passion fruit populations. The experiment was arranged in a randomized block design, in a 4x2 + 4 factorial scheme (cultivars / canopy x rootstocks), three replicates and nine plants per plot. Commercial cultivars and populations and Passiflora alata and P. nitida rootstocks, in addition to ungrafted plants were used as canopy. Cleft grafting was the grafting type adopted. Traits analyzed such as productivity and physical and chemical quality of fruits were submitted to analysis of variance and compared by the Tukey test. The canopy morphology was evaluated according to descriptors of the Ministry of Agriculture, Livestock and Supply. Grafting was carried out for each graft/rootstock combination for histological analysis. Sections were obtained by freehand cuts, stained and mounted on semi-permanent slides, examined under optical microscope and photomicrographed. Rootstocks affected the early cultivation and reduced productivity and number of fruits of passion fruit populations. Grafting did not affect the quality of fruits or the canopy morphology. Considering the complete culture cycle, P. alata species is able to be used as rootstock. The anatomical study demonstrates the occurrence of better compatibility in the connection of P. edulis tissues on P. alata, compared to grafting on P. nitida.

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O41 PREDICTORS OF LOW QUALITY AFTER OPEN INGUINAL HERNIA REPAIR USING THE EURAHS-QOL SCORE: PROSPECTIVE MULTICENTRIC COHORT STUDY

British Journal of Surgery ◽

10.1093/bjs/znab396.040 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Joana Simoes ◽

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Mesh Fixation ◽

Absorbable Mesh ◽

Open Inguinal Hernia Repair

Abstract Aim Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to identify predictors of low Quality of Life (QoL) after open inguinal hernia repair, to guide practice and inform patients at high risk. Material and Methods Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results 893 patients were included from 33 hospitals. The majority were men (89.9% [800/891]), had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair (52.9% [472/893]). The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3 months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). Conclusions This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

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P049 SAFETY AND EFFICACY OF ABSORBABLE AND NON-ABSORBABLE FIXATION SYSTEMS FOR INTRAPERITONEAL MESH FIXATION: AN EXPERIMENTAL STUDY IN SWINE

British Journal of Surgery ◽

10.1093/bjs/znab395.045 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Spyridon Kapoulas ◽

Apostolos Papalois ◽

Georgios Papadakis ◽

Georgios Tsoulfas ◽

Emmanouil Christoforidis ◽

...

Keyword(s):

Abdominal Wall ◽

Mesh Fixation ◽

Peel Strength ◽

Swine Model ◽

Abdominal Wall Defects ◽

Hernia Surgery ◽

Safety And Efficacy ◽

Mesh Placement ◽

Intraperitoneal Mesh ◽

Mesh Shrinkage

Abstract Aim Choice of the best fixation system in terms of safety and effectiveness for intraperitoneal mesh placement in hernia surgery remains controversial. The aim of this study was to compare the performance of four fixation systems in a swine model of intraperitoneal mesh fixation. Material and Methods Fourteen Landrace swine were utilized and the experiment included two stages. Initially, four pieces of polypropylene mesh with hydrogel barrier coating1 were fixed intraperitoneally to reinforce 4 small full thickness abdominal wall defects created with diathermy. Each mesh was anchored with a different tack device between titanium2, steel3 or absorbable (4,5) fasteners. The second stage took place after 60 days and included euthanasia, laparoscopy, and laparotomy. The primary endpoint was to compare the peel strength of the compound tack/mesh from the abdominal wall. Secondary parameters were the extent and quality of visceral adhesions to the mesh, the degree of mesh shrinkage and the histological response around the tacks. Results Thirteen out of 14 animals survived the experiment and 10 were included in the final analysis. Steel tacks had higher peel strength when compared to titanium and absorbable fasteners. No significant differences were noted regarding the secondary endpoints. Conclusions Steel fasteners provided higher peel strength that the other devices in this swine model of intraperitoneal mesh fixation. Our findings generate the hypothesis that this type of fixation may be superior in a clinical setting. Clinical trials with long-term follow-up are required to assess the safety and efficacy of mesh fixation systems in hernia surgery.

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