Abstract
To evaluate the morphological aspects of the behavior of 4 types of latex biomembranes implanted in preperitoneal videolaparoscopic inguinoplasty. Sixteen inguinoplasties were performed in 12 dogs: group 1 received an impermeable latex biomembrane in the right inguinal region and a prolene prosthesis, as control, in the contralateral inguinal region; groups 2, 3 and 4 received latex biomembranes respectively containing impermeable polyamide, 1-mm thick porous polyamide and 0.5-mm thick porous polyamide. Macro- and microscopic evaluations of the inguinal region and of the removed implants were made on the 7th, 14th, 21st and 28th days in group 1 and on the 28th postoperative day in the other groups. We observed absence of hematoma, seroma and infection; presence of tortuosities; induction of vascular neoformation, inflammatory reaction and collagen deposition, and full encystment of the latex biomembranes, except that with fine porous polyamide, which was partially incorporated, with the formation of microcysts. No latex biomembrane induced fibrosis as observed in the prolene control group. The biomembranes maintain induction of the healing process without fibrosis, are fully encysted and, except for the one with fine porous polyamide, are not incorporated into adjacent tissues. The latex biomembrane, with or without polyamide, is not recommended as a separate material for preperitoneal inguinoplasty.
Highlights
Inguinal hernias are related to areas of the inguinal region weakened by elastase deficiency
Our objective was to assess the morphological aspects of the behavior of impermeable latex biomembranes, latex biomembranes with impermeable polyamide and latex biomembranes with porous polyamide in dogs submitted to videolaparoscopic inguinoplasty with placement of a prosthesis in the preperitoneal space
Sixteen inguinoplasties were performed by the preperitoneal transabdominal technique in 12 dogs divided into the following four groups: GROUP 1 (n = 8): the impermeable latex biomembrane was placed in the preperitoneal space of the right inguinal region and the prolene prosthesis, as control, was placed in the left inguinal region of dogs nos. 1, 2, 3 and 4
Summary
Inguinal hernias are related to areas of the inguinal region weakened by elastase deficiency. The increase in intra-abdominal pressure in patients with pulmonary emphysema, prostate hypertrophy and asthma, as well as malformation of the transverse abdominal muscle and collagen deficiency, favor the appearance of hernias. In 1884, Edoardo Bassini developed his operation, followed by other surgeons who used tissues of the inguinal region itself for reinforcement, such as transverse fascia, pectineal ligament, aponeurosis of the external oblique muscle, conjoint tendon, and internal inguinal ring[1,2,3]. In an attempt to improve the results, especially regarding recurrence, prostheses started to be applied in order to obtain a resistant tissue able to create a mechanical obstacle to the abdominal viscera. Absorbable or not, synthetic, biosynthetic and biological were tested on the abdominal wall and in the inguinal region[4,5,6,7]. The non-absorbable ones are made of polytetrafluoroethylene (PTFE, Gore-tex and Teflon), polypropylene (Marlex, Trelex and Prolene), polyethylene, nylon, polyester, dacron, and mersilene
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