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

Abstract

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.