Abstract
BACKGROUND: Mesh implantation by median laparotomy is believed to reduce the rate of incisional hernia. The present study was performed to determine the types of meshes and fixation that would provide the required reinforcement of the midline. METHODS: Median laparotomies were performed on 17 recently deceased cadavers. By the onlay technique, 6 different meshes were fixed by the following methods: Tissucol Duo Quick, ProGrip, A.M.I. EasyTack, AbsorbaTack, ProTack, continuous absorbable monofilament suture fixation using 4-0, 3-0, 2-0, 0, 1 (PDS). Tensile forces were applied to the meshes, using a tensiometer, until mesh ablation or mesh disruption. RESULTS: With regard to the suture fixations, retention strength increased in direct proportion to thread thickness. All other fixation techniques failed to achieve the stipulated fixation strength of 40 Newton. CONCLUSIONS: By continuous suture fixation and by using the onlay technique, a mean mesh stability of 58 N in tissue can be achieved with at least 3-0 sutures. In addition to its simple applicability, this fixation method is economical and may be recommended for clinical use in order to achieve prophylactic reinforcement of the midline.
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