Abstract
BackgroundCurrent data on shrinkage of intraperitoneal meshes come mainly from animal studies. High-quality human data in prospective studies are scarce.MethodsWe used the ability to visualize intraperitoneal PVDF meshes enhanced with iron particles (DynaMesh IPOM visible) with magnetic resonance imaging (MRI) to determine the amount of shrinkage between 1 and 13 months postoperatively. All measurements of the width, length, and surface area of the mesh were performed with a standardized methodology independently by four radiologists blinded for the timing of the MRI.ResultsOf the 15 patients undergoing laparoscopic ventral hernia repair, 13 patients received an MRI both at 1 and at 13 months. Evaluation of inter-rater reliability between the radiologists showed intra-class correlations of 0.95 (95% CI 0.92–0.98) for the width, 0.96 (95% CI 0.93–0.98) for the length, and 0.99 (90% CI 0.99–1.00) for the surface area of the mesh. The change between measurement at implantation and 1-month MRI was − 0.7 cm (P = 0.023; − 3.6%) for the width and − 1.9 cm (P = 0.001; − 7.2%) for the length. The change between 1 and 13 months was − 0.06 cm (P = 0.74; shrinkage = 0.3%) for the width, − 0.12 cm (P = 0.56; shrinkage = 0.5%) for the length, and − 4.0 cm2 (P = 0.20; shrinkage = 1.0%) for the surface area of the mesh.ConclusionThere is excellent inter-rater reliability between radiologists when measuring width, length, and surface area of visible intraperitoneal PVDF mesh with MRI. There is no significant shrinkage between 1 and 13 months of intraperitoneal PVDF mesh after laparoscopic ventral hernia repair.
Highlights
Current data on shrinkage of intraperitoneal meshes come mainly from animal studies
The objective is to evaluate in a clinical setting the shrinkage, defined as the decrease of mesh surface area, between 1 and 13 months after implantation of intraperitoneal iron oxide-impregnated polyvinylidene fluoride (PVDF) mesh measured with magnetic resonance imaging (MRI)
Of 15 patients entered in the study, 13 were evaluated according to protocol with two postoperative MRI scans
Summary
Current data on shrinkage of intraperitoneal meshes come mainly from animal studies. All measurements of the width, length, and surface area of the mesh were performed with a standardized methodology independently by four radiologists blinded for the timing of the MRI. The change between 1 and 13 months was − 0.06 cm (P = 0.74; shrinkage = 0.3%) for the width, − 0.12 cm (P = 0.56; shrinkage = 0.5%) for the length, and − 4.0 cm (P = 0.20; shrinkage = 1.0%) for the surface area of the mesh. Conclusion There is excellent inter-rater reliability between radiologists when measuring width, length, and surface area of visible intraperitoneal PVDF mesh with MRI. There is no significant shrinkage between 1 and 13 months of intraperitoneal PVDF mesh after laparoscopic ventral hernia repair. It is believed that meshes used for intraperitoneal laparoscopic ventral hernia repair shrink to a variable extent after implantation [1]. At the University of Aarhus in Denmark, Paul Wara and Hans Friis-Andersen have developed an animal model of laparoscopic ventral hernia repair in sheep, which allows
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