Prosthetic strap system for simplified ventral hernia repair: results of a porcine experimental model

Abstract

Aiming to achieve a simplified ventral hernia repair, a proprietary oval-shaped mesh was experimentally tested in a porcine model. The mesh is structured with a large central body and radiating straps. The friction of the straps passing through the tissues are hypothesized to be adequate to maintain the position of the mesh during tissue ingrowth, avoiding classic point fixation while ensuring a wide coverage of the abdomen. The mesh, having six radial straps, was placed using a sublay preperitoneal technique in four pigs. All straps were passed laterally through the abdominal wall and exteriorized from the skin. The straps were trimmed at the level of the skin, allowing the stumps to recoil into the subcutaneous space. The animals were euthanized at 1 and 4 months to determine the integration of the straps. Macroscopically, all 24 straps were firmly incorporated within the abdominal wall. The tension-free placement of the mesh by using the straps was effective. The friction of the straps passing through the tissues was adequate to keep the mesh well orientated. No dislocation of the implants was observed. The strap system also allowed a broader coverage of the abdominal wall, far beyond the wound opening. The described arm system of the aforementioned implant seems to be effective in eliminating point fixation of the mesh. The fixation arms seemed to have ensured that the mesh stayed orientated in all of the animals. A very wide lateral mesh placement was accomplished, assuring sufficient defect overlap when shrinkage occurs.