Flat Mesh Research Articles

Experimental study on heat transfer performance of mesh-type ultra-thin vapor chamber for large-area pouch battery

Ultra-thin vapor chambers (UTVCs) with high heat transfer characteristics in tight spaces are ideal for the heat dissipation needs of compact, high-energy-density battery systems for electric vehicles (EVs). This has also led to the expansion of the UTVC area to accommodate the battery size. In this study, a large-area (197 mm × 215 mm) UTVC with cost-effective flat meshes as the internal structure was designed for LiNi1-x-yCoxMnyO2 (NCM) pouch battery. Different from traditional mesh-type UTVCs, the vapor core is designed with multiple partially-through vapor channels to reduce vapor flow resistance. Experimental methods were used to investigate the impact of the UTVC placement and the position of the vapor channel in the vapor core on the heat transfer performance, as well as to examine the actual heat dissipation effect on the battery. The results show that gravity affects the performance of UTVC through placement. The UTVC under gravity-assisted placement has an advantage in both heat transfer performance and maximum heat dissipation power, reaching 0.142 °C/W and 144 W, respectively. And it is beneficial to reduce the thermal resistance of the UTVC by locating the vapor channel deeper into the evaporation section. The heat dissipation of the large-area battery by UTVC reduces the maximum temperature of the battery at the rate of 2.4C charging and 3C discharging by 22.3 and 23.8 °C, and the temperature difference is reduced by 62.31 % and 67 %, respectively.

Metallic Metamaterials with Auxetic Properties: Re-Entrant Structures

The present article is an exploration of metamaterial structures exhibiting auxetic properties. The study shows the effect of three geometric parameters of re-entrant auxetic cells, namely, the internal initial cell angle (θ0), the strut length ratio h/l, and the degree of opening of the unit cells expressed by the change in the Δθ angle, on the value of the Poisson’s ratio. It combines theoretical insights into physical re-entrant auxetic structures with the demonstration of structures that can be subjected to cyclic loading without being damaged. The experimental section features the results of the compression tests of a symmetrical structure made up of four re-entrant cells and tensile tests of a flat mesh structure of size 4 × 4. In the mesh structure, a modification was applied to the re-entrant cells, creating arched strut connections. It was shown that the value of the maximum load for such structures depends on the bending angle and the length of the inclined strut. The mesh structure was created using torsion springs. Its cyclic tension for different amplitudes yielded Poisson’s ratio values in the range of −1.4 to −1.7. These modifications have enabled stable, elastic, and failure-free cyclical changes of the structure’s dimensions under load.

The DySLOH Study: Comparative Evaluation of the Results between the ProFlor and Lichtenstein Techniques for Open Inguinal Hernia Repair-A Randomized Controlled Trial.

Background: The Lichtenstein open anterior approach with static flat meshes, the most popular inguinal hernia repair technique, has raised concerns regarding mesh fixation, defect patency, and poor quality biological response. To address these issues, the 3D dynamic ProFlor scaffold promoting a fixation-free hernia defect obliteration has been developed as an alternative. Methods: The results of open inguinal hernia repair with the ProFlor approach compared with those of the Lichtenstein repair were evaluated. Results: In a time frame of 24 months, two cohorts of patients were enrolled, 95 in the ProFlor group and 93 in the Lichtenstein group. ProFlor demonstrated superior outcomes compared to the Lichtenstein technique, with shorter procedure times, decreased intraoperative complications, and lower rates of postoperative complications. Additionally, ProFlor provided enhanced postoperative pain relief, a faster return to daily activities, and no long-term discomfort. No chronic pain was reported in the ProFlor group and 11.8% reported chronic pain in the Lichtenstein group. Conclusions: The results highlight the need to reevaluate the conventional Lichtenstein approach and align it with recent scientific progress. Further consideration of the evolving understanding of inguinal pathophysiology and groin protrusion genesis is crucial for advancing surgical techniques.

Criteria for choosing a mesh implant in laparoscopic Transabdominal Preperitoneal Patch hernioplasty

Laparoscopic Transabdominal Preperitoneal Patch hernioplasty is an important method of treating inguinal hernias, but the lack of data on the comparative effectiveness of anatomical 3D mesh and traditional flat mesh makes it difficult to choose the optimal implant to reduce the risk of recurrence and complications. The aim of the study was to compare the effectiveness of anatomical 3D mesh and traditional flat mesh in laparoscopic hernioplasty with Transabdominal Preperitoneal Patch, as well as to determine the key criteria for implant selection. The objectives of the study were to analyse the recurrence rate, duration of surgery, postoperative pain, complication rate and patient satisfaction in the two groups. The study included 187 patients who were divided into two groups: 92 patients received traditional flat meshes and 95 patients received 3D anatomical meshes. Data were collected over 18 months and analysed using statistical methods. The use of anatomical 3D meshes reduced the time of surgery. The average level of postoperative pain according to the Visual Analogue Scale in the group with anatomical meshes was 30% lower. The complication rate in the anatomical mesh group was 5%, while in the flat mesh group it was 12%. Patient satisfaction in the group with anatomical 3D meshes was significantly higher. The results of the study confirm the advantage of anatomical 3D mesh in laparoscopic hernioplasty with Transabdominal Preperitoneal Patch, which reduces the time of surgery, reduces the incidence of recurrence, postoperative pain and complications, and increases patient satisfaction

Three-Dimensional Guidance Laws for Spacecraft Propelled by a SWIFT Propulsion System

This paper discusses the optimal control law, in a three-dimensional (3D) heliocentric orbit transfer, of a spacecraft whose primary propulsion system is a Solar Wind Ion Focusing Thruster (SWIFT). A SWIFT is an interesting concept of a propellantless thruster, proposed ten years ago by Gemmer and Mazzoleni, which deflects, collects, and accelerates the charged particles of solar wind to generate thrust in the interplanetary space. To this end, the SWIFT uses a large conical structure made of thin metallic wires, which is positively charged with the aid of an electron gun. In this sense, a SWIFT can be considered as a sort of evolution of the Janhunen’s E-Sail, which also uses a (nominally flat) mesh of electrically charged tethers to deflect the solar wind stream. In the recent literature, the optimal performance of a SWIFT-based vehicle has been studied by assuming a coplanar orbit transfer and a two-dimensional scenario. The mathematical model proposed in this paper extends that result by discussing the optimal guidance laws in the general context of a 3D heliocentric transfer. In this regard, a number of different forms of the spacecraft state vectors are considered. The validity of the obtained optimal control law is tested in a simplified Earth–Venus and Earth–Mars transfer by comparing the simulation results with the literature data in terms of minimum flight time.

Experimental Study of Auxetic Structures Made of Re-Entrant ("Bow-Tie") Cells.

This article presents a study of metamaterial structures that exhibit auxetic properties. This unusual phenomenon of simultaneous orthogonal expansion of the metamaterial in tension, and vice versa in compression, with vertical and horizontal contraction, is explored for structures made of re-entrant unit cells. The geometry of such structures is analysed in detail, and the relationships are determined by the value of the Poisson's ratio. It is shown that the Poisson's ratio depends not only on the geometry of the unit cell but also on the degree of strain. Depending on the dimensions of the structure's horizontal and inclined struts, the limit values are determined for the angle between them. By creating physical structures made of re-entrant cells, it is demonstrated that the mechanism of change in the structure's dimensions is not due to the hinging but to the bending of the struts. The experimental section contains the results of compression tests of a symmetrical structure and tensile tests of a flat mesh structure. In the case of the mesh structure, a modification of the re-entrant cells was used to create arched strut joints. This modification makes it possible to obtain greater elongation of the mesh structure and larger NPR values.

Glass-fiber catalysts for selective catalytic reduction of nitrogen oxides by CO and hydrocarbons

Glass-fiber catalysts (GFCs) are investigated in the process of the catalytic reduction of nitrogen oxides by hydrocarbons and carbon monoxide contained in waste and flue gases. Studies show that the platinum-based GFCs prepared by surface high-temperature synthesis approach demonstrates higher activity in the reactions of NOx reduction and CO and CxHy oxidation, in comparison with conventional GFCs and catalytic systems based on oxides of MnCe and FeV. Structured cartridges with a corrugated and flat metal mesh with longitudinal flow direction and satin type GFC were found to provide the highest apparent catalyst activity. The kinetic model for Pt/GFC was proposed based on the experimental data. The best kinetic description is provided under account of formation of nitrite-nitrate surface compounds resulting from NO chemisorption and further interaction of these compounds with CO, as well as under account of simultaneous catalytic and non-catalytic oxidation of propane by oxygen both to CO and CO2. The proposed model may adequately reproduce the non-trivial experimental regularities, such as CO and NO conversion decrease at high temperatures and synergetic effect of oxygen on the rate of NO reduction by CO.

Fibreglass Catalysts for the Removal of Nitrogen Oxides from Industrial Exhaust Gases

A method for removing nitrogen oxides from industrial of exhaust gases by catalytic reduction using fibreglass carriers was studied. It was noted that this know-how reduces nitrogen oxides and oxidizes carbon monoxide and hydrocarbons to safe compounds at moderate temperatures without additional reagents (ammonia, urea). It was proven that catalytic blocks structured with corrugated flat metal meshes provide the highest catalyst activity, and the best carrier is macosatin fabric. It was concluded that the described catalysts are characterized by high internal mass exchange rate in combination with low hydraulic resistance, high permeability, and the possibility of being used in dusty flows, which makes them very promising for treating various flue and exhaust gases.

P-094 FLAT PATCH MESH VERSUS THREE-DIMENSIONAL MESH (PLUG) FOR OPEN UMBILICAL OR EPIGASTRIC HERNIA REPAIR: A RETROSPECTIVE STUDY

Abstract Aim The aim of this retrospective study was to compare open small- and medium-sized ventral hernia repair with flat patch mesh versus three-dimensional mesh (plug) in terms of recurrence and complication rates. Methods The medical records of 300 patients who underwent ventral hernia repair using flat mesh versus plug between January 2010 to December 2015 were reviewed. All patients were followed up after 1 month, 3 month and 1 year. The rate of recurrence, and short-term postoperative complications such as incidence of Surgical Site Infections (SSIs), hematoma and seroma were evaluated. Results Short-term follow-up data were available for all patients. The first group was composed of 150 patients that were treated with plug (60% presented umbilical hernia and 40% presented epigastric hernia). The second group was composed of 150 patients that were treated with flat mesh (68% presened umbilical hernia and 32% presented epigastric hernia). The majority of postoperative complications were wound related, representing superficial SSI or seroma. Our results showed a statistically significant reduction of SSIs [3 (2%) vs 13 (8.6%); p = 0.038] and seroma [2 (1.3%) vs 12 (8%); p = 0.030] in the group of patients treated with plugs. There was no statistically significant difference in hernia recurrences. Conclusions Usage of plugs represents a feasible and safe technique that significantly lowers the incidence of complications. Furthermore, compared to flat mesh, plugs displayed non-inferiority in terms recurrence. Further, well-designed clinical trials could be realized to investigate possible applications of plugs for umbilical and epigastric hernias repair.

P-042 SHORT-TERM RESULTS OF LAPAROSCOPIC TOTALLY EXTRAPERITONEAL (TEP) GROIN HERNIA REPAIR WITH LIGHTWEIGHT FLAT MESH WITHOUT FIXATION. AGAINST THE ESTABLISHED?

Abstract Aim International guidelines concerning mesh and mesh fixation options in TEP and transabdominal preperitoneal (TAPP) groin hernia repair are based on studies focusing on either mesh or fixation. The value of such recommendations is limited by lacking knowledge on how mesh and fixation interact. The Swedish Hernia Registry Study published in 2022 a cohort study where it recommended in TEP and TAPP the use of lightweight flat mesh with fibrin glue fixation and the use of standar polypropylene flat mesh without fixation, as the two methods with the lowest rate of reoperations for recurrence (3,7%). We present the short-term results of TEP groin hernia repair with lightweight polypropylene flat mesh without fixation. Material and Methods In 2021, 32 TEP were electively performed in 27 adults with inguinal hernias L, M, F, P or R (EHS-Classification). The endpoint was reoperation due to recurrence at 1 year after surgery. Results 32 hernias L1 P, 1 L2 P, 2 L2 R and 1 F1 P were operated as outpatient surgery. 24 males and 4 females. Average age 57,5; Average BMI 28; The most frecuent postoperative complication was mild self-limiting scrotal hematoma (10%; Clavien-Dindos-I). Recurrence rate of hernia was 3,7%. Conclusions The TEP groin hernia repair with lightweight flat mesh without fixation could be an option to consider. However, due to the small sample size used in this study, the results should be interpreted with caution and longer-term studies are needed.

P-060 PREFORMED PATCH VS. FLAT PREPERITONEAL MESH FOR PRIMARY AND INCISIONAL HERNIA: A PROPENSITY-SCORE MATCHED ANALYSIS

Abstract Aim The MORPHEUS trial (Ponten et al. [2018]) reported better outcomes with a flat preperitoneal polypropylene mesh compared with a preformed patch for primary midline hernia repair. The aim was to evaluate our results with these meshes and to explore the recurrence factors. Material & Methods Observational retrospective study of patients undergoing hernia repair in a tertiary referral center. The preformed patch (PP) was used since April 2013, and the flat preperitoneal mesh (FPM) since March 2016. Recruitment finished in December 2021. A 3:1 Propensity-Score matching was performed to select cases for analysis. Results A total of 156 patients were analysed, 117 with PP and 39 with FPM. There were no differences in baseline characteristics, patients’ comorbidities, rates of midline (96.6% vs. 71.4%) or lateral hernias (3.4% vs. 28.6%) or in the proportion of primary (70.9% vs. 69.2%) and incisional hernias (29.1% vs. 30.8%) in PP and FPM groups, respectively. The median hernia defect was 2.5 cm (IQR: 2–3.22). There was a higher rate of defect closure in FPM (100%; 39/39) compared with PP group (12.8%; 15/117). The recurrence rate was higher in the PP group, with 16.2% (19/117), compared to 2.6% (1/39) in the FPM group (p: 0.027) with a median follow-up of 33.6 months (IQR: 14.2–48.7). In logistic regression, there were no statistically significant differences between meshes (OR: 0.136 [CI95%: 0.018-1.050]), while BMI was a risk factor for recurrence and the defect closure was a protective factor. Conclusion Mesh choice did not influence hernia recurrence.

P-077 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL HERNIA REPAIR (TAPP): OUR EXPERIENCE IN 200 PATIENTS

Abstract Aim To review and report our experience in the laparoscopic hernia treatment. Material & Methods It's a retrospective observational study including all patients who underwent a laparoscopic transabdominal preperitoneal hernia repair (TAPP) in our hospital between January 2016 to April 2022. Results From a total of 190 patients, 92% were male with a median age of 55,7 years old. Most of the cases were a primary hernia repair (81%) and 51,6% had bilateral presentation. Regarding the type of mesh employed, 89,1% were Adhesix®, 7,5% were Progrip® and 3,2% were flat polypropylen meshes. Tackers were used to fix the mesh only in a 11,2% of the patients. To close the peritoneum flap an absorbable barbed suture was used in a 94% of the cases, while tackers in a 5,9%. No intra-operative complications were described and 91,5% of surgeries were performed on an outpatioent basis. Concerning complications on the first fllow-up month: 7 patients suffered pain (3,4%) and 7 hematoma/seroma. Long-term complications were: chronic pain in 4 patients (2 with Adhesix®, 1 Progrip®, the forth one unknown; in none of them tackers were used); recurrence happened in 14 patients (7,6%) (11 Adhesix®, 2 Progrip®, 1 flat polypropylen mesh; tackers were used in three of these patients to fix the mesh). Conclusions Adhesix® mesh was the most employed (89,1%) and the one with the lowest recurrence rate (6,6%). According to our experience, tackers aren't necessary when an auto-adhesive mesh is used. Although they weren't related with postoperative pain, they didn't seem to prevent recurrence eiher.

OC-114 FEASIBILITY OF SUBCUTANEOUS ONLAY LAPAROSCOPIC APPROACH (SCOLA) UNDER LOCAL ANESTHESIA FOR THE PATIENTS WITH INCISIONAL HERNIA

Abstract Aim Incisional hernia is a benign disease and the indications for elective surgery are relative. Therefore, it is expected to expand the indications and improve patient quality of life by reducing invasiveness of surgery and anesthesia. We have been performing incisional hernia repair under local anesthesia for the past 12 years and report our clinical results. Material & Methods From 2009 to 2021, a consecutive group of 64 patients with incisional hernia was included. We used 0.5% lidocaine with epinephrine as local anesthesia. Pethidine was used as analgesic and dexmedetomidine as sedative. An incision of 30 mm at the top of the hernia bulge was made and a wound protector with sealing silicon cap was attached. We used three 5-mm trocars and a 5-mm flexible laparoscope. A flat self-fixating mesh with was placed over the primarily closed fascia and fixed using laparoscopic tacking devices. Results Forty-nine patients operated without endoscopy (Op). The others (n=15) required endoscopic subcutaneous dissection (LA). The mean ages of Op and LA were 66.9 and 64.3, respectively. The mean operating time of Op was significantly shorter than that of LA (100 vs 132, P=0.006). Similar hernia recurrence rete was observed (4.1% vs 6.7%, respectively). Clavien-Dindo Grade III and IV complications were not observed in both groups. Conclusions Incisional hernia repair under local anesthesia can be performed relatively safely even on elderly patients with serious co-morbidities, and the possibility of contributing to the improvement of patient quality of life by expanding the indications for surgery was expected.

V-043 Laparoscopic TAPP repair for strangulated femoral hernia

Abstract Aim To present a case of a strangulated femoral hernia successfully submitted to laparoscopic transabdominal preperitoneal (TAPP) repair and segmental enterectomy. Material and Methods Video recording of the surgical procedure and patient clinical files. Results A 75-year-old woman with previous medical history of diabetes and dyslipidaemia, went to the Emergency Department with complaints of generalized abdominal pain and absence of bowel moves since the previous day. On physical exam, an incarcerated left femoral hernia was evident. She also presented a renal dysfunction and computed tomography scan revealed a femoral hernia containing a bowel segment with upstream intestinal occlusion. Laparoscopic correction was proposed. Laparoscopy revealed an ischemic loop of bowel incarcerated in the femoral hernia defect, which was manually reduced. Signs of irreversible ischemia were present, but no perforation was evident. TAPP correction was performed with a polypropylene flat mesh of 37.8g/m2 with wide pores. After, the umbilical incision was extended and an extracorporeal segmental enterectomy with totally mechanical anastomosis was made. The patient had a favourable postoperative course with no complications. Conclusions Urgent groin hernia surgery with mesh requiring segmental enterectomy, but without gross peritoneal contamination, is associated with decreased recurrence rates and similar postoperative complications. In experienced centres, laparoscopic surgery may be associated with better results, although randomized multicentre studies are needed.

OC-073 THE 3-D FUNNEL MESH TECHNIQUE FOR PARASTOMAL HERNIA REPAIR

Abstract Background In previous studies, three-dimensional funnel mesh devices have been used successfully for the repair of PSHs by combining a laparoscopic and ostomy-opening approach Methods We performed an analysis of prospectively collected data of patients who underwent a same-sided stoma reposition with 3D funnel-shaped mesh augmentation in intraperitoneal- onlay position at three departments between the years of 2012 and 2021. 56 patients received an implant with 2.5 cm funnel length and 25 patients with 4cm funnel length. Primary outcome parameters were surgical complications and recurrence rate. Results 81 patients could be included in this analysis. PSH repair was performed in 91% as elective surgery and in 87% in laparoscopic technique. A concomitant incisional hernia (EHS type 2 and 4) was found in 39% and repaired in a single-step procedure with PSH. Major postoperative complications requiring redo surgery were identified in 9.8% (8/81). Overall recurrence rate was 11% (9/81). Only 1 recurrence occurred in the group of 4 cm long implants (1/25= 4%). Median follow-up time was 44 months, and a 1-year follow-up rate of 91.4% was reached. Conclusion PSH repair with 3D funnel mesh in IPOM technique is safe, efficient and easy to perform providing advantageous results compared to other techniques. However the origin mesh funnel (2.5cm length) becomes shortened over time and further shrinkage happens eccentric concerning the flat mesh parts widening the funnel. Changing mesh construction according to consequently use the narrowest funnel (2cm) and it`s lengthening to 4cm led to reduction in recurrence without increasing implant-associated complications

Static flat meshes vs 3D dynamic regenerative scaffolds: is it time for a concept change in inguinal hernia repair?

Static flat meshes vs 3D dynamic regenerative scaffolds: is it time for a concept change in inguinal hernia repair?

Physiologic Cyclical Load on Inguinal Hernia Scaffold ProFlor Turns Biological Response into Tissue Regeneration

Surgical repair of groin protrusions is one of the most frequently performed procedures. Currently, open or laparoscopic repair of inguinal hernias with flat meshes deployed over the hernial defect is considered the gold standard. However, fixation of the implant, poor quality biologic response to meshes and defective management of the defect represent sources of continuous debates. To overcome these issues, a different treatment concept has recently been proposed. It is based on a 3D scaffold named ProFlor, a flower shaped multilamellar device compressible on all planes. This 3D device is introduced into the hernial opening and, thanks to its inherent centrifugal expansion, permanently obliterates the defect in fixation-free fashion. While being made of the same polypropylene material as conventional hernia implants, the 3D design of ProFlor confers a proprietary dynamic responsivity, which unlike the foreign body reaction of flat/static meshes, promotes a true regenerative response. A long series of scientific evidence confirms that, moving in compliance with the physiologic cyclical load of the groin, ProFlor attracts tissue growth factors inducing the development of newly formed muscular, vascular and nervous structures, thus re-establishing the inguinal barrier formerly wasted by hernia disease. The development up to complete maturation of these highly specialized tissue elements was followed thanks to biopsies excised from ProFlor from the short-term up to years post implantation. Immunohistochemistry made it possible to document the concurrence of specific growth factors in the regenerative phenomena. The results achieved with ProFlor likely demonstrate that modifying the two-dimensional design of hernia meshes into a 3D outline and arranging the device to respond to kinetic stresses turns a conventional regressive foreign body response into advanced probiotic tissue regeneration.

Perspectives of prevention and treatment of parastomal hernia-what do we really know and where should we go?

Parastomal hernia is a frequent complication after ostomy formation, causing a significant reduction of the quality of life of patients. In contrast to surgical dogmas dealing with the surgical technique of ostomy formation, mesh-based prophylaxis of parastomal hernia seemed to be effective, leading to the strong recommendation in the European Hernia Society(EHS) guidelines. More recent studies do not favor prophylaxis of parastomal hernia anymore, mainly due to the lack of clearly differentiating the techniques. The mostly used keyhole technique (flat mesh) cannot be equated with the “chimney technique” (3-dimensional mesh) that can be easily performed laparoscopically. Very recent results of the Finnish Randomized Study showed a dramatic reduction of parastomal hernia using the chimney technique. Concerning therapy of parastomal hernia, the chimney technique was also revealed to be effective. The laparoscopic “sandwich technique” should also be used therapeutically with very promising mid- and long-term results and seems to be superior to any other approaches. In a conclusion, investigating the prevention of parastomal hernia should clearly differentiate between the keyhole and chimney techniques and adopt strict technical standardization. Therapy of parastomal hernia should be based on the most effective sandwich or the chimney technique in specialized centers, according to recent registry results. Both techniques are based on the intraperitoneal placement of meshes requiring 3-dimensionality or the possibility of overlapping two meshes. Up to now, these requirements are only fulfilled by meshes made by polyvinylidene fluoride.

Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias

Aims: The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias. Materials and Methods: Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay. Results: Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay. Conclusion: For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.

Dynamic Responsive Inguinal Scaffold Activates Myogenic Growth Factors Finalizing the Regeneration of the Herniated Groin.

Postoperative chronic pain caused by fixation and/or fibrotic incorporation of hernia meshes are the main concerns in inguinal herniorrhaphy. As inguinal hernia is a degenerative disease, logically the treatment should aim at stopping degeneration and activating regeneration. Unfortunately, in conventional prosthetic herniorrhaphy no relationship exists between pathogenesis and treatment. To overcome these incongruences, a 3D dynamic responsive multilamellar scaffold has been developed for fixation-free inguinal hernia repair. Made of polypropylene like conventional flat meshes, the dynamic behavior of the scaffold allows for the regeneration of all typical inguinal components: connective tissue, vessels, nerves, and myocytes. This investigation aims to demonstrate that, moving in tune with the groin, the 3D scaffold attracts myogenic growth factors activating the development of mature myocytes and, thus, re-establishing the herniated inguinal barrier. Biopsy samples excised from the 3D scaffold at different postoperative stages were stained with H&E and Azan-Mallory; immunohistochemistry for NGF and NGFR p75 was performed to verify the degree of involvement of muscular growth factors in the neomyogenesis. Histological evidence of progressive muscle development and immunohistochemical proof of NFG and NFGRp75 contribution in neomyogenesis within the 3D scaffold was documented and statistically validated. The investigation appears to confirm that a 3D polypropylene scaffold designed to confer dynamic responsivity, unlike the fibrotic scar plate of static meshes, attracts myogenic growth factors turning the biological response into tissue regeneration. Newly developed muscles allow the scaffold to restore the integrity of the inguinal barrier.