Mesh For Treatment Research Articles

Comparative Evaluation of Onlay vs Sublay Mesh in Treatment of Ventral Hernias

Abstract Background Hernias of the anterior abdominal wall, or ventral hernias have a various type that can be categorized into primary ventral hernias which include two subtypes lateral ventral hernia, and midline ventral hernias, and incisional hernias (acquired hernias) is another type according to the location, occur at the site of a pervious surgical scar. Objective To compare the outcome of the onlay versus sublay mesh repair for ventral hernias in terms of mean operative time, frequency of post-operative wound infection, seroma formation, hematoma formation, flap necrosis, mesh infection, hospital stay and time for drain removal. Patients and Methods This study will be conducted on 30 patients presenting to Ain shams University hospitals with uncomplicated ventral hernias starting from February 2021 till July 2021. Results Regarding the post operative complications, Seroma formation was more in the onlay group and this was statistically significant. Other post operative complications like wound infection, flap necrosis, Mesh infection, hematoma formation was more in the onlay group but were found to be statistically insignificant in the present study. Regarding the time taken for drain removal was more in the onlay group and this was statistically significant. Conclusion Sublay mesh repair is a good alternative to onlay mesh repair. This study advocates this method of ventral hernia repair, as it is applicable to all sites of ventral hernia. The mesh is mostly hidden and anchored behind the rectus sheath, the complication rate is low, and there is low recurrence rate. Finally, we suggest carrying out more trials on the sublay mesh repair technique to include bigger number of cases and longer period of follow-up.

Use of titanium miniplates and titanium mesh for treatment of mandibular fractures – A comparative study

Use of titanium miniplates and titanium mesh for treatment of mandibular fractures – A comparative study

Morbidity and Efficiency of Transobturator Polypropylene Mesh in Treatment of Urinary Incontinence A 12 years experience

Urinary incontinence is a socio-economic problem with a major impact on quality of life. Although there are multiple non-surgical and drug solutions, surgical treatment remains the most effective method for stress urinary incontinence. Placement of transobturator polypropylene tape is a safe method with minimal intraoperative and postoperative complications. This study had a minimal rate of complications at a one-year follow-up; the biggest problem is represented by de novo overactive bladder (20.26%) that responded successfully to conservative treatment in most cases. The surgical treatment cure rate was 97.8%. TOT is a safer method with less intraoperative complications than TVT, at the same time the success rate is comparable to TVT.

Laparoscopic sacrocolpopexy with the use of a mesh for treatment of uterine prolapse

Laparoscopic sacrocolpopexy with the use of a mesh for treatment of uterine prolapse

Is There Still a Role for Transvaginal Mesh in Treatment of Pelvic Organ Prolapse?

The purpose of this review is to facilitate an understanding of where TVM may still serve a role in POP repair surgery. It provides a broad overview of evidence examining the differences in outcomes between TVM and other surgical interventions for POP. Although in 2003 TVM was introduced into the treatment paradigm for POP with limited data regarding safety and efficacy, the body of literature that has accrued in years gone by finds a narrow list of utility. Certain sub-categories of POP patients at increased risk for recurrence could potentially benefit from TVM placement for POP, including those with advanced preoperative vaginal prolapse stage (stage III or stage IV), levator avulsion, or increased levator hiatal area during Valsalva on ultrasound; in addition, perhaps those that are not surgical candidates for laparoscopic sacrocolpopexy. That being said, the informed consent should use a benefit-risk assessment of intervention, avoiding a discussion solely based on risk of recurrence of POP. Despite the loss of many TVM kits from the market, the role for TVM continues to be elucidated with registries and long-term data analysis. TVM does not have a role in routine POP surgery, but may have benefit in a narrow segment of patients at increased risk for recurrence. Understanding the challenges presented by the use of TVM products, the future of surgical repair of POP may involve next-generation biomimetic implants, yielding an entirely new armamentarium in years to come.

A comparative study between light and heavy polypropylene mesh in lichtenstein repair of inguinal hernia

Background: Inguinal hernia repair is one of the most common surgical procedures performed in practice. Although numerous techniques have been described, currently tension free mesh repair is the standard of care in the treatment of hernias because of the low recurrence rates.Methods: A comparative study between Light and Heavy Polypropylene mesh in Lichtenstein repair of inguinal hernia was conducted at Department of General Surgery in MVJ Medical college and Research Hospital, Hoskote, Bangalore on patients admitted in Department of General Surgery between November 2014 to July 2016 undergoing Lichtenstein tension free mesh repair for inguinal hernia. The study is a prospective study. 30 Patients were in Light mesh group and 30 were in Heavy mesh group.Results: Age group of 31-40 yrs had highest incidence of inguinal hernia. Males outnumber Females in incidence of Inguinal Hernia. Foreign body sensation in Heavy mesh group is significantly high. Average of 26.7% of the patients had foreign body sensation in Heavy mesh group. Whereas in Light group average was 10%. Chronic pain also showed significant readings in Heavy mesh group. Stiffness over abdominal wall was complained by 10% of patients overall in the light mesh group whereas no patients had this complaint in light mesh group. Recurrence was high in light mesh group where total of 5 patients had recurrence and in heavy there were only 2 patients with recurrence.Conclusions: In my study light mesh has been proved to be better than heavy mesh in treatment of inguinal hernia.

Bioprosthetic mesh of bacterial cellulose for treatment of abdominal muscle aponeurotic defect in rat model.

The use of meshes for treatment of hernias continues to draw attention of surgeons and the industry in the search of an ideal prosthesis. The purpose of this work is to use meshes manufactured from bacterial cellulose, evaluate their organic tissue interaction and compare with an expanded polytetrafluorethylene (ePTFE's) prosthesis used to repair acute defect of muscle aponeurotic induced in rats. Forty-five male Wistar rats were classified using the following criteria: (1) surgical repair of acute muscle aponeurotic defect with perforated bacterial cellulose film (PBC; n=18); (2) compact bacterial cellulose film (CBC; n=12) and (3) ePTFE; (n=15). After postoperative period, rectangles (2×3cm) including prosthesis, muscles and peritoneum were collected for biomechanical, histological and stereological analysis. In all cases, the maximum acceptable error probability for rejecting the null hypothesis was 5%. Between PBC and CBC samples, the variables of strain (P=0.011) and elasticity (P=0.035) were statistically different. The same was found between CBC and ePTFE (elasticity, P=0.000; strain, P=0.009). PBC differed from CBC for giant cells (P=0.001) and new blood vessels (P=0.000). In conclusion, there was biological integration and biomechanical elasticity of PBC; therefore, we think this option should be considered as a new alternative biomaterial for use as a bio prosthesis.

Outcomes of Two Different Meshes for Treatment of POP with a Concomitant Midurethral Sling for SUI: a Retrospective Cohort Study at 2 Years Postoperatively

Objective: Patients had pelvic organ prolapse (POP) often suffered stress urinary incontinence (SUI) simultaneously. We evaluated the outcomes of two different kits, Prosima and Avaulta pelvic repair systems, with a concomitant midurethral sling by treating the disease and compared the efficacies in a single center. Methods: A retrospective cohort study involving 57 consecutive patients underwent either of the two kits followed by tension-free vaginal transobturator tape (TVT-O). The combined surgeries were performed between October 2010 and January 2012. Women who complained bothersome POP had stage II or higher prolapse of anterior vaginal wall were included. All patients were assessed by POP-Q for anatomy, questionnaires for pelvic symptoms and sexual function at 2 years after the surgery. Perioperative outcomes and complications were also recorded. Results: Of 57 women, 29 underwent Prosima and 28 underwent Avaulta meshes procedures. The basic patient demographics and perioperative characteristics were similar between two groups. The number of success were 28 versus 26 (P=0.53) at 1 month and 27 versus 26 (P=0.97) at 2 years of Prosima and Avaulta groups, respectively. The overall and each scale scores of 3 validated questionnaires were improved significantly from baseline (P<0.05), but not different statistically between two groups. Complication rates did not differ significantly from two groups. Conclusions: Both the combined procedures improved POP and concomitant SUI significantly. The efficacy and safety of the two different transvaginal meshes was promising.

Laparoscopic anti-reflux surgery with biological mesh in treatment of gastroesophageal reflux disease

To evaluate the application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease (GERD). The clinical data of 20 consecutive GERD patients underwent anti-reflux surgery in Sir Run Run Shaw Hospital from December 2012 to April 2014 were retrospectively analyzed. The laparoscopic hiatal repair with 360 fundoplicaiton was performed and the biological mesh (BiodesignTM, Surgsis) was implanted for reinforcement of hiatal repair. All laparoscopic procedures were successful, no conversion and no intra-operative complications occurred. The pre-operative complains were relieved in all patients, and no recurrence was observed during 3-18 month of follow-up. Six patients got dysphagia after operation; 5 of them were controlled through medication and psychological induction; 1 received esophageal dilatation by bougie. The application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease is satisfactory.

Should mesh be used to correct anterior vaginal prolapse?

A multicenter randomized trial comparing a trocar-guided mesh kit to anterior colporrhaphy for treatment of cystocele adds to evidence that transvaginal mesh for treatment of anterior vaginal prolapse improves anatomical outcomes at the expense of greater complications. Careful consideration of benefits and risks is required when considering transvaginal mesh for prolapse repair.

Simple sling resection and a second, intermediate polypropylene mesh for treatment of vaginal tape protrusion concurrent with recurrent urinary stress incontinence after TVT procedure

The tension-free vaginal tape (TVT) procedure is a simple, effective and minimally invasive method for the surgical treatment of urodynamic stress incontinence (USI). Yet, complications such as mesh protrusion and recurrent urinary leakages after TVT have been reported. A case of recurrent USI complicated with vaginal mesh protrusion following a TVT procedure was referred. Video-urodynamics and introital ultrasonography confirmed that the recurrence of USI was secondary to mal-position of the protruded TVT. A simple salvaging procedure was carried out. The mal-positioned distal protruded TVT was resected and a second intermediate piece of polypropylene (Prolene) mesh was replaced at mid-urethra. The operation time was short and blood loss was minimal. The patient was objectively continent at 6 months follow-up with no defect of healing. Considering the cost-effectiveness and invasiveness of the surgeries, the method of inserting an intermediate mesh is clinically useful.

Traitement cœlioscopique des éventrations. Étude prospective non randomisée de 51 éventrations

Aim of the study. – Insertion of a mesh in treatment of incisional hernias reduces the risk of recurrence. A single prospective randomized trial have compared laparoscopic and open approach: there were less postoperative complications and fewer recurrences in the laparoscopic group. Aim of this prospective trial was to control these results. Patients and methods. – From January 2000 to May 2005, 51 consecutive incisional hernias were operated on by a laparoscopic approach. Incisional hernia was single in 41 and double in 5. It was median in 41 and lateral in 10. Previous hernia repair was noticed in 33.3%. Main criteria was recurrence. We have considered whether one of the following criteria was associated with the risk of recurrence: sex, obesity, previous repair, pre and preoperative sizes of the hernia, uni or multi orificial aspect of the hernia, median or lateral location, mesh size, ratio mesh surface/hernia surface. Others were postoperative mortality and morbidity, duration of hospitalisation and occurrence of late events. Results. – At 2 years all patients were followed. Follow up achieved 3 years in 23 cases and 4 years in 9. Recurrence was observed in 7 (13.7%). None predictive factor was disclosed. No death occurred. Median postoperative pain score at D1, D2 and D3 was respectively 3.1 ± 1.9, 2.9 ± 2.3 and 2.3 ± 2.1. Mean postoperative stay was 4.1 ± 1.9 days. Seven postoperative complications occurred, al benign. During follow-up 18 events were noticed and of these 8 were chronic abdominal pain. Conclusion. – This technique could be employed for every type of incisional hernia but peristomial hernias (not assessed in this study) and every patient. Technical improvements ought to be find to reduce recurrence rate.