Experimental evaluation of intra-abdominal adhesions comparing two different intraperitoneal meshes and the effect of a natural anti-inflammatory product on their formation

Filho, Paulo Vicente dos Santos; Santos, Rafael Silva; Leão, Sydney Correia; Duarte, Ivisson Xavier; Lima, Sônia Oliveira

doi:10.1590/acb351205

Cited by 4 publications

(7 citation statements)

References 23 publications

(10 reference statements)

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“…The other animals showed adhesions on the mesh surface with or without SC. Some experimental and even clinical studies demonstrated that, even with the protective barrier, these intraperitoneal meshes present different degrees of adhesions with intra-abdominal structures [9][10][11][12][13]36 . For this reason, ways to mitigate this complication and its clinical repercussions are being studied.…”

Section: Discussionmentioning

confidence: 99%

“…Polyester is the result of the reaction of alcohol with carboxylic acid and is a strong, durable, and hydrophilic material. It has pores of 2.3 – 3.3 mm and 66 g/m 2 and has multiple filaments 10 . The mesh was donated by the company.…”

Section: Methodsmentioning

confidence: 99%

“…Then, necroscopy was performed, and the macroscopic aspects related to the mesh were observed. The degree of adhesions between the organs and meshes (adhesion scoring), area of adhesion between the surface of the mesh and intraperitoneal structures (adhesion coverage on the mesh surface), and integration of the mesh into the abdominal wall (tissue integration score) were evaluated 10,29,30 (Tables 1-3). Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes…”

Section: Euthanasia Of the Animals And Macroscopic Post-mortem Examin...mentioning

confidence: 99%

“…Despite these advantages, laparoscopic repairs using the intraperitoneal onlay mesh (IPOM) technique expose the patient to the risks of mesh in direct contact with intra-abdominal organs and structures. Even when using meshes which supposedly provide a protective barrier, there are reports of complications secondary to ileus, adhesions, mesh infections, abscesses, fibrosis, chronic pain, and even intestinal obstruction, and enteric fistulas [9][10][11][12][13] . In addition, possible long-term complications of this technique have not been fully elucidated 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Adhesions that increase these potential risks occur due to foreign body reaction secondary to the inflammatory reaction generated by the presence of a prosthesis inside the abdominal cavity and in contact with intracavitary organs 10,11,15,16 . Some products available on the market can reduce adhesion formation whether between organs or intraperitoneal structures [17][18][19][20][21] or between the mesh and intra-abdominal structures 22,23 .…”

Section: Introductionmentioning

confidence: 99%

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Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes

Santos Filho,

Hirano

2023

Acta Cir. Bras.

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Purpose: Laparoscopic hernia repair involves a risk of adhesion between coated mesh and viscera. Plant polysaccharides such as starch and carboxymethylcellulose (SC) make up a product that acts as a barrier and prevents intraperitoneal adhesions. This study aimed to evaluate whether topical SC can also reduce adhesions between mesh and intra-abdominal organs. Methods: Forty rats each received placement of two intraperitoneal mesh fragments, one on each side of the abdominal wall. Randomly, 20 animals received SC on the right and other 20 on the left, leaving the contralateral side as a control. Fourteen days after the surgery, the animals underwent an additional laparotomy in which macroscopic analysis was performed. Results: As for the percentage of the mesh area affected by adhesion, one (2.6%) animal had > 75% adhesion on the experimental side, and 11 animals (28.9%) on the control side. The adhesion intensity score showed firm adhesions in three (7.9%) animals on the experimental side and nine (23.7%) on the control side. Conclusion: The use of SC decreased the intensity of adhesions and the surface area of the mesh affected by adhesions. There was no negative interference of the product in the incorporation of the mesh into the abdominal wall.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Euthanasia Of the Animals And Macroscopic Post-mortem Examin...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes

Santos Filho,

Hirano

2023

Acta Cir. Bras.

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Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis

Delorme,

Cottenet,

Abo-Alhassan

et al. 2023

Hernia

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Primary Ventral Hernia Repair and the Risk of Postoperative Small Bowel Obstruction: Intra Versus Extraperitoneal Mesh

Goullieux,

Abo-Alhassan,

Vieira-Da-Silva

et al. 2023

JCM

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Objective: The aim of this study was to compare the likelihood of bowel obstruction according to the placement of the mesh (either intraperitoneal or extraperitoneal) in ventral hernia repairs. Materials and methods: Patients were divided into two groups, an intraperitoneal (IP) group (mesh placed by laparoscopy or with an open approach) and an extraperitoneal (EP) group, all operated on in the Digestive Surgery Department at the Dijon University Hospital. The primary outcome was the occurrence of an episode of bowel obstruction requiring hospitalization and confirmed by abdominal CT scan. Results: Between March 2008 and July 2021, 318 patients were included, with 99 patients in the EP group (71 meshes placed preperitoneally and 28 placed retromuscularly) and 219 patients in the IP group (175 patients operated on laparoscopically versus 44 patients by direct approach). Three patients presented an episode of acute intestinal obstruction, with no difference between the two groups (p = 0.245), although all bowel obstructions occurred in the IP group and with the laparoscopic approach (1.7% of patients operated on by laparoscopy). The occlusive events occurred at 1 month, 2 years, and 3 years. There was no difference in terms of recurrence or postoperative chronic pain. There were more seroma and mesh infections in the EP group (p < 0.05). Two patients operated on by laparoscopy had undetected bowel injuries, prompting emergent surgery for peritonitis. Conclusions: No statistically significant difference was found in terms of bowel obstruction between the intraperitoneal and the extraperitoneal position, but all cases of obstruction happened in the intraperitoneal mesh group. Visceral lesions remain a major complication of the laparoscopic approach that should not be neglected.

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Experimental evaluation of intra-abdominal adhesions comparing two different intraperitoneal meshes and the effect of a natural anti-inflammatory product on their formation

Cited by 4 publications

References 23 publications

Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes

Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes

Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis

Primary Ventral Hernia Repair and the Risk of Postoperative Small Bowel Obstruction: Intra Versus Extraperitoneal Mesh

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