First In-Human Magnetic Resonance Visualization of Surgical Mesh Implants for Inguinal Hernia Treatment

Hansen, Nienke L.; Barabasch, Alexandra; Distelmaier, Martina; Ciritsis, Alexander; Kuehnert, Nicolas; Otto, Jens; Conze, Joachim; Klinge, U.; Hilgers, Ralf‐Dieter; Kuhl, Christiane K.; Kraemer, Nils A.

doi:10.1097/rli.0b013e31829806ce

Cited by 31 publications

(29 citation statements)

References 23 publications

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“…STI normally consist of polymers that cannot be depicted using conventional radiological methods. For the first time, meshes can be clearly distinguished from the ambient tissue because superparamagnetic iron oxides are compounded with the polymer of the mesh and this results in magnetic field distortion, which can be detected as signal voids in MRI [4,5]. CT was also considered to visualize iron-marked meshes and even provides better spatial resolution than MRI.…”

Section: Resultsmentioning

confidence: 98%

“…Experimental studies report magnetic resonance (MR) visualization of superparamagnetic iron oxide-loaded textile implants for delineation of meshes [4]. The first evaluation in human reports on adequate mesh visualization in open and laparoscopic inguinal hernia repair and introduced a MR protocol with different sequences for visual conspicuity of the implant and evaluation of the surrounding anatomy [5]. The imaging aspect seems to be important for surgeons.…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment

Köhler

Wundsam²,

Pallwein-Prettner

et al. 2015

Eur Surg

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Background Funnel mesh implants can be used for both prevention and repair of parastomal hernia (PSH). We aimed to prove the practice of such implants as well as the magnetic resonance (MR) presentability in humans.Methods Five patients were surgically treated for laparoscopic PSH prevention, and five patients underwent laparoscopic repair of manifest and symptomatic PSH with iron-loaded 3-D funnel meshes in an intraperitoneal onlay technique. MR investigation was performed on postoperative day 7 to assess mesh delineation, and additionally 6 and 12 months postoperatively to evaluate hernia recurrences and biocompatibility of mesh integration.Results We could demonstrate precise mesh depiction and delineation with MR in all 10 cases, as well as accurate assessment of the surrounding tissue. No funnel alterations and no functional change of the stoma bowel patency occurred due to the tightly fitting funnel implant. We documented no mesh-related complications, no PSH formation, and no stoma prolapse occurrence during the follow-up period of 1 year comprising all ten cases.Conclusion The pilot use of a new method of MR investigation using a mesh with enhanced signal through the addition of iron particles into the polyvinylidene fluoride base material provides detailed mesh depiction. Furthermore, funnel mesh implantation seems to offer a safe and promising surgical alternative for both PSH prevention and treatment.

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Section: Resultsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment

Köhler

Wundsam²,

Pallwein-Prettner

et al. 2015

Eur Surg

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“…This new implant for endoscopic inguinal hernia repair (TAPP) base upon MRI in vivo information of our prospective cohort study (code no. 194/11) using MR-visible meshes for inguinal hernia repair in human [15]. With the MR-visible mesh even motion-picture visualization seem to become feasible, which might give additional information about mesh related problems like adhesion with corresponding transit disorder or pain because of fixation material.…”

Section: Discussionmentioning

confidence: 99%

“…According to our findings we propose a combination of different gradient echo sequences (GRE) and T2-weighted turbo spinecho sequences (T2wTSE) for mesh configuration. T2wTSE for anatomy assessment, and GRE3 for evaluation of hernia coverage and mesh localization ( Figure 6) [15]. …”

Section: Visible Mesh In Abdominal Wall Of Humansmentioning

confidence: 99%

MR-visualization of surgical textile implants

et al. 2014

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The use of surgical textile implants (so-called "mesh") for hernia repair is an accepted standard. They may cause mesh-related problems such as chronic pain, migration or fistula formation. Nevertheless, these polymer-based textile meshes are often invisible by conventional imaging methods like computed tomography (CT) and magnetic resonance imaging (MRI). In this study we outlined the major steps in the development of a MRvisible textile implant, which can be used in patients. To achieve MR-visability, ferrooxide particles were incorporated into the base material polyvinylidene fluoride (PVDF), during the spinning process. We could proof the MR-visibility of this new textile implant in different phantoms. After clinical approval of these implants in vivo in different animal studies, we pursued to evaluate the MRconspicuity of such ferrooxide-loaded mesh implants in patients treated for inguinal hernias and explored the postsurgical mesh configuration by MRI. In this study we described the development and first results of a ferrooxide-loaded MR-visible mesh. In animal model and in clinical use such implants turned out to be a valuable tool for diagnostic and development.

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“…It is also not known whether patients especially with painful inguinal hernias may express similar BME changes in MRIs compared to patients with athletic pubalgia. In diagnostics of posthernioplasty pain, recent advantages in mesh properties in conjunction with MRI techniques have also provided the possibility of visualizing the mesh in place [9].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging has no role in diagnosing the origin of pain in patients with overwhelmingly painful inguinal hernia

Kouhia

Silvasti

Kainulainen

et al. 2015

Hernia

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First In-Human Magnetic Resonance Visualization of Surgical Mesh Implants for Inguinal Hernia Treatment

Cited by 31 publications

References 23 publications

Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment

Magnetic resonance visible 3-D funnel meshes for laparoscopic parastomal hernia prevention and treatment

MR-visualization of surgical textile implants

Magnetic resonance imaging has no role in diagnosing the origin of pain in patients with overwhelmingly painful inguinal hernia

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