Imaging and Treatment of Complications of Abdominal and Pelvic Mesh Repair

Gavlin, Alexander; Kierans, Andrea S.; Chen, Johnson; Song, Christopher; Guniganti, Preethi; Mazzariol, Fernanda S.

doi:10.1148/rg.2020190106

Cited by 29 publications

(24 citation statements)

References 71 publications

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“…Polyprolene mesh has been used for hernia repair for over 50 years and is considered the standard of care to reinforce the abdominal wall muscles after a hernia. Nonetheless, there are a host of issues with polyprolene mesh, resulting in complications reviewed by Gavlin et al (2020) . Two common complications of synthetic meshes are infection and fibrosis, triggering chronic inflammation and discomfort to the patient ( Wang See et al, 2020 ).…”

Section: Musclementioning

confidence: 99%

Mobilizing Endogenous Repair Through Understanding Immune Reaction With Biomaterials

Karkanitsa

Fathi

Ngo

et al. 2021

Front. Bioeng. Biotechnol.

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With few exceptions, humans are incapable of fully recovering from severe physical trauma. Due to these limitations, the field of regenerative medicine seeks to find clinically viable ways to repair permanently damaged tissue. There are two main approaches to regenerative medicine: promoting endogenous repair of the wound, or transplanting a material to replace the injured tissue. In recent years, these two methods have fused with the development of biomaterials that act as a scaffold and mobilize the body’s natural healing capabilities. This process involves not only promoting stem cell behavior, but by also inducing activity of the immune system. Through understanding the immune interactions with biomaterials, we can understand how the immune system participates in regeneration and wound healing. In this review, we will focus on biomaterials that promote endogenous tissue repair, with discussion on their interactions with the immune system.

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Section: Musclementioning

confidence: 99%

Mobilizing Endogenous Repair Through Understanding Immune Reaction With Biomaterials

Karkanitsa

Fathi

Ngo

et al. 2021

Front. Bioeng. Biotechnol.

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“…So far, computed tomography was mainly used to image complications of surgery or mesh repair (25). Here, we present evidence that the tissue elasticity, as a major influence on the durability of repair on the bench test, can be analyzed with the aid of an added Valsalva's maneuver in patients (4).…”

Section: Preoperative Assessment Of the Tissue Elasticity With Ct Abdomen At Rest And During Valsalva's Maneuver In Individual Patientsmentioning

confidence: 99%

The Grip Concept of Incisional Hernia Repair—Dynamic Bench Test, CT Abdomen With Valsalva and 1-Year Clinical Results

et al. 2021

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Incisional hernia is a frequent consequence of major surgery. Most repairs augment the abdominal wall with artificial meshes fixed to the tissues with sutures, tacks, or glue. Pain and recurrences plague at least 10–20% of the patients after repair of the abdominal defect. How should a repair of incisional hernias be constructed to achieve durability? Incisional hernia repair can be regarded as a compound technique. The biomechanical properties of a compound made of tissue, textile, and linking materials vary to a large extent. Tissues differ in age, exercise levels, and comorbidities. Textiles are currently optimized for tensile strength, but frequently fail to provide tackiness, dynamic stiction, and strain resistance to pulse impacts. Linking strength with and without fixation devices depends on the retention forces between surfaces to sustain stiction under dynamic load. Impacts such a coughing or sharp bending can easily overburden clinically applied composite structures and can lead to a breakdown of incisional hernia repair. Our group developed a bench test with tissues, fixation, and textiles using dynamic intermittent strain (DIS), which resembles coughing. Tissue elasticity, the size of the hernia under pressure, and the area of instability of the abdominal wall of the individual patient was assessed with low-dose computed tomography of the abdomen preoperatively. A surgical concept was developed based on biomechanical considerations. Observations in a clinical registry based on consecutive patients from four hospitals demonstrate low failure rates and low pain levels after 1 year. Here, results from the bench test, the application of CT abdomen with Valsalva's maneuver, considerations of the surgical concept, and the clinical application of our approach are outlined.

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“…Abdominal wall hernias are repaired at open or laparoscopic surgery. Meshes are used to provide a tension-free closure with a lower recurrence incidence [36]. Laparoscopic repair is not recommended in > 10 cm hernias [10,37].…”

Section: Postsurgical Evaluationmentioning

confidence: 99%

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification

et al. 2021

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Abdominal wall hernias are common and can present as technical challenges to surgeons. When large, hernias diminish quality of life. Various classifications of incisional hernias have been proposed; however, there are many terms, sometimes causing confusion (1). Radiologists must know the normal anatomy of the abdominal wall, the CT protocol, and what if any maneuvers can be performed to better identify an abdominal wall defect. The description of the radiological approach for primary and incisional wall hernias is based on the 2007 European Hernia Society classification, with particular emphasis on presurgical and postsurgical imaging findings. This classification provides a simple and reproducible method to describe hernias to offer proper surgical management. We highlight this classification so that radiologists and surgeons can have a unified language.

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Imaging and Treatment of Complications of Abdominal and Pelvic Mesh Repair

Cited by 29 publications

References 71 publications

Mobilizing Endogenous Repair Through Understanding Immune Reaction With Biomaterials

Mobilizing Endogenous Repair Through Understanding Immune Reaction With Biomaterials

The Grip Concept of Incisional Hernia Repair—Dynamic Bench Test, CT Abdomen With Valsalva and 1-Year Clinical Results

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification

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