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

Abstract

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.

Meta-analysis of prophylactic mesh to prevent parastomal hernia

“…Overall, 38 potentially relevant studies were identified, of which 28 were excluded because they were not RCTs ( Fig. ).…”

Prophylactic funnel mesh to prevent parastomal hernia in permanent end colostomy: A retrospective cohort study

“…An additional advantage of the mesh used in this study is its visibility in magnetic resonance imaging (MRI) [46]. This can help in the diagnosis of PSH, especially when CT scans are not conclusive or not possible to perform.…”

“…This can help in the diagnosis of PSH, especially when CT scans are not conclusive or not possible to perform. Other stoma‐related complications, such as mechanical or functional stenosis, can be correlated with the mesh by MRI [46].…”

Surgery with qualities or: “how to foster yourself”

“…The authors of the present issue of European Surgery compose an harmonic symphony of themes and directories reflecting different approaches to the world of surgery and basic science [5][6][7][8][9][10]. In addition, the articles sense the highly positive notion, that there can be short lights of true awareness, off the power-tuned path of the despotism-driven "normal" life within the academy.…”

“…In addition, the articles sense the highly positive notion, that there can be short lights of true awareness, off the power-tuned path of the despotism-driven "normal" life within the academy. The colorful spectrum of papers ranges from molecular to clinical science, from open to laparoscopic and minimally invasive surgery [5][6][7][8][9][10]. The globe of variations indicates that there exist amigos out there in the surgical community who have NOT given up to raise questions, who have NOT given up their wish to discover and to understand and tune themselves with the golden shine (Fig.…”