Mesh shrinkage in hernia surgery

Langer, Claus; Förster, Hans-Heinrich; Konietschke, Frank; Raab, Björn; Schaper, Andreas; Brunner, Edgar; Becker, Heinz

doi:10.1007/s00104-009-1853-2

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…These findings are in line with the results of Rogmark et al and Langer et al. The significant differences between their studies and ours, include the fact that they studied mesh shrinkage using different mesh materials in an open retrorectus technique, in addition to using different imaging modalities for mesh surface calculation [10,11]. In our study, the excellent inter-rater reliability among radiologists, together with the detailed MRI investigations, allowed us to correctly interpret mesh behavior in retrorectus robot-assisted minimal invasive ventral hernia repair.…”

Section: Discussionsupporting

confidence: 91%

“…In all other patients 46/50 (92%), a significant increase in the mesh surface area and transverse diameter was seen over time (p < 0.0001 and p < 0.001, respectively). Results were the same for heavyweight and lightweight meshes (p = 0.121) [11]. Similarly, Rogmark et al reported their data on 17 patients who had an open retrorectus ventral hernia repair (ProLite™, Atrium).…”

Section: Discussionmentioning

confidence: 70%

“…However, these results cannot automatically be used to estimate the shrinkage rate of meshes in the extraperitoneal or retrorectus position as the location of the implanted mesh is believed to play an important role in mesh behavior. Two previous studies where mesh shrinkage was analyzed in open ventral hernia repair using a retrorectus mesh position illustrated that the overall mean mesh surface area increased by about 10% [10,11]. The new method of incorporating iron-oxide particles into meshes allows for precise mesh depiction on postoperative magnetic resonance imaging (MRI) and has been previously studied in studies with intraperitoneal mesh placement [8,12].…”

Section: Introductionmentioning

confidence: 99%

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Prospective cohort study on mesh shrinkage measured with MRI after robot-assisted minimal invasive retrorectus ventral hernia repair using an iron-oxide-loaded polyvinylidene fluoride mesh

et al. 2023

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Background Mesh-reinforced ventral hernia repair is considered the gold standard treatment for all but the smallest of hernias. Human data on mesh shrinkage in the retrorectus mesh position is lacking. A prospective observational cohort study was performed to measure mesh shrinkage in robot-assisted minimal invasive retrorectus repair of ventral hernias. Methods A cohort of 20 patients underwent a robot-assisted minimal invasive retrorectus repair of their ventral hernia. Magnetic resonance imaging (MRI) imaging was performed one month and thirteen months after implantation of an iron-oxide-impregnated polyvinylidene fluoride (PVDF) mesh to assess the decrease in mesh surface area. Inter-rater reliability among three radiologists regarding measurement of the mesh dimensions was analyzed. Quality of Life scoring was evaluated. Results The inter-rater reliability between the radiologists reported as the intra-class correlations proved to be excellent for mesh width (ICC 0.95), length (ICC 0.98) and surface area (ICC 0.99). Between MRI measurements at one month and thirteen months postoperatively, there was a significant increase in mesh surface area (+ 12.0 cm2, p = 0.0013) and mesh width (+ 0.8 cm, p < 0.001), while the length of the mesh remained unchanged (−0.1 cm, p = 0.754). Quality of Life Scoring showed a significant improvement in Quality of Life after one month and a further improvement at thirteen months (p < 0.001). Conclusion There was an excellent inter-rater reliability between three radiologists when measuring width, length, and surface area of an iron-oxide-impregnated PVDF mesh using MRI visualization. Mesh shrinkage was not observed, instead the effective mesh surface area and width of the mesh increased.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

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Prospective cohort study on mesh shrinkage measured with MRI after robot-assisted minimal invasive retrorectus ventral hernia repair using an iron-oxide-loaded polyvinylidene fluoride mesh

et al. 2023

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“…In an experimental study in goats, Zinther et al could demonstrate a 40% shrinkage of Parietex and 20% shrinkage of DynaMesh three months after insertion, with no further shrinkage thereafter [ 8 ]. In a study of polypropylene mesh with radioopaque markers, CT, after mesh insertion and two years postoperatively, demonstrated no shrinkage in 46 out of 50 patients and 3–22% shrinkage in the rest [ 9 ]. The observed size-reduction in our study might therefore have other causes than true shrinkage, like bulging and doubling, as previously described [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Adhesions to Mesh after Ventral Hernia Mesh Repair Are Detected by MRI but Are Not a Cause of Long Term Chronic Abdominal Pain

Langbach

Holmedal

Grandal

et al. 2016

Gastroenterology Research and Practice

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Aim. The aim of the present study was to perform MRI in patients after ventral hernia mesh repair, in order to evaluate MRI's ability to detect intra-abdominal adhesions. Materials and Methods. Single-center long term follow-up study of 155 patients operated for ventral hernia with laparoscopic (LVHR) or open mesh repair (OVHR), including analyzing medical records, clinical investigation with patient-reported pain (VAS-scale), and MRI. MRI was performed in 124 patients: 114 patients (74%) after follow-up, and 10 patients referred for late complaints after ventral mesh repair. To verify the MRI-diagnosis of adhesions, laparoscopy was performed after MRI in a cohort of 20 patients. Results. MRI detected adhesions between bowel and abdominal wall/mesh in 60% of the patients and mesh shrinkage in 20–50%. Adhesions were demonstrated to all types of meshes after both LVHR and OVHR with a sensitivity of 70%, specificity of 75%, positive predictive value of 78%, and negative predictive value of 67%. Independent predictors for formation of adhesions were mesh area as determined by MRI and Charlson index. The presence of adhesions was not associated with more pain. Conclusion. MRI can detect adhesions between bowel and abdominal wall in a fair reliable way. Adhesions are formed both after open and laparoscopic hernia mesh repair and are not associated with chronic pain.

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“…Mit der generierten Kollagenschicht werden somit sowohl das implantierte Fasermaterial als auch die umgebenden Strukturen im kleinen Becken fixiert, gestrafft und stabilisiert, und auch unsere tierexperimentellen Messungen bestätigten die Kontraktion dieser narbigen Generate sowie die Ausrissstabilität eingeheilter Netze [46,47]. Es ist also kein unerwünschter Effekt [48], sondern auf der Schrumpfung [49,50] der induzierten narbigen Strukturen beruht das eigentliche Wirkprinzip der spannungslosen Netzimplantation im Beckenbodenbereich. Die in der Hernienchirurgie unter Spannung transplantierten Netze zur Defektdeckung sind deutlich solider und zugbelastbarer.…”

Section: Abstract !unclassified

Urogynäkologie für Urologen

Neymeyer¹,

Miller²

2011

Aktuel Urol

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The field of urogynaecology represents an interdisciplinary subspecialty which is dedicated to qualified diagnostics and effective treatment of functional, static, endocrine and urological pelvic floor disorders. Core areas of the surgical uro-gynaecology are pelvic floor reconstruction for the treatment of urinary and anal incontinence, descensus and prolapse including proctological surgery. Also included are the therapy and correction after trauma of the pelvic floor, as well as reconstruction after oncological interventions. In urogynaecological pelvic floor reconstruction, supporting tapes and mesh implants are usually implanted tension-free. The principle of the tension-free tape and mesh graft implantation is based on the induction of collagen regeneration as well as the development of scar tissue creating a tight, statically effective tissue within the pelvic floor. Surgical goal is the improvement of quality of life and the restitution of an appropriate coenaesthesia with preservation of a regular micturition and continence. Another important aspect is the restitution of a regular sexuality. Conservative urogynaecology represents the medicinal, physiotherapeutic or neuromodulatory treatment of mainly descensus disorders and urinary and anal incontinence. Other foci are urinary infections, chronic pelvic pain as well as postoperative and posttraumatic insufficiency of the pelvic floor.

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Mesh shrinkage in hernia surgery

Cited by 12 publications

References 29 publications

Prospective cohort study on mesh shrinkage measured with MRI after robot-assisted minimal invasive retrorectus ventral hernia repair using an iron-oxide-loaded polyvinylidene fluoride mesh

Prospective cohort study on mesh shrinkage measured with MRI after robot-assisted minimal invasive retrorectus ventral hernia repair using an iron-oxide-loaded polyvinylidene fluoride mesh

Adhesions to Mesh after Ventral Hernia Mesh Repair Are Detected by MRI but Are Not a Cause of Long Term Chronic Abdominal Pain

Urogynäkologie für Urologen

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