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Atraumatic laparoscopic intraperitoneal mesh fixation using a new laparoscopic device: an animal experimental study

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Abstract

Purpose

Laparoscopic ventral and incisional hernia repair (LVIHR) has become a common procedure because of its feasibility and safety, but it is not free of complications. Acute and chronic post-operative pain and bleeding caused by traumatic fixation of the mesh are frequently prolonging the hospital stay. The aim of this study was to analyze the behavior of n-butyl-cyanoacrylate (GLUBRAN® 2) as only mesh fixation

Methods

Ten female pigs were involved in the study and were divided into two groups of five (A and B). Animals in each group underwent a laparoscopic procedure in which two meshes were placed intraperitoneally and fixed with the same synthetic glue only. Animals in group A were sacrificed after 3 weeks, and those in group B were sacrificed after 12 weeks. We studied the morphological, biomechanical, and histological characteristics of the intraperitoneal mesh–tissue interface

Results

No disruption, migration or folding was observed in any of the pigs. In group A, the mean tensile strength was 1.4 N/cm (± 0.2) while in group B, the mean tensile strength was 2.5 N/cm (± 0.8). Histological analyses, in areas where mesh was fixed using the glue, showed a chronic lymphocytic inflammatory reaction with a granulomatous component and a marked desmoplastic reaction made up of immature collagen and numerous fibroblasts acquiring myofibroblastic characteristics. In some areas corresponding to fixation, the desmoplastic reaction originated from mature lamellar bone tissue with osteocytes and osteoblasts.

Conclusion

Laparoscopic mesh fixation with only the synthetic comonomer glue GLUBRAN® 2 is feasible, effective, and safe in intraperitoneal incisional/ventral hernia repair in this animal model.

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Acknowledgements

We thank Immunohistochemistry Unit, from IRBLleida for Immunohistochemical support. Also we thank Prof. Alessandro Poli of the Veterinarian Science department from Pisa University (Italy). A special acknowledgment to CREBA (Centre de Recerca Biomèdica Avançada) center and their excellent team for facilitating the operating rooms and taking care of the animals during this study

Funding

This study was funded by GEM S.R.L. (LU) Italy.

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Authors and Affiliations

  1. Abdominal Wall Surgery Unit, General Surgery Department, Arnau de Vilanova University Hospital, 80 Rovira Roure Avenue, 25198, Lleida, Catalonia, Spain

    R. N. Villalobos & J. J. Olsina

  2. General Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain

    M. C. Mias, C. Gas & Y. Maestre

  3. Engineering Faculty, University of Lleida, Lleida, Spain

    M. Nogués

  4. Pathology Department, Arnau de Vilanova University Hospital, Lleida, Spain

    F. Vilardell

Authors
  1. R. N. Villalobos
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  2. M. C. Mias
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  3. C. Gas
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  4. Y. Maestre
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  5. M. Nogués
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  6. F. Vilardell
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  7. J. J. Olsina
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Corresponding author

Correspondence to R. N. Villalobos.

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Conflict of interest

Author RV, author CM, author CG, author YM, author MN, author FV, and author JO declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and institutional guidelines for the care and use of animals were followed: Resolution No .9769 of directorate general for environmental policy, Generalitat de Catalunya, Spain.

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This study does not contain any studies directly involving human participants .

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For this type of study formal consent was not necessary.

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Villalobos, R.N., Mias, M.C., Gas, C. et al. Atraumatic laparoscopic intraperitoneal mesh fixation using a new laparoscopic device: an animal experimental study. Hernia 23, 1123–1132 (2019). https://doi.org/10.1007/s10029-019-02008-5

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  • DOI: https://doi.org/10.1007/s10029-019-02008-5

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