Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs
Background The main reason for hospital stay after laparoscopic ventral hernia repair (LVHR) is probably pain, which also causes a lengthening of the patient’s time to assume normal daily activities and work. It is likely that titanium tacks may be the main contributing factor to early (and maybe ch...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2008-10, Vol.12 (5), p.483-491 |
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| creator | Eriksen, J. R. Bech, J. I. Linnemann, D. Rosenberg, J. |
| description | Background
The main reason for hospital stay after laparoscopic ventral hernia repair (LVHR) is probably pain, which also causes a lengthening of the patient’s time to assume normal daily activities and work. It is likely that titanium tacks may be the main contributing factor to early (and maybe chronic) pain after LVHR. Therefore, non-invasive and patient-friendly mesh fixation methods must be considered. The present study was designed to investigate the technical applicability, safety and effect of Tisseel
®
for intraperitoneal mesh fixation.
Methods
Nine 40-kg Danish Landrace female pigs had two pieces of MotifMESH
®
and two pieces of Proceed
®
mesh fixed in the intraperitoneal position by a laparoscopic technique. The two pieces of the same mesh were fixed with fibrin glue (Tisseel) and titanium tacks, respectively. All pigs were euthanised on the 30th postoperative day and the mesh–tissue samples were tested for strength of ingrowth (peel test), adhesion formation, mesh shrinkage and examined for histological alterations.
Results
No meshes were displaced from their initial position at autopsy, but we observed two cases of mesh folding that could have resulted in hernia recurrence in real patients. There were no significant differences in the strength of ingrowth between different mesh types or fixation methods, measured as peel work per area of mesh (J/m
2
) and peak force per width of mesh (N
max
/cm). The Proceed mesh shrank by 11% compared to 4% for the MotifMESH mesh (
p
= 0.002). There was no difference in the grade of adhesions (%) between fixation methods (
p
= 0.794) or different mesh types (
p
= 0.296). In the same fashion, there was no difference in the strength of adhesions (grades 0–4) between the two fixation methods or different mesh types (
p
>0.5, χ
2
test). There was no significant difference in the formation of fibrosis or inflammation between the different meshes or fixation methods. All samples showed significant foreign-body reaction with giant cells.
Conclusion
Our results suggest that the laparoscopic fixation of an intraperitoneal mesh with Tisseel is safe and technically feasible in a pig model. There is still no evidence that fibrin-sealing alone is appropriate for intraperitoneal mesh fixation in hernia repair, but the technique might become an alternative or supplement to mechanical mesh fixation. Until then, further experimental research in animal hernia models with larger meshes is needed, especially with a focus on |
| doi_str_mv | 10.1007/s10029-008-0375-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69621279</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69621279</sourcerecordid><originalsourceid>FETCH-LOGICAL-c369t-6c6d7ee1084b984d9ffcc9b2a604151f42b9191e5dddd5341d206fede5ab70163</originalsourceid><addsrcrecordid>eNp1UUFu1TAQtRCIlsIB2CCLBYJFiu04TswOVbQgfYlNWVuOMykuiR1sB9regotwCE7GRP9LlZDwwh5r3rw3M4-Q55ydcsbatxlvoSvGuorVbVPdPSDHXMiu0oLJh1usmkpqpo7Ik5yvGQKl6h6TI97Jrm67-pj82tnFpphdXLyjPpRkF0i-xAB2ojPkr3T0N7b4GOhPX7Zfn3ygGdM2FPr60ucMMP35_Yb-yKe0-GKDX2darPuW31FLkw1DnH2GgbqI_HGaMISbTWaGUFAml3W4RXG6-Kv8lDwa7ZTh2eE9IV_OP1yefax2ny8-nb3fVa5WulTKqaEF4DhSrzs56HF0TvfCKiZ5w0cpes01h2bA09SSD4KpEQZobN8yruoT8mrPu6T4fYVcDDbpYMKxIK7ZKK0EF61G4Mt_gNdxTQF7M4K1uGktOgTxPcjhMnOC0Sw4nk23hjOzmWX2Zhn0wGxmmTuseXEgXvsZhvuKgzsIEHtAxlS4gnSv_H_Wv0ADo_c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>207204928</pqid></control><display><type>article</type><title>Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Eriksen, J. R. ; Bech, J. I. ; Linnemann, D. ; Rosenberg, J.</creator><creatorcontrib>Eriksen, J. R. ; Bech, J. I. ; Linnemann, D. ; Rosenberg, J.</creatorcontrib><description>Background
The main reason for hospital stay after laparoscopic ventral hernia repair (LVHR) is probably pain, which also causes a lengthening of the patient’s time to assume normal daily activities and work. It is likely that titanium tacks may be the main contributing factor to early (and maybe chronic) pain after LVHR. Therefore, non-invasive and patient-friendly mesh fixation methods must be considered. The present study was designed to investigate the technical applicability, safety and effect of Tisseel
®
for intraperitoneal mesh fixation.
Methods
Nine 40-kg Danish Landrace female pigs had two pieces of MotifMESH
®
and two pieces of Proceed
®
mesh fixed in the intraperitoneal position by a laparoscopic technique. The two pieces of the same mesh were fixed with fibrin glue (Tisseel) and titanium tacks, respectively. All pigs were euthanised on the 30th postoperative day and the mesh–tissue samples were tested for strength of ingrowth (peel test), adhesion formation, mesh shrinkage and examined for histological alterations.
Results
No meshes were displaced from their initial position at autopsy, but we observed two cases of mesh folding that could have resulted in hernia recurrence in real patients. There were no significant differences in the strength of ingrowth between different mesh types or fixation methods, measured as peel work per area of mesh (J/m
2
) and peak force per width of mesh (N
max
/cm). The Proceed mesh shrank by 11% compared to 4% for the MotifMESH mesh (
p
= 0.002). There was no difference in the grade of adhesions (%) between fixation methods (
p
= 0.794) or different mesh types (
p
= 0.296). In the same fashion, there was no difference in the strength of adhesions (grades 0–4) between the two fixation methods or different mesh types (
p
>0.5, χ
2
test). There was no significant difference in the formation of fibrosis or inflammation between the different meshes or fixation methods. All samples showed significant foreign-body reaction with giant cells.
Conclusion
Our results suggest that the laparoscopic fixation of an intraperitoneal mesh with Tisseel is safe and technically feasible in a pig model. There is still no evidence that fibrin-sealing alone is appropriate for intraperitoneal mesh fixation in hernia repair, but the technique might become an alternative or supplement to mechanical mesh fixation. Until then, further experimental research in animal hernia models with larger meshes is needed, especially with a focus on mesh folding and displacement.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-008-0375-z</identifier><identifier>PMID: 18483783</identifier><language>eng</language><publisher>Paris: Springer-Verlag</publisher><subject>Abdominal Surgery ; Animals ; Biocompatible Materials ; Disease Models, Animal ; Feasibility Studies ; Female ; Fibrin Tissue Adhesive - administration & dosage ; Hernia, Ventral - surgery ; Laparoscopy - methods ; Medicine ; Medicine & Public Health ; Models, Animal ; Original Article ; Surgical Mesh ; Swine ; Tissue Adhesives - administration & dosage ; Titanium</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2008-10, Vol.12 (5), p.483-491</ispartof><rights>Springer-Verlag 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-6c6d7ee1084b984d9ffcc9b2a604151f42b9191e5dddd5341d206fede5ab70163</citedby><cites>FETCH-LOGICAL-c369t-6c6d7ee1084b984d9ffcc9b2a604151f42b9191e5dddd5341d206fede5ab70163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-008-0375-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-008-0375-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18483783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eriksen, J. R.</creatorcontrib><creatorcontrib>Bech, J. I.</creatorcontrib><creatorcontrib>Linnemann, D.</creatorcontrib><creatorcontrib>Rosenberg, J.</creatorcontrib><title>Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Background
The main reason for hospital stay after laparoscopic ventral hernia repair (LVHR) is probably pain, which also causes a lengthening of the patient’s time to assume normal daily activities and work. It is likely that titanium tacks may be the main contributing factor to early (and maybe chronic) pain after LVHR. Therefore, non-invasive and patient-friendly mesh fixation methods must be considered. The present study was designed to investigate the technical applicability, safety and effect of Tisseel
®
for intraperitoneal mesh fixation.
Methods
Nine 40-kg Danish Landrace female pigs had two pieces of MotifMESH
®
and two pieces of Proceed
®
mesh fixed in the intraperitoneal position by a laparoscopic technique. The two pieces of the same mesh were fixed with fibrin glue (Tisseel) and titanium tacks, respectively. All pigs were euthanised on the 30th postoperative day and the mesh–tissue samples were tested for strength of ingrowth (peel test), adhesion formation, mesh shrinkage and examined for histological alterations.
Results
No meshes were displaced from their initial position at autopsy, but we observed two cases of mesh folding that could have resulted in hernia recurrence in real patients. There were no significant differences in the strength of ingrowth between different mesh types or fixation methods, measured as peel work per area of mesh (J/m
2
) and peak force per width of mesh (N
max
/cm). The Proceed mesh shrank by 11% compared to 4% for the MotifMESH mesh (
p
= 0.002). There was no difference in the grade of adhesions (%) between fixation methods (
p
= 0.794) or different mesh types (
p
= 0.296). In the same fashion, there was no difference in the strength of adhesions (grades 0–4) between the two fixation methods or different mesh types (
p
>0.5, χ
2
test). There was no significant difference in the formation of fibrosis or inflammation between the different meshes or fixation methods. All samples showed significant foreign-body reaction with giant cells.
Conclusion
Our results suggest that the laparoscopic fixation of an intraperitoneal mesh with Tisseel is safe and technically feasible in a pig model. There is still no evidence that fibrin-sealing alone is appropriate for intraperitoneal mesh fixation in hernia repair, but the technique might become an alternative or supplement to mechanical mesh fixation. Until then, further experimental research in animal hernia models with larger meshes is needed, especially with a focus on mesh folding and displacement.</description><subject>Abdominal Surgery</subject><subject>Animals</subject><subject>Biocompatible Materials</subject><subject>Disease Models, Animal</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Fibrin Tissue Adhesive - administration & dosage</subject><subject>Hernia, Ventral - surgery</subject><subject>Laparoscopy - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Animal</subject><subject>Original Article</subject><subject>Surgical Mesh</subject><subject>Swine</subject><subject>Tissue Adhesives - administration & dosage</subject><subject>Titanium</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1UUFu1TAQtRCIlsIB2CCLBYJFiu04TswOVbQgfYlNWVuOMykuiR1sB9regotwCE7GRP9LlZDwwh5r3rw3M4-Q55ydcsbatxlvoSvGuorVbVPdPSDHXMiu0oLJh1usmkpqpo7Ik5yvGQKl6h6TI97Jrm67-pj82tnFpphdXLyjPpRkF0i-xAB2ojPkr3T0N7b4GOhPX7Zfn3ygGdM2FPr60ucMMP35_Yb-yKe0-GKDX2darPuW31FLkw1DnH2GgbqI_HGaMISbTWaGUFAml3W4RXG6-Kv8lDwa7ZTh2eE9IV_OP1yefax2ny8-nb3fVa5WulTKqaEF4DhSrzs56HF0TvfCKiZ5w0cpes01h2bA09SSD4KpEQZobN8yruoT8mrPu6T4fYVcDDbpYMKxIK7ZKK0EF61G4Mt_gNdxTQF7M4K1uGktOgTxPcjhMnOC0Sw4nk23hjOzmWX2Zhn0wGxmmTuseXEgXvsZhvuKgzsIEHtAxlS4gnSv_H_Wv0ADo_c</recordid><startdate>20081001</startdate><enddate>20081001</enddate><creator>Eriksen, J. R.</creator><creator>Bech, J. I.</creator><creator>Linnemann, D.</creator><creator>Rosenberg, J.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20081001</creationdate><title>Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs</title><author>Eriksen, J. R. ; Bech, J. I. ; Linnemann, D. ; Rosenberg, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-6c6d7ee1084b984d9ffcc9b2a604151f42b9191e5dddd5341d206fede5ab70163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Animals</topic><topic>Biocompatible Materials</topic><topic>Disease Models, Animal</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Fibrin Tissue Adhesive - administration & dosage</topic><topic>Hernia, Ventral - surgery</topic><topic>Laparoscopy - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Models, Animal</topic><topic>Original Article</topic><topic>Surgical Mesh</topic><topic>Swine</topic><topic>Tissue Adhesives - administration & dosage</topic><topic>Titanium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eriksen, J. R.</creatorcontrib><creatorcontrib>Bech, J. I.</creatorcontrib><creatorcontrib>Linnemann, D.</creatorcontrib><creatorcontrib>Rosenberg, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eriksen, J. R.</au><au>Bech, J. I.</au><au>Linnemann, D.</au><au>Rosenberg, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2008-10-01</date><risdate>2008</risdate><volume>12</volume><issue>5</issue><spage>483</spage><epage>491</epage><pages>483-491</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Background
The main reason for hospital stay after laparoscopic ventral hernia repair (LVHR) is probably pain, which also causes a lengthening of the patient’s time to assume normal daily activities and work. It is likely that titanium tacks may be the main contributing factor to early (and maybe chronic) pain after LVHR. Therefore, non-invasive and patient-friendly mesh fixation methods must be considered. The present study was designed to investigate the technical applicability, safety and effect of Tisseel
®
for intraperitoneal mesh fixation.
Methods
Nine 40-kg Danish Landrace female pigs had two pieces of MotifMESH
®
and two pieces of Proceed
®
mesh fixed in the intraperitoneal position by a laparoscopic technique. The two pieces of the same mesh were fixed with fibrin glue (Tisseel) and titanium tacks, respectively. All pigs were euthanised on the 30th postoperative day and the mesh–tissue samples were tested for strength of ingrowth (peel test), adhesion formation, mesh shrinkage and examined for histological alterations.
Results
No meshes were displaced from their initial position at autopsy, but we observed two cases of mesh folding that could have resulted in hernia recurrence in real patients. There were no significant differences in the strength of ingrowth between different mesh types or fixation methods, measured as peel work per area of mesh (J/m
2
) and peak force per width of mesh (N
max
/cm). The Proceed mesh shrank by 11% compared to 4% for the MotifMESH mesh (
p
= 0.002). There was no difference in the grade of adhesions (%) between fixation methods (
p
= 0.794) or different mesh types (
p
= 0.296). In the same fashion, there was no difference in the strength of adhesions (grades 0–4) between the two fixation methods or different mesh types (
p
>0.5, χ
2
test). There was no significant difference in the formation of fibrosis or inflammation between the different meshes or fixation methods. All samples showed significant foreign-body reaction with giant cells.
Conclusion
Our results suggest that the laparoscopic fixation of an intraperitoneal mesh with Tisseel is safe and technically feasible in a pig model. There is still no evidence that fibrin-sealing alone is appropriate for intraperitoneal mesh fixation in hernia repair, but the technique might become an alternative or supplement to mechanical mesh fixation. Until then, further experimental research in animal hernia models with larger meshes is needed, especially with a focus on mesh folding and displacement.</abstract><cop>Paris</cop><pub>Springer-Verlag</pub><pmid>18483783</pmid><doi>10.1007/s10029-008-0375-z</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1265-4906 |
| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2008-10, Vol.12 (5), p.483-491 |
| issn | 1265-4906 1248-9204 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Animals Biocompatible Materials Disease Models, Animal Feasibility Studies Female Fibrin Tissue Adhesive - administration & dosage Hernia, Ventral - surgery Laparoscopy - methods Medicine Medicine & Public Health Models, Animal Original Article Surgical Mesh Swine Tissue Adhesives - administration & dosage Titanium |
| title | Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel®) vs. titanium tacks: a randomised controlled experimental study in pigs |
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