Skip to main content
Log in

Comparative investigation of alloplastic materials for hernia repair with improved methodology

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background:

A variety of alloplastic materials are used for hernia repair. We discuss the long-term stability and possible shrinkage of these materials. In the past, measurement of pore sizes was used to study the physical properties of alloplastic meshes. The aim of this study was to evaluate the measurement of pore sizes with regard to its correlation to possible mesh alteration.

Methods:

The water absorption of different polypropylene (PP) and polyester (PE) mesh materials under defined conditions was studied. For shrinkage studies, meshes were stored in formaldehyde, distilled water, saline solution, trypsin solution, urea solution, and hydrogen peroxide. The measurement of the relation between material and pore was evaluated to investigate the potential shrinking and enlargement processes. This material–pore index (MPI) before as well as 1, 7, and 14 days after incubation was measured.

Results:

In comparison to measuring single pore sizes, MPI determination is the more efficient method to evaluate the possible shrinking or enlargement processes of alloplastic materials. With this technique, incorrect determination of pore sizes due to the dynamic textile structure of meshes and to shrinkage or enlargement, is excluded. All tested alloplastic materials showed an insignificant increase in water absorption under the condition of rehydration up to 0.4%. We did not observe variances in the material in shrinking or enlargement.

Conclusions:

MPI was found to be more reliable than measuring single pores to investigate possible external influences on polymer materials. Biomaterials such as PP and PE proved to be absolutely inert under various in vitro conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Amid PK, (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery Hernia 1: 15–21

    Google Scholar 

  2. Amid PK, (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula Br J Surg 87: 1436–1437

    Article  Google Scholar 

  3. Amid PK, (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty Hernia 7: 13–16

    Article  PubMed  Google Scholar 

  4. Anwar S, (2003) The use of prosthetics in hernia repair Hosp Med 64: 34–35

    PubMed  Google Scholar 

  5. Arnaud JP, Tuech JJ, Pessaux P, Hadchity Y (1999) Surgical treatment of postoperative incisional hernias by intraperitoneal insertion of Dacron mesh and an aponeurotic graft: a report on 250 cases Arch Surg 134: 1260–1262

    Article  PubMed  Google Scholar 

  6. Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults Br J Surg 88: 1321–1323

    Article  PubMed  Google Scholar 

  7. Cassar K, Munro A (2002) Surgical treatment of incisional hernia Br J Surg 89: 534–545

    Article  PubMed  Google Scholar 

  8. Coda A, Bendavid R, Botto-Micca F, Bossotti M, Bona A (2003) Structural alterations of prosthetic meshes in humans Hernia 7: 29–34

    PubMed  Google Scholar 

  9. DeBord JR, (1998) The historical development of prosthetics in hernia surgery Surg Clin North Am 78: 973–1006

    Article  PubMed  Google Scholar 

  10. Durden JG, Pemberton LB (1974) Dacron mesh in ventral and inguinal hernia repair Am Surg 60: 662–665

    Google Scholar 

  11. Ghadimi BM, Langer C, Becker H (2002) The carcinogenic potential of biomaterials in hernia surgery Chirurg 73: 833–837

    Article  PubMed  Google Scholar 

  12. Grant AM, (2002) Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data Hernia 6: 130–136

    Article  PubMed  Google Scholar 

  13. Klinge U, Klosterhalfen B, Muller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs Eur J Surg 164: 965–969

    Article  PubMed  Google Scholar 

  14. Klosterhalfen B, Klinge U, Hermanns B, Schumpelick V (2000) Pathology of traditional surgical nets for hernia repair after long-term implantation in humans Chirurg 71: 43–51

    PubMed  Google Scholar 

  15. LeBlanc KA, (2001) Complications associated with the plug-and-patch method of inguinal herniorrhaphy Hernia 5: 135–138

    Article  PubMed  Google Scholar 

  16. Sher W, Pollack D, Paulides CA, Matsumoto T (1980) Repair of abdominfal wall defects: Gore-Tex vs Marlex graft. Am Surg 46: 618–623

    Google Scholar 

  17. Usher FC, Alien JE, Crosthwait RW (1962) Polypropylene monofilament; a new biologically inert suture for closing contaminated wounds J Am Med Assoc 79: 780–786

    Google Scholar 

  18. Witherspoon P, Bryson G, Wright DM, Reid R, O’Dwyer PJ (2004) Carcinogenic potential of commonly used hernia repair prostheses in an experimental model Br J Surg 91: 368–372

    Article  PubMed  Google Scholar 

  19. Wulfhorst B (1989) Polypropylene fibres Chemiefaser/Textilindustrie 39: 3–11

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Kapischke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kapischke, M., Prinz, K., Tepel, J. et al. Comparative investigation of alloplastic materials for hernia repair with improved methodology. Surg Endosc 19, 1260–1265 (2005). https://doi.org/10.1007/s00464-004-2235-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-004-2235-y

Key words:

Navigation