Experimental comparison of type of Tissucol dilution and composite mesh (Parietex) for laparoscopic repair of groin and abdominal hernia: observational study conducted in a university laboratory |
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Authors: | Stefano Olmi Alessandro Addis Cinzia Domeneghini Alberto Scaini Enrico Croce |
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Institution: | (1) Department of General Surgery, Center for Laparoscopic and Minimally Invasive Surgery, Ospedale S. Gerardo, Monza, Italy;(2) Veterinary Department, University of Milan, Center S. Ambrogio, Milan, Italy;(3) Via de Castillia 7, 20124 Milan, Italy |
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Abstract: | Purpose The primary objective of this observational study was to determine the best possible dilution of fibrin glue (Tissucol) to
employ for prosthesis fixing in laparoscopic treatment of abdominal wall defects and, secondly, to assess its feasibility
and safety.
Materials and methods This study was carried out in a university experimental animal laboratory in accordance with all international laws, ethics
regulations and quality criteria associated with animal experiments. The tests were carried out on two pigs, using four samples
of mesh (Parietex). All meshes were fixed using two different Tissucol dilutions (standard with distilled water and that
with calcium chloride). Follow-up evaluations were at 15 days after 30 days, with the latter consisting of traction tests
and a biopsy for histological analysis.
Results No post-operative complications were observed. The collagen-coated polyester meshes showed 0% adhesions, and reperitonealization
had ensued after 15 days. We saw no shrinkage or migration of any of the meshes. Histopathological analyses confirmed a greater
stability, greater tissue integration and the largest number of fibroblasts in meshes fixed with a 1/10 Tissucol dilution
without calcium chloride.
Conclusions This observational study using animals showed that the 1/10 standard dilution – not that with calcium chloride – provided
the best fixation and integration and prevented the formation of intraperitoneal adhesions, provided a hydrophilic collagen
film-covered mesh was used. |
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Keywords: | Composite mesh Fibrin glue dilution Intra-peritoneal onlay mesh Laparoscopy Thrombin |
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