The new 4DDome prosthesis: an original light and partially absorbable composite mesh for hernia repair |
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Authors: | J L Leroy D Mutter A Forgione H Inoue M Vix C Bailey J Marescaux |
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Institution: | 1. IRCAD/EITS, Louis Pasteur University, 1 Place de l’ H?pital, 67091, Strasbourg, France
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Abstract: | Introduction The use of non-absorbable meshes for the repair of inguinal hernias has become standard; however, these meshes have been associated
with complications including long-term postoperative pain. To this end, a new partially absorbable composite mesh has been
developed, and the aim of this study was to investigate its efficacy in animal and human trials.
Materials and methods Sixty male Wistar rats were used to evaluate the behavior of the newly designed composite mesh. Composite meshes were implanted
in the extra-peritoneal plane for 2, 4 and 8 weeks and compared to a standard polypropylene mesh. Forty patients with symptomatic
inguinal hernias were treated using a new 4DDome designed prosthesis. Follow-up was by clinical and ultrasound examination
at 1, 6 and 12 months.
Results The animal study demonstrated that the inflammatory reaction associated with the new composite mesh was significantly lower
than a standard polypropylene mesh, characterized by a lower macrophage infiltrate (P < 0.001). The mesh did not shrink over the 8-week period, unlike the polypropylene mesh (P < 0.05). The human study showed that there were three minor postoperative complications, no recurrences and the mesh was
well tolerated. Follow-up with serial ultrasound showed that at 10 days and 1 month the dome was clearly visible in position;
however, by 6 months it had flattened out, been partially absorbed and become incorporated into the repair.
Conclusion These experimental and clinical studies have validated the concept of the new 4DDome composite mesh. It was well tolerated
and was associated with good short-term results. The combination of the dome shape and the new composite mesh means that less
polypropylene is required and represents a significant advance in anterior hernia repair. |
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Keywords: | Hernia Repair Mesh Plug Composite Polypropylene PLLA dome |
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