Document Detail


Functional cine MRI and transabdominal ultrasonography for the assessment of adhesions to implanted synthetic mesh 5-7 years after laparoscopic ventral hernia repair.
MedLine Citation:
PMID:  20490585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Laparoscopic ventral hernia repair (LVHR) has gained worldwide acceptance, due to its minimally invasive character, feasibility and low rate of complications. Animal experiments have shown marked adhesions to the intraperitoneal mesh (IPM), the clinical consequences being unclear. This study aimed to describe the extension of adhesions to the mesh, 5-7 years after LVHR, using two validated non-invasive radiologic methods.
METHODS: Real-time transabdominal ultrasonography (TAU) and cine magnetic resonance imaging (MRI) was applied to 30 patients with prior LVHR and implantation of IPM (Intramesh W3, Cousin Biotech, France). The visceral slide was measured in nine predefined abdominal segments. Values <or=1 cm were defined as an area with adhesion.
RESULTS: The mean time between LVHR and TAU/cine MRI was 67 months (range, 58-80 months). We found adhesion to the mesh in 90% of the patients using TAU and 100% of the patients using cine MRI. In the latter, 65% were between the bowel and IPM.
CONCLUSIONS: LVHR is known to reduce recurrences and postoperative complications, while improving patient outcome. The intraperitoneal placement of the mesh has been shown to induce adhesions; the amount and extension in the clinical setting is unclear. The present study showed a marked proportion of adhesions to the mesh with an average surgery to scan time of 5.6 years, despite an anti-adhesive barrier on the visceral surface of the mesh. Together with existing data, this result increases the concern related to the long-term consequences of an IPM. As a consequence, a comprehensive and comparable test system for medical devices, i.e. IPM, is needed.
Authors:
N B Zinther; A Zeuten; E Marinovskij; M Haislund; P Wara; H Friis-Andersen
Related Documents :
10818415 - Adhesions: laparoscopic surgery versus laparotomy.
2709355 - Epidural adhesions after chymopapain chemonucleolysis.
15277815 - Reduction of adhesions with composite alloderm/polypropylene mesh implants for abdomina...
18660685 - A review of techniques for adhesion prevention after gynaecological surgery.
23590235 - High affinity dna base analogs as supramolecular, nanoscale promoters of macroscopic ad...
10580655 - Changes in extracellular matrix components after excimer laser photoablation in rat cor...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-21
Journal Detail:
Title:  Hernia : the journal of hernias and abdominal wall surgery     Volume:  14     ISSN:  1248-9204     ISO Abbreviation:  Hernia     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-25     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715168     Medline TA:  Hernia     Country:  France    
Other Details:
Languages:  eng     Pagination:  499-504     Citation Subset:  IM    
Affiliation:
Surgical Department, Horsens Regional Hospital, Horsens, Denmark. nellie@zinther.dk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abdomen / pathology,  ultrasonography*
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Follow-Up Studies
Hernia, Ventral / surgery*
Humans
Laparoscopy / methods*
Magnetic Resonance Imaging, Cine / methods*
Male
Middle Aged
Polytetrafluoroethylene / adverse effects*
Retrospective Studies
Surgical Mesh / adverse effects*
Tissue Adhesions / diagnosis*,  etiology
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene
Comments/Corrections
Erratum In:
Hernia. 2010 Oct;14(5):551
Note: Wara, P [removed]; Zeuten, A [added]; Marinovskij, E [added]; Haislund, M [added]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Inguinal-scrotal hernias in young patients: is laparoscopic repair a possible answer? Preliminary re...
Next Document:  Harrahill's technique: a simple screening test for intra-abdominal pressure measurement.