Journal Article

FZJ-2020-03930

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png A peritoneal defect covered by intraperitoneal mesh prosthesis effects an increased and distinctive foreign body reaction in a minipig model

Eickhoff, R. M. (Corresponding author) ; Kroh, A. ; Eickhoff, S.FZJ* ; Heise, D. ; Helmedag, M. J. ; Tolba, R. H. ; Klinge, U. ; Neumann, U. P. ; Klink, C. D. ; Lambertz, A.RWTH*

2020
Sage Thousand Oaks, Calif. [u.a.]

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Please use a persistent id in citations: http://hdl.handle.net/2128/26630  doi:10.1177/0885328220963918

Abstract: Background: The incidence of incisional hernia is with up to 30% one of the frequent long-term complication afterlaparotomy. After establishing minimal invasive operations, the laparoscopic intraperitoneal onlay mesh technique(lap. IPOM) was first described in 1993. Little is known about the foreign body reaction of IPOM-meshes, which covereda defect of the parietal peritoneum. This is becoming more important, since IPOM procedure with peritoneal-sacresection and hernia port closing (IPOM plus) is more frequently used.Methods: In 18 female minipigs, two out of three Polyvinylidene-fluoride (PVDF) -meshes (I: standard IPOM; II: IPOMwith modified structure [bigger pores]; III: IPOM with the same structure as IPOM IIþdegradable hydrogel-coating)were placed in a laparoscopic IPOM procedure. Before mesh placement, a 2x2cm peritoneal defect was created. After30 days, animals were euthanized, adhesions were evaluated by re-laparoscopy and mesh samples were explanted forhistological and immunohistochemichal investigations.Results: All animals recovered after implantation and had no complications during the follow-up period. Analysingforeign body reaction, the IPOM II mesh had a significant smaller inner granuloma, compared to the other meshes (IPOMII: 8.4 mm1.3 vs. IPOM I 9.1 mm1.3, p<0.001). The degradable hydrogel coating does not prevent adhesionsmeasured by Diamond score (p¼0.46). A peritoneal defect covered by a standard or modified IPOM mesh was asignificant factor for increasing foreign body granuloma, the amount of CD3þ lymphocytes, CD68þ macrophages anddecrease of pore size.Conclusion: A peritoneal defect covered by IPOM prostheses leads to an increased foreign body reaction compared tointact peritoneum. Whenever feasible, a peritoneal defect should be closed accurately before placing an IPOM-mesh toavoid an excessive foreign body reaction and therefore inferior biomaterial properties of the prosthesis.

Note: The author(s) disclosed receipt of the following financial supportfor the research, authorship, and/or publication of thisarticle: This study was granted by the BMBF (FederalMinistry of Education and Research) (Funding number:13N12599.

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Contributing Institute(s):

1. Gehirn & Verhalten (INM-7)

Research Program(s):

1. 572 - (Dys-)function and Plasticity (POF3-572) (POF3-572)

Appears in the scientific report 2020

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