Morphological Characteristics of Reparative Process after Intraperitoneal Abdominal Wall Mesh Plasty Depending on Endoprosthetic Material and Structure in Experiment

The aim of the investigation was to study in experiment morphological characteristics of reparative process in the zone of intraperitoneal repair of the abdominal wall by meshes in immediate postoperative period depending on endoprosthetic material and composition.

Materials and Methods. Meshes were implanted in rabbits by open IPOM technique (n=61). Polypropylene (PP Std), polyvinylidenfluoride (PVDF), reperene (R) endoprostheses and composite endoprostheses (PP Std/R, PVDF/R, PP Std/PVDF) were used. The implantation area was analyzed morphologically in 30 days.

Conclusion. The course of reparative process depends on mesh material and structure that should be taken into consideration when choosing a technique for their implantation. The use of standard polypropylene for intraperitoneal plasty without isolation procedure is possible in exceptional cases. PVDF implants have a number of advantages in intraperitoneal implantation and can be extensively used. Reperen endoprostheses are appropriate for temporary closure of the abdominal cavity best of all. The use of composite synthetic meshes with fibrous (mesh) structure of parietal side and complete adhesive cover on visceral side for intraperitoneal abdominal wall plasty is an optimal and morphologically proved approach.

1. Averyanov M.Y., Gaar E.V., Gorokhov V.N. Sravnitel’nyy analiz primeneniya nenatyazhnykh i traditsionnykh sposobov gernioplastiki pri gryzhakh zhivota [Comparative analysis of the use of non-tension and traditional hernioplasty techniques in abdominal hernias of various localizations]. Sovrem Tehnol Med — Modern Technologies in Medicine 2011; 3: 39–43.
2. Blagovestnov D.A., Upyrev A.V., Srukova A.H. Rol’ i mesto proteziruyushchikh metodov plastiki peredney bryushnoy stenki v khirurgii pervichnykh sredinnykh gryzh [The role and place of prosthesis fitting methods of forward belly wall plasticity in primary median hernia surgery]. Vestnik novykh meditsinskikh tekhnologiy — Journal of New Medical Technologies 2011; 1(18): 153–155.
3. Pushkin S.Yu., Belokonev V.I. Rezul’taty lecheniya bol’nykh sredinnoy ventral’noy gryzhey s primeneniem sinteticheskikh endoprotezov [The results of treatment of patients with median ventral hernia using synthetic endoprostheses]. Khirurgiya — Surgery 2010; 6: 43–45.
4. Tsverov I.A., Bazaev A.V. Khirurgicheskoe lechenie bol’nykh s ventral’nymi gryzhami: sovremennoe sostoyanie voprosa [Surgical treatment of patients with ventral hernias: modern state]. Sovrem Tehnol Med — Modern Technologies in Medicine 2010; 4: 122–127.
5. Egiev V.N., Lyadov K.V., Voskresenskiy P.K. Atlas operativnoy khirurgii gryzh [Atlas of hernia operative surgery]. Moscow: Medpraktika–M; 2003; 228 p.
6. Grigor'ev S.G., Bratiychuk A.N., Krivoshchekov E.P., Grigor'eva T.S. Khirurgicheskoe lechenie gryzh zhivota i ikh oslozhneniy [Surgical management of abdominal hernias and their complications]. Samara; 2007; 300 p.
7. Romanov R.V., Fedaev A.A., Petrov V.V., Khodak V.A., Parshikov V.V. Sovremennoe sostoyanie problemy intraperitoneal’noy plastiki bryushnoy stenki sinteticheskimi endoprotezami [The intraperitoneal tension-free plasty of abdominal wall with mesh use — current state of problem]. Sovrem Tehnol Med — Modern Technologies in Medicine 2012; 4: 161–170.
8. Basoglu M. Late complications of incisional hernias following prosthetic mesh repair. Acta Chir Belg 2004; 4: 425–428.
9. Crovella F., Bartone G., Fei L. Incisional hernia. Springer; 2007; 261 p.
10. Nicolson A. Colovaginal fistula: a rare long-term complication of polypropylene mesh sacrocolpopexy. J Obstet Gynaecol 2009; 5: 444–445.
11. Novotny T. Evaluation of a knitted polytetrafluoroethylene mesh placed intraperitoneally in a New Zealand white rabbit model. Surg Endosc 2012; 7: 1884–1891.
12. Seker D. Long-term complications of mesh repairs for abdominal-wall hernias. J Long Term Eff Med Implants 2011; 3: 205–218.
13. Lyadov V.K. Sravnitel’naya otsenka materialov dlya vnutribryushinnogo razmeshcheniya pri lechenii gryzh peredney bryushnoy stenki. Avtoref. dis. … kand. med. nauk [Comparative assessment of the materials for intraperitoneal usage in the treatment of anterior abdominal wall hernias. Abstract for Dissertation for the degree of Candidate of Medical Science]. Moscow; 2010.
14. Brown C.N., Finch J.G. Which mesh for hernia repair? Ann R Coll Surg Engl 2010; 92(4): 272–278.
15. Zhukovskiy V.A. Sravnitel’naya otsenka otechestvennykh i zarubezhnykh endoprotezov dlya gernioplastiki [Comparative assessment of Russian and foreign endoprostheses for hernioplasty]. Vestn Hir Im II Grekova — Surgery Reporter named after I.I. Grekov 2011; 3(170): 69–74.
16. Khokhlov K.S., Bondarev O.I., Gorokhova L.G., Bugaeva M.S., Voenkova D.V. Patomorfologicheskoe issledovanie rezul’tatov nenatyazhnoy gernioplastiki pri posleoperatsionnoy ventral’noy gryzhe v eksperimente [Pathomorphological study of the results of tension-free plasty in incisional ventral hernia in experiment]. Fundamental’nye issledovaniya — Fundamental Researches 2011; 11: 372–376.
17. Ivanov S.V., Lazarenko V.A., Ivanov I.S., Katunina T.P., Tsukanov A.V. Osobennosti tsitokinovogo profilya u bol’nykh s posleoperatsionnymi ventral’nymi gryzhami pri ispol’zovanii endoprotezov “Ekoflon” i “Unifleks” [The peculiarities of cytokine profile in patients with incisional ventral hernias using “Ecoflon” and “Uniflex” endoprostheses]. Vestnik eksperimental’noy i klinicheskoy khirurgii — Vestnik of Experimental and Clinical Surgery 2011; 3: 441–445.
18. Egiev V.N. Sravnitel’naya otsenka materialov dlya vnutribryushinnoy plastiki ventral’nykh gryzh: eksperimental’noe issledovanie [Comparative evaluation of materials for intraperitoneal plasty of ventral hernias: experimental study]. Khirurgiya — Surgery 2010; 10: 36–41.
19. Petrov V.V., Parshikov V.V., Khodak V.A., Romanov R.V., Samsonov A.A., Dvornikov A.V., Mironov A.A. Nenatyazhnaya intraperitoneal’naya plastika bryushnoy stenki kompozitnymi endoprotezami (eksperimental’noe issledovanie) [Tension-free intraperitoneal plasty of abdominal wall using composite mesh (experimental study)]. Sovremennye problemy nauki i obrazovaniya — Modern science and education problems 2012; 2. URL: http:// www.science-education.ru/102-6062 (submission date: 24.04.2012).
20. Sedov V.M., Gostevskoy A.A., Tarbaev S.D., Gorelov A.S., Chulkhovin A.B., Nutfullina G.M., Zhukovskiy V.A. Setchatye implantaty iz polivinilidenftorida v lechenii gryzh bryushnoy stenki [Mesh polyvinylidenfluoride implants in the abdominal wall hernia repair]. Vestn Hir Im II Grekova — Surgery Reporter named after I.I. Grekov 2008; 2: 16–21.
21. Zaykov I.N., Podoluzhnyy V.I., Mikheev A.G., Kotov M.S., Kormadonov A.V., Volova T.G. Ispol’zovanie kombinirovannykh protezov dlya intraperitoneal’noy gernioplastiki posleoperatsionnykh ventral’nykh gryzh v eksperimente [The use of combined prostheses for intraperitoneal hernioplasty of incisional ventral hernias in experiment]. Sibirskiy meditsinskiy zhurnal (Tomsk) — Siberian Medical Journal (Tomsk) 2009; 1(24): 59–62.
22. Khodak V.A., et al. Primenenie sinteticheskikh materialov pri peritonite i eventratsii. V kn.: Sbornik materialov 7-y Vserossiyskoy konferentsii obshchikh khirurgov [The use of synthetic materials in peritonitis and eventration. In: Proceedings of the 7^th Russian conference of general surgeons]. Krasnoyarsk; 2012; р. 402–403.

Parshikov V.V., Snopova L.B., Zhemarina N.V., Prodanets N.N., Baskina О.S., Khodak V.А., Petrov V.V., Dvornikov А.V., Mironov А.А., Tsybusov S.N. Morphological Characteristics of Reparative Process after Intraperitoneal Abdominal Wall Mesh Plasty Depending on Endoprosthetic Material and Structure in Experiment. Sovremennye tehnologii v medicine 2013; 5(3): 23