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一种新设计的腹股沟疝修补补片植入物的内镜及组织学评估:在猪动物模型和人体尸体上的实验研究

Endoscopic and histological evaluations of a newly designed inguinal hernia mesh implant: Experimental studies on porcine animal model and human cadaver.

作者信息

Panaro Fabrizio, Matos-Azevedo Ana Maria, Fatas José Antonio, Marin Juan, Navarro Francis, Zaragoza-Fernandez Cristobal

机构信息

Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France.

Laparoscopy Unit-Minimally Invasive Surgery, Centre Jesús Usón, Carretera N-521, 10071, Cáceres, Spain.

出版信息

Ann Med Surg (Lond). 2015 Apr 20;4(2):172-8. doi: 10.1016/j.amsu.2015.04.007. eCollection 2015 Jun.

Abstract

PURPOSE

Conventional prostheses used for inguinal hernia repair are static and passive. This feasibility-study shows the features of a new 3D tension-free prosthesis in an experimental model.

METHODS

This study was divided into two-phases: 1) aimed to test the physics intrinsic features and the anatomical adaptability of a new 3D designed mesh, and 2) aimed to evaluate the inflammatory reaction associated with different materials used. On phase-1 implantations were performed in pigs. During the first trial phase, the prostheses were also implanted on human cadavers. On phase-2, implantation was carried out on large swine. Follow-up was of 60-days, after which the animals were anaesthetized for laparoscopic assessment, and for sample collection of mesh implantation site for histological analysis.

RESULTS

All animals showed good 3D mesh tolerance, and the follow-up period was uneventful. The laparoscopy showed no inflammatory lesions on the internal surface of the peritoneum. Macroscopic observation of implantation site revealed some local fibrosis and reorganization of tissue, no signs of infection, and no changes on original implant positioning. Histological analysis on phase-1 showed in most sample segments the deferent duct maintaining its central position and surrounded by vascular and nervous structures. On phase-2 differences in inflammatory lesion score could be found between subjects.

CONCLUSIONS

This new 3D mesh can be placed appropriately and from this preliminary animal study no untoward complications were noted over a 60 day period.

摘要

目的

用于腹股沟疝修补的传统假体是静态和被动的。本可行性研究在实验模型中展示了一种新型三维无张力假体的特点。

方法

本研究分为两个阶段:1)旨在测试一种新设计的三维网片的物理内在特性和解剖适应性,2)旨在评估与不同使用材料相关的炎症反应。在第一阶段,在猪身上进行植入。在第一个试验阶段,假体也被植入人体尸体。在第二阶段,在大型猪身上进行植入。随访60天,之后对动物进行麻醉以进行腹腔镜评估,并采集网片植入部位的样本进行组织学分析。

结果

所有动物对三维网片耐受性良好,随访期间无异常情况。腹腔镜检查显示腹膜内表面无炎症病变。植入部位的宏观观察显示有一些局部纤维化和组织重组,无感染迹象,原始植入位置无变化。第一阶段的组织学分析显示,在大多数样本切片中,输精管保持其中心位置,并被血管和神经结构包围。在第二阶段,受试者之间在炎症病变评分上存在差异。

结论

这种新型三维网片可以正确放置,从这项初步动物研究来看,在60天期间未发现不良并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13fa/4846821/b02f0cabb5c1/gr1.jpg

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