Institute of Image-Guided Surgery, Institut Hospitalo-Universitaire-Strasbourg, Strasbourg, France.
IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France.
Hernia. 2019 Dec;23(6):1175-1185. doi: 10.1007/s10029-019-01999-5. Epub 2019 Jul 16.
To evaluate the feasibility and safety of a new percutaneous image-guided surgery technique to simulate a hernia repair using hydrogel.
A comparative prospective study was conducted in animals, with survival. Five pigs without any hernias were used. A hydrogel was injected at a site corresponding to the preperitoneal inguinal region. This procedure was performed bilaterally. An image-guided needle (ultrasound and computed tomography) was used, through which the material was injected. After survival, the local and systemic inflammatory reaction generated by the new material, was studied.
All animals survived the procedure. No hemorrhagic or infectious complications were reported. The solidification of the material occurred as expected. In eight out of ten cases, the material was found in the planned site. No systemic inflammatory reaction secondary to the administration of hydrogel was reported. The adhesion of the material to surrounding tissues was satisfactory.
The introduction of a liquid material which solidifies after injection in a short time (hydrogel) using a needle is feasible. The combined CT-scan and US image guidance allows for the percutaneous placement of the needle in the required location. The introduced hydrogel remains in this space, corresponding to the inguinal region, without moving. The placed hydrogel compresses the posterior wall composed of the transversalis fascia, supporting the potential use of hydrogel for hernia defects.
评估一种新的经皮影像引导手术技术的可行性和安全性,该技术可使用水凝胶模拟疝修补术。
对动物进行了一项有生存期限的对照前瞻性研究。使用了 5 只没有疝气的猪。在对应腹膜前腹股沟区域的部位注射水凝胶。该程序双侧进行。使用影像引导针(超声和计算机断层扫描)将材料注入。生存后,研究了新材料引起的局部和全身炎症反应。
所有动物均完成了手术,无出血或感染性并发症。材料按预期固化。在十种情况中有八种发现材料位于计划部位。未报告因水凝胶给药引起的全身炎症反应。材料与周围组织的粘连令人满意。
使用针将在短时间内固化的液体材料(水凝胶)注入是可行的。结合 CT 扫描和 US 影像引导可使针在所需位置进行经皮放置。引入的水凝胶保留在腹股沟区域的这个空间内,不会移动。放置的水凝胶压缩由横筋膜组成的后壁,支持水凝胶用于疝缺陷的潜在用途。