| 1. |
- Falk, Peter, 1962, et al.
(författare)
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An ex vivo model using human peritoneum to explore mesh-tissue integration.
- 2017
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Ingår i: Biology open. - : The Company of Biologists. - 2046-6390. ; 6:9, s. 1391-1395
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Tidskriftsartikel (refereegranskat)abstract
- Biological compatibility, in terms of implantation of foreign mesh material in hernia surgery, still needs experimental investigation. Present study develops an experimental model using human peritoneum to study the integration between tissue and different mesh material. The ex vivo model using peritoneal tissue was studied with different mesh material, and integration was monitored over time using microscopy.It could be demonstrated that the peritoneal model may be kept viable in culture for several weeks. Cell migration was seen after 7-10 days in culture and could be further monitored over several weeks. The use of a human artificial model environment enabling the investigation of tissue/mesh integration has, to our knowledge, not been described previously.This proof-of-concept model was developed, for the investigation of peritoneal biology and the integration between tissue and different mesh material. It has the potential to be useful in studies on other important biological mechanisms involving the peritoneum.
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| 2. |
- Ruiz-Jasbon, Fernando
(författare)
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Aspects on the use of slowly degradable mesh in inguinal hernia surgery
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Synthetic non-degradable mesh used in inguinal hernia surgery can cause chronic inflammation, which in turn can lead to chronic post-operative pain (CPP). Theoretically, a degradable mesh could reduce the risk of chronic pain. Aims: Explore the possibility of keeping viable human peritoneum in contact with hernia meshes in an ex vivo model for several weeks. Evaluate the feasibility and the safety of a slowly degradable mesh in open and endoscopy inguinal hernia repair. Methods: Four publications are included in the doctoral thesis: an experimental method study with peritoneal tissue and three prospective clinical safety studies using a slowly degradable mesh in the repair of patients with inguinal hernias. Results: Ex-vivo model: Peritoneal tissue in contact with a mesh could be kept viable between 26 and 56 days. Safety Studies: At 3-year control, no patient experienced CPP. The recurrence rates in patients operated with the open technique were 44% for medial inguinal hernias and 0% for lateral inguinal hernias. In patients operated with the endoscopy technique, the recurrence rate for lateral inguinal hernias was 8.8%. Conclusions: Peritoneal tissue can be kept viable in contact with mesh during weeks in a human ex vivo model. Using slowly degradable mesh in the repair of medial inguinal hernia is not safe due to an increased recurrence risk. This mesh seems safe regarding the risk of chronic post-operative pain in patients with lateral inguinal hernias, but the risk of hernia recurrence should be further studied.
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| 3. |
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| 4. |
- Ruiz-Jasbon, Fernando, et al.
(författare)
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Results at 3-year follow-up of totally extraperitoneal (TEP) hernia surgery with long-term resorbable mesh
- 2020
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Ingår i: Hernia. - : Springer Science and Business Media LLC. - 1265-4906 .- 1248-9204. ; 24, s. 669-676
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Tidskriftsartikel (refereegranskat)abstract
- © 2020, The Author(s). Introduction: Synthetic non-resorbable mesh is almost standard in hernia surgery. However, several studies have showed negative effects of permanent implants such as chronic inflammation and complications involving different organs bordering the mesh. Such complications can raise the risk of chronic post-operative pain (CPP). Recently promising results regarding CPP have been published in patients with Lateral Inguinal Hernia (LIH) using a slowly resorbable mesh in Lichtenstein technique. For this reason the aim of the present study was to find the effect of a slowly resorbable implant on the long-term rate of hernia recurrence and chronic post-operative pain in patients with LIH repaired with TEP procedure. Methods: Prospective pilot study of TEP repair using TIGR® Matrix Surgical Mesh in 35 primary LIH. At 3-year follow-up the Visual Analogue Scale (VAS) and the Inguinal Pain Questionnaire were employed to assess pain. Recurrence was determined by ultrasound and clinical examination. Results: All patients completed the pain questionnaires but one patient did not attend the planned clinical examination for the 3-year follow-up. No patients had CPP, as defined in the World Guidelines for Groin Hernia Management. Almost all patients had lower VAS score in any activity 3years following surgery in comparison to the preoperative period. Three patients (8.8%) suffered symptomatic recurrence during the 3-year follow-up. Conclusion: TEP repair in patients with LIH using a synthetic long-term resorbable mesh was found to be encouraging respecting chronic post-operative pain at 3-year follow-up but at the cost of an increased risk of recurrence.
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| 5. |
- Ruiz-Jasbon, Fernando, et al.
(författare)
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TEP With Long-Term Resorbable Mesh in Patients With Indirect Inguinal Hernia.
- 2018
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Ingår i: JSLS : Journal of the Society of Laparoendoscopic Surgeons. - 1938-3797. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh. This is the first human study to use long-term degradable mesh with the TEP approach.This study was prospective, including 35 primary IHs surgically treated with TEP repair using TIGR Mesh (Novus Scientific Pte, Ltd, Singapore). At the 1-year follow-up recurrence was assessed by clinical examination and the incidence of pain or discomfort was assessed before and after surgery by Visual Analog Scale (VAS) and Inguinal Pain Questionnaire (IPQ).After 12 months, no patients had chronic pain. Only 1 (2.8%) patient reported pain using the VAS (score = 2), and 4 patients reported pain that could easily be ignored. All 4 patients reported less pain 1 year after the operation using both IPQ and VAS, compared with the preoperative assessment. One patient (2.8%) developed a recurrence 20 months after the primary operation.TEP repair using a synthetic long-term resorbable mesh was found to be safe and promising regarding pain and discomfort at 1-year follow-up in patients with IH. Longer follow-up is necessary to establish the risk of recurrence.
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