Is mesh fixation necessary in abdominal hernia repair? Results of an experimental study in the rat

Background: Abdominal hernia repair with implantation of synthetic meshes u sing the sublay technique has resulted in low recurrence rates and high pat ient satisfaction. Aim: The purpose of this experimental animal study was t o investigate whether mesh fixation is necessary in abdominal hernia repair using a polypropylene mesh in the sublay technique. Methods: Forty-five ra ts were divided into three groups after creating an abdominal wall defect ( CC control group, no mesh implantation; NoFixG mesh implantation without fi xation group; SG mesh with suture fixation group) with 15 animals in each g roup. Endpoints were clinical herniation pressure, hydroxyproline (HP) conc entration, mesh shape and number of fibroblasts/collagen fibres of the anch or zone 7, 14 and 90 days after implantation. Results: Herniation pressure, HP content and number of fibroblasts were similar between NoFixG and SG, a lthough significantly higher in these groups than in the CG (P<0.05). Both mesh groups had significantly higher counts of fibroblasts and collagen fib res than the CG. Mesh shrinking occurred in both groups but was less in the SG. Conclusion: Mesh fixation was not mandatory in abdominal hernia repair using this animal model.