L. Farmer et al., ADHESION FORMATION AFTER INTRAPERITONEAL AND EXTRAPERITONEAL IMPLANTATION OF POLYPROPYLENE MESH, The American surgeon, 64(2), 1998, pp. 144-146
Polypropylene mesh is commonly used in open and laparoscopic hernia re
pairs. We tested the hypothesis that intra-abdominal adhesion formatio
n secondary to polypropylene mesh is greater when mesh is placed in an
intraperitoneal versus an extraperitoneal position. Fifty adult male
rats underwent midline laparotomy with or without implantation of a no
nabsorbable mesh. There were ten rats in each of the following five gr
oups: EP-M, creation of an extraperitoneal pocket without mesh placeme
nt; EP+M, mesh placement in an extraperitoneal pocket; IP+M, intraperi
toneal mesh; IT-M, creation of an abdominal wall ischemic defect witho
ut mesh placement; IT+M, ischemic defect plus mesh. Adhesion formation
was graded on a scale of 0 to 5, 2 weeks after operation. All groups
formed adhesions. Tissue injury or the placement of a mesh in an intra
peritoneal position resulted in significantly more adhesions. An entir
ely extraperitoneal approach to mesh placement is needed to minimize a
dhesions after laparoscopic hernia repair.