Macroscopic evaluation of mesh incorporation placed intraperitoneally for laparoscopic ventral hernia repair. Experimental model

The laparosopic approach for ventral hernias is performed by placing a mesh intraperitoneally, but one of the main concerns of surgeons performing thi s technique is that this prosthesis may produce adhesion and fistulas. We h ave developed an experimental model to determine how to manage the mesh and the tacks to avoid recurrences and adherences, and also to determine mesh integration by analyzing some macroscopic parameters, including: the size o f the mesh and the formation of adhesions, fistulas, seromas, hematomas, gr anulomas, infection, and abscesses, all related to the center of the mesh a nd to the edge, were the tacks were placed. We have concluded that the e-PT FE Dual mesh plus with holes is a good mesh to be placed intraperitoneally by laparoscopy, because this material creates few adhesions, and a correct integration in the abdominal wall is observed. Helicoidal sutures and the e dge of the mesh should not be left hanging from the abdominal wall to avoid adhesions. The mesh used should overlap the defect at least 3 cm in order to avoid recurrences, because a reduction of its size is observed.