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Original Scientific Articles
Abdominal Adhesions to Prosthetic Mesh Evaluated by Laparoscopy
and Electron Microscopy
Michael L Baptista, MD, Margaret E Bonsack, MS, Isaac Felemovicius,
MD, John P Delaney, MD, PhD, FACS
Background: Most adhesion experiments involve observations
at a single time point. We developed a method to evaluate abdominal
adhesions to surgical mesh by sequential laparoscopy.
Study Design: An abdominal wall defect was created
in rats and repaired with polypropylene mesh. Sequential laparoscopic
evaluation of adhesion formation was performed in each animal.
The percentage of mesh area involved was scored (0% to 100%).
At various time intervals animals were sacrificed and samples
were obtained for light and scanning electron microscopy.
Results: Adhesions were already present on day 1, increased
by day 7, and did not progress thereafter. Mesh surfaces free
of adhesions were covered with a confluent mesothelial cell layer,
first seen by scanning electron microscopy on day 5 and complete
by day 7.
Conclusions: Intraabdominal adhesions are best studied
by sequential laparoscopy. Adhesions develop within 1 day of
prosthesis placement. Adhesion-free surfaces are carpeted with
mesothelial cells by day 7 and remain free thereafter, for duration
of study.
Introduction
| Methods
| Results
| Discussion
| References
Full
Text of Article
JACS |
