Prospective cohort study on mesh shrinkage measured with MRI after laparoscopic ventral hernia repair with an intraperitoneal iron oxide-loaded PVDF mesh

Surg Endosc. 2018 Jun;32(6):2822-2830. doi: 10.1007/s00464-017-5987-x. Epub 2017 Dec 21.

Abstract

Background: Current data on shrinkage of intraperitoneal meshes come mainly from animal studies. High-quality human data in prospective studies are scarce.

Methods: We used the ability to visualize intraperitoneal PVDF meshes enhanced with iron particles (DynaMesh IPOM visible) with magnetic resonance imaging (MRI) to determine the amount of shrinkage between 1 and 13 months postoperatively. All measurements of the width, length, and surface area of the mesh were performed with a standardized methodology independently by four radiologists blinded for the timing of the MRI.

Results: Of the 15 patients undergoing laparoscopic ventral hernia repair, 13 patients received an MRI both at 1 and at 13 months. Evaluation of inter-rater reliability between the radiologists showed intra-class correlations of 0.95 (95% CI 0.92-0.98) for the width, 0.96 (95% CI 0.93-0.98) for the length, and 0.99 (90% CI 0.99-1.00) for the surface area of the mesh. The change between measurement at implantation and 1-month MRI was - 0.7 cm (P = 0.023; - 3.6%) for the width and - 1.9 cm (P = 0.001; - 7.2%) for the length. The change between 1 and 13 months was - 0.06 cm (P = 0.74; shrinkage = 0.3%) for the width, - 0.12 cm (P = 0.56; shrinkage = 0.5%) for the length, and - 4.0 cm2 (P = 0.20; shrinkage = 1.0%) for the surface area of the mesh.

Conclusion: There is excellent inter-rater reliability between radiologists when measuring width, length, and surface area of visible intraperitoneal PVDF mesh with MRI. There is no significant shrinkage between 1 and 13 months of intraperitoneal PVDF mesh after laparoscopic ventral hernia repair.

Trial registration: ClinicalTrials.gov NCT02177214.

Keywords: Intraperitoneal mesh; Laparoscopy; Magnetic resonance imaging; PVDF; Shrinkage; Ventral hernia.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Animals
  • Female
  • Ferric Compounds*
  • Follow-Up Studies
  • Hernia, Ventral / diagnosis
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Materials Testing
  • Middle Aged
  • Peritoneum / surgery
  • Polyvinyls*
  • Postoperative Period
  • Prospective Studies
  • Prosthesis Design
  • Reproducibility of Results
  • Surgical Mesh*

Substances

  • Ferric Compounds
  • Polyvinyls
  • ferric oxide
  • polyvinylidene fluoride

Associated data

  • ClinicalTrials.gov/NCT02177214