Impairment of the Peritoneal Surface as a Decisive Factor for Intestinal Adhesions in Intraperitoneal Onlay Mesh Surgery - Introducing a New Rat Model

摘要: Background: Meshes implanted intraperitoneally are known to cause adhesions potentially resulting in complications such as chronic pain, enterocutaneous fistula, or mesh infection. This study introduces a model for investigation of intestine-to-mesh and evaluates whether missing visceral peritoneum is causative. Methods: In 18 rats, rectangular 1.5 x 2 cm patches an uncoated polypropylene (Ultrapro®) were sewn the inner abdominal wall next cecum. Additionally, meso-suture ensured contact between cecum mesh. Rats assigned groups: 8 rats was left intact, 10 depleted from with abrasion. Sacrifice on day 7. Macroscopic evaluation used two adhesion scores. Specimens evaluated microscopically, statistical analyses employed student's t-test. Results: On 7, implantation combined locally de-peritonealization by cecal abrasion mostly showed severe cecum-to-mesh agglutination (mean Lauder score 92%, mean total Hoffmann 90%), whereas meshes most animals without only had some coverage intraabdominal fat (33%, 24%; p = 0.0002). Histological work-up adequate ingrowth all rats. abrasion, adhesive wall. However, when unimpaired, above well usually revealed sub-peritoneal tissue mono-layer cell seen normal peritoneum. Conclusion: mimicking clinical situation e.g. hernia repair has de-peritonealized intestine. The might be useful testing types coatings other devices their efficacy prevention. high scores local compared low intact indicate that integrity intestinal decisive factor formation.