Background

Ventral hernia repair needs to be improved since recurrence, postoperative pain and other complications are still reported in many patients. The behavior of implants in vivo is not sufficiently understood to design a surgical mesh mechanically compatible with the human abdominal wall.

Methods

This analysis was based on radiological pictures of patients who underwent laparoscopic ventral hernia repair. The pictures show the trunk of the patient at rest in a standing position and under side bending. The change in the distance between different tacks due to trunk movement was analyzed, which allowed us to determine the in vivo elongation of the mesh incorporated into the abdominal wall.

Findings

The relative elongations of the surgical mesh varied from a few percent to greater than 100% in two cases. The median of the median relative elongations obtained for all patients is 9.5%, and the median of the maximum relative elongations for all patients is 32.6%. The maximum elongation occurs between tacks that are next to each other. Trunk movement causes implant deformation, and this study provides quantitative information regarding changes in the distance between fasteners.

Interpretation

The physiological movement of the human abdomen must be regarded as a very important factor in mesh deformation and should be considered in surgical practice to reduce the hernia recurrence rate and postoperative pain.

中文翻译：

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腹疝修补后腹膜内贴网的体内表现。

背景

由于许多患者仍存在复发，术后疼痛和其他并发症，因此需要改善腹疝修补术。体内植入物的行为还不足以设计与人腹壁机械兼容的手术网。

方法

该分析基于接受腹腔镜腹侧疝修补术的患者的放射影像学。图片显示了站立时处于侧弯状态的患者躯干。分析了由于躯干运动造成的不同粘性之间的距离变化，这使我们能够确定并入腹壁的网孔的体内伸长率。

发现

在两种情况下，手术网片的相对伸长率从百分之几到大于100％不等。所有患者的相对相对伸长率中位数为9.5％，所有患者的最大相对相对伸长率中位数为32.6％。最大伸长率出现在彼此相邻的大头钉之间。躯干移动会导致植入物变形，这项研究提供了有关紧固件之间距离变化的定量信息。

解释

人腹部的生理运动必须被认为是网状结构变形的一个非常重要的因素，并且在外科手术中应考虑降低疝气的复发率和术后疼痛。