Artikel
The MR-visible-Mesh as IPOM in rabbits: First in-vivo imaging of mesh ingrowth und delineation to its surrounding structures
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Veröffentlicht: | 20. Mai 2011 |
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Introduction: Implantation of textile meshes can cause severe complications like migration, erossion, shrinkage, deformation and fistula formation. In some of these cases the indication for surgical correction is beyond despute, but often “only” funtional problems or unspecific discomfort may be suspected. In these cases the required procedere is not clear.
Until now the conventional diagnostic is limited because X-ray, ultrasound, CT and MRI usually fail to visualize the mesh device. Only in exceptional cases, if the mesh is surrounded by fluids or fat, the structure of the mesh can be delineated.
Materials and methods: After we could establish a possibility to produce and to visualize a MR-visible mesh melting down MR-contrast medium into PVDF, we could now present the first trial of imaging the mesh ingrowth und its delineation to surrounding structures.
Therefor we implanted MR visible MeshInSight (6x4 cm) in IPOM-position in 10 rabbits laparoscopically. After 4 and 12 weeks we explanted 5 animals in each case. The histological analysis and the macroscopic results of adhesion and deformation were compared to the findings of MR investigations, which were done repeatedly during the whole period of examination.
Results: In the underlaying study in a living animal we could evaluate a mesh ingrowth in terms of position, deformation and delineation to its surrounding structures for the first time.
The use of such a visible mesh will be helpful for decision whether a revison operation of the mesh is necessary (explantation, refixation, implantation of a bigger mesh…) or not (in case of not mesh-related current complaints). Furthermore the visible mesh then could be useful to plan a revision.
Conclusion: This work is supported by the German Federal Mininstry of Education and Research (BMBF 01EZ 0849).