Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates
Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates
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DOI：
10.1007/s00464-008-9936-6
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发表时间：
2008-12-01
影响因子：
3.1
通讯作者：
Seidler, Sabine
中科院分区：
文献类型：
--
作者：
Hollinsky, Christian;Sandberg, Simone;Seidler, Sabine
背景腹腔镜腹股沟疝修补术可以使用轻型或重型补片进行。除了网片的大小，它的摩擦系数（mu（0））和弯曲刚度是至关重要的，以避免疝recurrent.Methods在目前的生物力学研究，拉伸试验进行，以确定最终的拉伸强度和弹性模量的六个轻量级网片和六个重量级网片腹腔镜腹股沟疝修补术。为了确定其摩擦系数（mu（0）），在尸检期间将补片放置在切除的腹膜和腹股沟肌肉之间。网片测量15 - 9 - 10厘米的大小，然后在疝模型中使用的开口尺寸为1.5，3，或5 cm.Results的极限拉伸强度和弹性模量显着低于轻量型网片组比重量级网片组。补片的平均摩擦系数（mu（0））为0.4。考虑到1.5 cm的开口，所有补片均保持充分稳定。在3 cm和5 cm的开口尺寸下，轻量型补片的平均弯曲分别为3.16 +/- 0.4 mm和10.40 +/- 2.5 mm。另一方面，重型补片的柔韧性明显较差。其平均弯曲度分别为0.34 ± 0.2 mm和3.97 ± 0.7 mm（p < 0.001）。结论稳定的补片具有较小的弯曲度，即使在重复载荷下也不会滑入差距。因此，在疝复发方面，具有更大弯曲刚度的补片或充分覆盖疝缺损的固定良好的轻质补片可用于腹腔镜治疗大型腹股沟疝。
Background Laparoscopic inguinal hernia repair can be performed using light- or heavyweight meshes. Apart from the size of the mesh, its friction coefficient (mu(0)) and flexural stiffness are of crucial importance to avoidance of hernia recurrence.Methods In the current biomechanical study, tensile tests were performed to determine the ultimate tensile strength and modulus of elasticity of six lightweight meshes and six heavyweight meshes for laparoscopic inguinal hernia repair. To determine their friction coefficient (mu(0)), the meshes were placed between a resected peritoneum and groin muscles during an autopsy. Meshes measuring 15 9 10 cm in size then were used in a hernia model with an opening size of 1.5, 3, or 5 cm.Results The ultimate tensile strength and modulus of elasticity were significantly lower in the lightweight mesh group than in the heavyweight mesh group. The mean friction coefficient (mu(0)) of the meshes was 0.4. Given an opening of 1.5 cm, all meshes remained adequately stable. At opening sizes of 3 and 5 cm, the lightweight meshes flexed on the average by 3.16 +/- 0.4 mm and 10.40 +/- 2.5 mm, respectively. Heavyweight meshes, on the other hand, were significantly less flexible. Their mean flexure was, respectively, 0.34 +/- 0.2 mm and 3.97 +/- 0.7 mm (p < 0.001).Conclusion Stable meshes are characterized by a small degree of flexure and do not slide into the gap even when subjected to repetitive loads. Therefore, in terms of hernia recurrence, meshes with greater flexural stiffness or well-fixed lightweight meshes that adequately overlap the hernia defect can be used for laparoscopic treatment of large inguinal hernias.