Evaluation of soft tissue attachments to a novel intra-abdominal prosthetic in a rabbit model

Background. Laparoscopic ventral hernia repair requires placement of an intraperitoneal prosthetic. Composite mesh types have been developed to address the shortcomings of standard meshes. The authors evaluated the host reaction to intraperitoneal placement of a novel composite material. Materials and Methods. A comparison of an innovative polypropylene/polylactide composite mesh was made to Parietex Composite (PCO), Proceed, and DualMesh. Eighteen meshes per group were implanted on intact peritoneum in New Zealand White rabbits. The main outcome measures included the formation of visceral adhesions, adhesion tenacity, tensiometric measurements, and histological analysis. Evaluations of adhesions were made at 1, 4, and 16 weeks using a 2-mm minilaparoscopy. Results. There were no significant differences in the mean adhesion scores between the composite mesh types at week 1 (P =.15) and week 16 (P =.06). At 4 weeks, PCO had significantly fewer adhesions when compared with the other 3 mesh types (P =.02). Adhesion tenacity was also equivalent within the group at 16 weeks (P =.06). Tensiometry and histological analysis revealed no statistically significant differences between the mesh types. Conclusions. Four different composite mesh types had equivalent intra-abdominal soft tissue attachments in a rabbit model after a 16-week implantation period. PCO demonstrated the lowest mean adhesion score of each mesh type. Each mesh exhibited equivalent stiffness and energy to failure after explantation. The 4 composite mesh types demonstrated the successful formation of a neoperitoneum and comparable host biocompatibility as evidenced by similar degrees of inflammation.