Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

Abstract

After laparoscopic ventral hernia repair, the nature of the adhesions to fixation materials or to mesh had not been clarified. We examined adhesion formation specific to the fixation material in rats. We designed an experimental laparoscopy setup, and placed four intraperitoneal fixation materials on the peritoneum of rats without a mesh graft. Another group of researchers documented the incidence and intensity of postoperative adhesion formation. The adhesion scores for the nickel-titanium anchor were significantly greater than those for polylactic acid (p=0.004), a titanium tacker (p<0.0001), and fibrin glue (p<0.0001). No adhesions occurred in the fibrin glue group. Fibrin glue is the preferred fixation material because it produced no postoperative adhesions. The nickel-titanium anchor produced heavy adhesions but may be applicable for recurrent hernia cases and in patients with thin abdominal walls. © 2010 Association of Surgeons of India.