Preparation And Release Of Umbrella-shaped Hernia Repair Mesh With Poly-l-lactic Acid Stents

ObjectiveTo study the feasibility of the release way of umbrella-shaped herniarepair mesh with poly-lactic acid (PLLA) stents in simple incisional herniarepair surgery.MethodsPLLA stents manufactured by injection molding technique werecombined with hernia repair mesh to carry out animal experiment, thediameter of the PLLA stents were made in the form of1mm. To test if thePLLA stents made in the technique of injection molding meet the demand ofmechanical properties in clinical. Twenty-four rabbits were divided into twogroups A and B, group A as experimental group (n=12) and group B ascontrol group (n=12). Simple abdominal wall incisional hernia model wasmanufactured for groups A and B, group A adopted the new release way withthe mesh and group B adopted the ordinary tension-free hernia repair.Operating time, wound length, postoperative complications and postoperative infection between group A and B were compared.ResultsThe average maximum load of the PLLA stents is646N, and theaverage tensile stress at the maximum load of the PLLA stents is80MPa.Theaverage maximum bending load is176N. There were significant differencesin length of incision between group A and B,(4.09±0.47) cm vs.(6.05±0.25)cm, P=0.000. There were significant differences in operating time betweengroup A and B,(41.75±1.60) min vs.(73.25±3.84) min, P=0.000. There wasone case of postoperative hematoma in group A and2cases in group B.There were3cases of postoperative infection in group B and one case ingroup A. There was one case of intestinal injury during the operative ingroup B and none in group A(hematoma:P=0.999,infection:P=0.59,intestinal injury:P=0.999). There was no significant difference in thecomplications between the two groups.Conclusion1The PLLA stents in the diameter of1mm can provide enoughmechanican support against the intra-abdominal pressure,and will not breakor bend or shift in the process of releasing.2New release way of umbrella-shaped hernia repair mesh with PLLAstents can simplify the operation, diminish the length of incision, shorten theoperation time without increasing complications; meanwhile, it providesanother ‘intervention’ typed idea and method for treating incisional hernia of abdominal wall.