Which mesh is appropriate for laparoscopic use? Prevention of adhesions to macroporous mesh, a rabbit model

Laparoscopic hernioplasty is the method of choice for the repair of certain types of incisional and ventral hernias; however, complications from intraperitoneally implanted inappropriate meshes can be life threatening. On the other hand, the appropriate meshes are costly and that limit their routine use. The aim of these experiments was to create a simple mesh which generates adhesions in the abdominal wall but prevents adhesion formations intra-abdominally. The behaviour of different materials covering routinely used macroporous meshes were investigated in a rabbit model (n = 48) in which two disks of meshes were implanted in the abdominal wall in a way that the covered side faced the abdominal cavity. Depending on the mesh and the material covering it, the rabbits were divided into four groups of 12. The animals from each group were studied at 30, 60, 90 and 120 days to determine the presence and degree of adhesion formation macroscopically. Non-coated polypropylene mesh caused massive adhesions, but coating with silicone-layer adhesion formation was highly decreased. Intraperitoneal implantation of silicon impregnated low-weight polypropylene mesh decreased the incidence of adhesions. Use of silicone-covered mesh may provide a cheap alternative means for laparoscopic hernia repair.