Hernia : the journal of hernias and abdominal wall surgery · 2026
Macroscopic, radiologic, and microscopic analysis of explanted abdominal wall prosthesis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Christ Léna, Romain Benoit, Philouze Guillaume, Neumann Nicole, Lejay Anne, Tabouret Juliette, Chakfé Nabil
Аннотация
PURPOSE: Characterize the textile structure, degradation patterns, and calcification of explanted parietal reinforcement implants (PRI), in order to better understand potential mechanisms contributing to mesh-related complications.
METHODS: A multimodal analytical approach combining macroscopic examination, high-resolution radiographic imaging and microscopic analysis was performed before and after removal of surrounding biological tissues on explanted PRI.
RESULTS: Twenty-two explanted PRI were analyzed, including five biosynthetic meshes and seventeen fully synthetic non-resorbable meshes. Mean implantation duration was 41 months (range, [0-220]). Indications for explantation were hernia recurrence (n = 14, 64%), mesh infection (n = 4, 18%), unrelated surgery (n = 3, 14%), and bowel obstruction (n = 1, 4%). Macroscopic analysis showed encapsulation within biological tissues (n = 16), rigidity (n = 6), and fragmentation (n = 3), sometimes combined. Radiographic imaging revealed suggestive calcifications in four explants, and suggestive fibrosis and/or milder mineralized deposits in twelve. Nineteen non-resorbable meshes underwent digital optical microscopy after enzymatic cleaning (2 explants each contained 2 devices). Textile structures included warp-knitted meshes (n = 16), weft-knitting mesh (n = 1), and nonwoven materials (n = 2); six devices also incorporated a plastic membrane. Monofilament yarns predominated (n = 15) whereas multifilament yarns (n = 4) showed signs of fibrillation. Fixation systems included staples (n = 3) and suture threads (n = 6). Structural abnormalities included holes (n = 7), clean cuts (n = 7), tearing (n = 1), and forceps marks (n = 3), variably attributable to surgical/handling artefacts or pre-existing degradation, though this could not be established with certainty.
CONCLUSION: This pilot study demonstrates the feasibility of a multimodal approach for characterizing explanted PRI. Larger studies are needed to clarify mesh failure mechanisms and thereby optimize implant selection and surgical use.
METHODS: A multimodal analytical approach combining macroscopic examination, high-resolution radiographic imaging and microscopic analysis was performed before and after removal of surrounding biological tissues on explanted PRI.
RESULTS: Twenty-two explanted PRI were analyzed, including five biosynthetic meshes and seventeen fully synthetic non-resorbable meshes. Mean implantation duration was 41 months (range, [0-220]). Indications for explantation were hernia recurrence (n = 14, 64%), mesh infection (n = 4, 18%), unrelated surgery (n = 3, 14%), and bowel obstruction (n = 1, 4%). Macroscopic analysis showed encapsulation within biological tissues (n = 16), rigidity (n = 6), and fragmentation (n = 3), sometimes combined. Radiographic imaging revealed suggestive calcifications in four explants, and suggestive fibrosis and/or milder mineralized deposits in twelve. Nineteen non-resorbable meshes underwent digital optical microscopy after enzymatic cleaning (2 explants each contained 2 devices). Textile structures included warp-knitted meshes (n = 16), weft-knitting mesh (n = 1), and nonwoven materials (n = 2); six devices also incorporated a plastic membrane. Monofilament yarns predominated (n = 15) whereas multifilament yarns (n = 4) showed signs of fibrillation. Fixation systems included staples (n = 3) and suture threads (n = 6). Structural abnormalities included holes (n = 7), clean cuts (n = 7), tearing (n = 1), and forceps marks (n = 3), variably attributable to surgical/handling artefacts or pre-existing degradation, though this could not be established with certainty.
CONCLUSION: This pilot study demonstrates the feasibility of a multimodal approach for characterizing explanted PRI. Larger studies are needed to clarify mesh failure mechanisms and thereby optimize implant selection and surgical use.