Ultrasound assessment of reparative processes in the area of installation of titanium mesh implants after laparoscopic inguinal hernioplasty

   Introduction. The use of various implants in herniology dictates the need to study the quality of their integration. In this aspect, it is often impossible to perform morphological studies in patients.

   The purpose of the study. Assessment of reparative processes in the implant placement area depending on its material.

   Materials and methods of research. The study included 25 patients with inguinal hernia, all underwent laparoscopic hernioplasty. Titanium mesh implant was installed in 11 patients (group 1), polypropylene implant was installed in 14 patients (group 2). Ultrasound evaluation of the implant placement zone was performed 1–3 days, 2 weeks, 2, 6 and 12 months after surgery.

   Research results. 2 weeks after surgery, residual exudation in the implant placement area was detected in 35,7 % of group 2 patients. Patients of group 1 showed earlier germination of implant cells by connective tissue (2 weeks after surgery) than in group 2 patients (6 months later). 12 months after surgery, a thicker periimplantation scar was formed in patients of group 1 than in patients of group 2 (2,5 ± 0,2 mm vs. 1,25 ± 0,1 mm, at p < 0,05). During this period, 28,6 % of group 2 patients retained echo signs of ongoing reparative processes around the implant.

   Conclusion. The results obtained indicate the advantage of titanium mesh implants over polypropylene ones in the surgical treatment of patients with inguinal hernias.

1. Vinnik Y. S., Petrushko S. I., Miller S. V., Yakovlev A. V., Nazaryants Y. A. Characteristic of allohernioplasty implants esfil and ethicon in surgical treatment of postoperative ventral hernias. Sibirskoe mediczinskoe obozrenie, 2007, № 4 (45), рр. 32–35. (In Russ.)

2. Kapustin B. B., Mingazova G. F., Elkhov I. V., Anisimov A. V. Ultrasonic monitoring of regenerative process at patients with fitting a prosthesis hernioplasty. Sovremenny`e problemy` nauki i obrazovaniya, 2012, № 2, рр. 76. (In Russ.)

3. Kharitonov S. V., Ziniakova M. V. The ultrasound semiotics of uncomplicated wound healing after inguinal mesh plastics. Khirurgiya. Zhurnal im. N. I. Pirogova, 2012, № 12, рр. 27–33. (In Russ.)

4. Kharitonov S., Kuznetsov N., Zinyakova M. The role of ultrasonic scanning in definition of the type abdominoplasty in patients with ventral hernias. Khirurg, 2013, № 4, рр. 17–23. (In Russ.)

5. Bloemen A., van Dooren P., Huizinga B. F., Hoofwijk A. G. Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study. Hernia, 2012, Feb; 16 (1), рр. 53–57. doi: 10.1007/s10029-011-0865-2.

6. den Hartog D., Dur A. H., Kamphuis A. G., Tuinebreijer W. E., Hermans J. J., Kreis R. W. Pre-, intra-, and postoperative sonography of the abdominal wall in patients with incisional hernias repaired via a three-layered operative suture method. J Clin Ultrasound, 2009, Sep; № 37 (7). рр. 394–398. doi: 10.1002/jcu.20606.

7. Jamadar D. A., Jacobson J. A., Girish G., Balin J., Brandon C. J., Caoili E. M., Morag Y., Franz M. G. Abdominal wall hernia mesh repair: sonog-raphy of mesh and common complications. J Ultrasound Med, 2008, Jun; № 27 (6), рр. 907–917. doi: 10.7863/jum.2008.27.6.907.

8. Petter-Puchner A., Gruber-Blum S., Walder N., Fortelny R. H., Redl H., Raum K. Ultrasound biomicroscopy (UBM) and scanning acoustic microscopy (SAM) for the assessment of hernia mesh integration: a comparison to standard histology in an experimental model. Hernia, 2014, Aug; № 18 (4), рр. 579–585. doi: 10.1007/s10029-013-1201-9.