Research Article

Evaluation Of Mesh Fixation Strength After Placement Of Polypropylene Mesh Secured Using Polypropylene Suture, Titanium Stapler And Nitinol Anchors

  • Erol Aksoy
  • Atıl Çakmak
  • Erkinbek Orozakunov
  • Mehmet Gürel

Received Date: 17.08.2009 Accepted Date: 05.10.2009 J Ankara Univ Fac Med 2009;62(1):39-43

Aim:

Fixation of the mesh with the appropriate material to the abdominal wall is the basic prin-ciple of successful hernia repair. The aim of this experimental study is the comparison of rupture potencies of the nonabsorbable suture material and metallic fixators which are used for fixating polypropylene mesh to the tissue.

Material and Methods:

In our study, 60 adult, male Wistar Albino rats were used, which had weights ranging between 214-244 grams. Polypropylene mesh with the dimensions of 3x1. 5 cm was fixated from its borders to the healthy tissue by polypropylene suture (n=20), titanium stapler (n=20) and nitinol anchor (n=20). Meshes were totally excised with the surrounding healthy tissue in the 7th and 14th days for measuring rupture potencies. A special mechanism was prepared to measure the rupture potencies of excised materials. Measurements were made in gram and then transmuted to Newton as the force unit.

Results:

The average operation time of the rats which the mesh was fixated by polypropylene suture was statistically longer than the other groups (p<0,05). In the postoperative 7th day the rats which the mesh was fixated by polypropylene fixating suture had the maximum rupture po-tency. The group which the mesh was fixated by titanium stapler was found as the second group. The group with the lowest rupture potency was the group which the mesh was fixated by nitinol anchor.

The rupture potencies between the groups were statistically significant (p<0,01). The same mea-surement results were found in postoperative 14th day and the differences were also statistically significant (p<0,01). When the groups were compared inside itself in the 7th and 14th day, the rupture potencies for all groups were found higher in the14th day (p<0,01).

Conclusions:

The fixation of the mesh to the tissue with nonabsorbable polypropylene suture has the advantage of maximum rupture potency. However there is no fixation material which reduces the operation time and obtains the best rupture potency at the same time.

Keywords: Hernia, Polypropylene Mesh, Polypropylene Suture, Titanium Stapler, Nitinol Anchor