June 24, 2008 Scientists from the University of Alcalá (UAH) have designed a prosthesis made of silicon and polypropylene shaped like an “upside down T” that substantially reduces cases of incisional hernias.
A hernia is produced when the content of the abdominal cavity protrudes through a weakened natural orifice of the abdominal wall such as the inguinal canal, the umbilical area, the epigastrium or a previous incision in the abdomen such as from a surgical operation. The hernia manifests itself as a bulging lump since the internal lining of the abdomen protrudes in what is called a hernial sac that shrinks or grows depending on the effort exerted by the affected individual.
Hernias are more frequent in the groin or navel areas and in the area of an old surgical scar, and they never improve or disappear naturally; on the contrary, they tend to grow. Not only painful but unaesthetic too, hernias can produce complications such as bowel obstructions and strangulations.
Primary hernias are produced by structural defects in tissues, while the incisional hernias arise from a previous aperture in the abdominal wall, usually the scar of a previous surgery. Irrespective of the techniques used, different types of sutures or medical devices used to hold the abdominal wall, the number of incisional hernias has been constant over the last decade.
One of the most susceptible areas for their appearance is the linea alba, especially when oblique-transverse fibres are sectioned, which is what occurs in the longitudinal laparotomy procedures. The likelihood of a patient developing incisional hernias increases with associated risks, such as advanced age, neoplasia related surgery, obesity and related chronic pathologies.
Presented with these circumstances, a research group from the University of Alcalá managed by Professor Juan Manuel Bellón from the department of surgery of the UAH has developed and patented a new device to prevent the occurrence of incisional hernias. This prevention is carried out by the incorporation of prosthesis into the suture of the abdominal wall which is designed to increase the cohesive forces of the scar. The new design and concept of the prosthesis, named Laparomesh has the shape of a upside down T and is made with silicone and polypropylene, which are biomaterials that will not be absorbed by the body.
The goal of the Laparomesh is to create a reinforcement much like a tendon in the linea alba that would efficiently consolidate the suture of the laparotomy and significantly reduce the cases of incisional hernias. Different to the other prostheses of its type, the design by Professor Bellon and his team is placed neither above nor below, but it encloses both apertures of the abdominal wall, attaching itself to the different anatomical planes by means of a polypropylene suture.
Professor Bellón, stated that the current average number of cases of incisional hernias is around 15% to 20%, and it is estimated to reduce these numbers to 3%-4% using this newly patented mesh.
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