Human fibrin sealant (Tisseel) for hiatal mesh fixation in an experimental model in pigs

Introduction The fixation of hiatal meshes with perforating devices, such as tacks or sutures, can be associated with potentially life threatening complications1. Fibrin sealant (FS, Tissucol, Baxter Biosciences, Vienna, Austria) is successfully used for atraumatic mesh fixation in inguinal and incisional hernia repair2,3. The rationale of this study was to test the potential of FS fixation of hiatal meshes in pigs. Methods In general anaesthesia, 6 domestic pigs were subjected to laparotomy and designated meshes (Ti-Sure, GfE, Nuremberg, Germany) were implanted at the hiatus. The titanized polypropelene material was found to be favorable in combination with FS4 in a previous study. The key hole of the TS was placed around the esophageus at the gastroesophageal junction. 1 milliliter of FS was applied with the Easy Spray® system (Baxter Biosciences, Vienna, Austria) for circular and three dimensional mesh fixation onto the diaphragm. Animals were sacrificed after 4 weeks, meshes were explanted after macroscopical assessment of the correct position and tissue integration. Histology was performed. Results All meshes showed excellent integration and no sign of dislocation or perforation into the neighbouring organs. Histology confirmed these macroscopical findings. Conclusion FS provides a safe and effective alternative to perforating fixation devices in an animal model of hiatal mesh repair. Literature
1) Kemppainen et al., SurgEnd 2000
2) Lovisetto et al., AnnSurg 2007
3) Olmi et al., SurgEnd 2006
4) Petter-Puchner et al., Hernia 2005

Session: Poster

Program Number: P342

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