Manuel Garcia, MD, Daniel Srikureja, MD, Marcos J Michelotti, MD, FACS. Loma Linda University Health
Introduction: Prosthetic mesh use has become standard practice during ventral hernia repair to reduce the risk of recurrence. The ideal mesh is macro-porous which favors rapid cellular ingrowth and tissue integration, has limited tissue reactivity, low profile and weight, and has high tensile strength to add resilience to the repair. Additionally, the material is expected to have good handling characteristics. Currently, there is a wide variety of options for mesh. Biosynthetic material (poliglycolic acid / trimethylene carbonate – PGA/TMC) has been shown to behave well in terms of early vascularization and ingrowth as well as adequate long term tissue generation. GORE® Synecor® Biomaterial is a composite mesh including two layers of absorbable biosynthetic material (PGA/TMC) with one tridimensional non-absorbable macro-porous knit of dense PTFE mesh. It has shown good vascularization and ingrowth at 30 days in animal examination. However, there is still no evidence of long term behavior of this mesh in human tissue. We present the first histologic analysis of this mesh 1 year after placement in a human.
Objective: To perform a histologic analysis of the GORE® Synecor® Biomaterial one year after placement in the human body.
Methods: After incidentally finding incorporated GORE® Synecor® mesh in a patient with prior ventral hernia repair 1 year ago, during open bilateral inguinal hernia repair, a sample of mesh was taken and sent to pathology lab for analysis. Tissue healing, vascularization, and ingrowth of the composite mesh were analyzed.
Results: Histologic findings significant for a biomaterial consistent with a knitted PTFE material surrounded by mature fibrovascular tissue and foreign body inflammation consistent with expected healing response for this time frame. No evidence of any other biomaterial (PGA/TMC) or evidence of infection.
Conclusion: GORE® Synecor® Biomaterial has shown to be well integrated into appropriately healed tissue, with pronounced vascularization and ingrowth. The PGA/TMC layers have been seen to be completely absorbed and replaced by collagen. These findings, in a human 12 months sample, replicate what had been shown in animal specimens.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88527
Program Number: P028
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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