Abstract
The use of surgical textile implants (so-called “mesh”) for hernia repair is an accepted standard. They may cause mesh-related problems such as chronic pain, migration or fistula formation. Nevertheless, these polymer-based textile meshes are often invisible by conventional imaging methods like computed tomography (CT) and magnetic resonance imaging (MRI). In this study we outlined the major steps in the development of a MR-visible textile implant, which can be used in patients. To achieve MR-visability, ferrooxide particles were incorporated into the base material polyvinylidene fluoride (PVDF), during the spinning process. We could proof the MR-visibility of this new textile implant in different phantoms. After clinical approval of these implants in vivo in different animal studies, we pursued to evaluate the MR-conspicuity of such ferrooxide-loaded mesh implants in patients treated for inguinal hernias and explored the postsurgical mesh configuration by MRI. In this study we described the development and first results of a ferrooxide-loaded MR-visible mesh. In animal model and in clinical use such implants turned out to be a valuable tool for diagnostic and development.
Acknowledgments
This project was supported by the German Federal Ministry of Education and Research (Ref. 01 EZ 0849) and the German Federal Ministry of Economics and Technology (Support Code KF2545603AJ1).
References
1. Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V. Impact of polymer pore size on the interface scar formation in a rat model. J Surg Res 2002;103:208–14.10.1006/jsre.2002.6358Search in Google Scholar PubMed
2. Aasvang EK, Bay-Nielsen M, Kehlet H. Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia 2006;10: 316–21.10.1007/s10029-006-0098-ySearch in Google Scholar PubMed
3. Hamouda A, Kennedy J, Grant N, Nigam A, Karanjia N. Mesh erosion into the urinary bladder following laparoscopic inguinal hernia repair; is this the tip of the iceberg? Hernia 2010;14:317–9.10.1007/s10029-009-0539-5Search in Google Scholar PubMed
4. Rakic S, LeBlanc KA. The radiologic appearance of prosthetic materials used in hernia repair and a recommended classification. Am J Roentgenol 2013;201:1180–3.10.2214/AJR.13.10703Search in Google Scholar PubMed
5. Zinther NB, Zeuten A, Marinovskij E, Haislund M, Wara P, Friis-Andersen H. Functional cine MRI and transabdominal ultrasonography for the assessment of adhesions to implanted synthetic mesh 5-7 years after laparoscopic ventral hernia repair. Hernia 2010;14:499–504.10.1007/s10029-010-0676-xSearch in Google Scholar PubMed
6. Fischer T, Ladurner R, Gangkofer A, Mussack T, Reiser M, Lienemann A. Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results. Eur Radiol 2007;17:3123–9.10.1007/s00330-007-0678-ySearch in Google Scholar PubMed
7. Svabík K, Martan A, Masata J, El-Haddad R, Hubka P, Pavlikova M. Ultrasound appearances after mesh implantation – evidence of mesh contraction or folding? Int Urogynecol J 2011;22:529–33.10.1007/s00192-010-1308-9Search in Google Scholar PubMed
8. Kraemer NA, Donker HC, Kuehnert N, Otto J, Schrading S, Krombach GA, et al. In vivo visualization of polymer-based mesh implants using conventional magnetic resonance imaging and positive-contrast susceptibility imaging. Invest Radiol 2013;48:200–5.10.1097/RLI.0b013e31827efd14Search in Google Scholar PubMed
9. Kraemer NA, Donker HC, Otto J, Hodenius M, Senegas J, Slabu I, et al. A concept for magnetic resonance visualization of surgical textile implants. Invest Radiol 2010;45:477–83.10.1097/RLI.0b013e3181e53e38Search in Google Scholar PubMed
10. Donker HC, Kraemer NA, Otto J, Klinge U, Slabu I, Baumann M, et al. Mapping of proton relaxation near superparamagnetic iron oxide particle-loaded polymer threads for magnetic susceptibility difference quantification. Invest Radiol 2012;47:359–67.10.1097/RLI.0b013e3182484fdfSearch in Google Scholar PubMed
11. Slabu I, Guentherodt G, Schmitz-Rode T, Hodenius M, Kraemer N, Donker H, et al. Investigation of superparamagnetic iron oxide nanoparticles for MR-visualization of surgical implants. Curr Pharmaceut Biotechnol 2012;13:545–51.10.2174/138920112799436249Search in Google Scholar PubMed
12. Kuehnert N, Kraemer NA, Otto J, Donker HC, Slabu I, Baumann M, et al. In vivo MRI visualization of mesh shrinkage using surgical implants loaded with superparamagnetic iron oxides. Surg Endosc 2012;26:1468–75.10.1007/s00464-011-2057-7Search in Google Scholar PubMed PubMed Central
13. Otto J, Kuehnert N, Kraemer NA, Ciritsis A, Hansen NL, Kuhl C, et al. First in vivo visualization of MRI-visible IPOM in a rabbit model. J Biomed Mater Res B Appl Biomater 2014. DOI: 10.1002/jbm.b.33098. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24470265.10.1002/jbm.b.33098Search in Google Scholar PubMed
14. Otto J, Busch D, Klink C, Ciritsis A, Woitok A, Kuhl C, et al. In vivo MRI visualization of parastomal mesh in a porcine model. Hernia 2014. DOI: 10.1007/s10029-014-1270-4. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24912733.10.1007/s10029-014-1270-4Search in Google Scholar PubMed
15. Hansen NL, Barabasch A, Distelmaier M, Ciritsis A, Kuehnert N, Otto J, et al. First in-human magnetic resonance visualization of surgical mesh implants for inguinal hernia treatment. Invest Radiol 2013;48:770–8.10.1097/RLI.0b013e31829806ceSearch in Google Scholar PubMed
©2014 by De Gruyter