Impact of endoscopic and histological evaluations of two different types of mesh plug for a groin hernia model

Yasuhiro Mandai, Minoru Naito, Tatsuro Hayashi, Hiroaki Asano, Hideo Ino, Kazunori Tsukuda, Shinichiro Miyoshi

Research output: Contribution to journalArticlepeer-review


Purpose: The biological responses to mesh in vivo have been evaluated in some papers, but the in vivo condition of mesh and plugs have not been sufficiently evaluated. This study evaluated the endoscopic observations and histological assessments of mesh plugs using swine models. Methods: An artificial abdominal hernia was established in the porcine abdomen, and repaired using three different sizes of two types of plug, Proloop (ATRIUM Medical Corporation, Hudson, NH, USA) or Perfix (BARD Medical Division, Covington, GA, USA). The in vivo conditions of each plug were periodically observed using a laparoscope. Moreover, a histological evaluation of the plugs was performed 3 months after implantation. Results: The laparoscopic observation revealed that inversion of the plugs occurred in 10 out of 18 cases repaired with Perfix, while no case repaired with Proloop inverted. The large and medium sizes of Perfix plugs were inclined by an average of more than 30°. In addition, the triangular shape of Perfix plugs was broken and the vertical/horizontal ratio was enlarged during the observation period, while Proloop plugs shrank both vertically and horizontally. The infl ammatory cell count was significantly lower within the Proloop plugs than within Perfix plugs. Conclusion: Proloop plugs are apparently superior because they are stable even 3 months after implantation.

Original languageEnglish
Pages (from-to)1512-1518
Number of pages7
JournalSurgery today
Issue number11
Publication statusPublished - Nov 2011


  • Groin hernia
  • Histological evaluation
  • Laparoscopic evaluation
  • Mesh plug
  • Porcine

ASJC Scopus subject areas

  • Surgery


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