Prospective cohort study on mesh shrinkage measured with MRI after laparoscopic ventral hernia repair with an intraperitoneal iron oxide-loaded PVDF mesh

Abstract

Background: Current data on shrinkage of intraperitoneal meshes come mainly from animal studies. High-quality human data in prospective studies are scarce. Methods: We used the ability to visualize intraperitoneal PVDF meshes enhanced with iron particles (DynaMesh IPOM visible) with magnetic resonance imaging (MRI) to determine the amount of shrinkage between 1 and 13 months postoperatively. All measurements of the width, length, and surface area of the mesh were performed with a standardized methodology independently by four radiologists blinded for the timing of the MRI. Results: Of the 15 patients undergoing laparoscopic ventral hernia repair, 13 patients received an MRI both at 1 and at 13 months. Evaluation of inter-rater reliability between the radiologists showed intra-class correlations of 0.95 (95% CI 0.92–0.98) for the width, 0.96 (95% CI 0.93–0.98) for the length, and 0.99 (90% CI 0.99–1.00) for the surface area of the mesh. The change between measurement at implantation and 1-month MRI was − 0.7 cm (P = 0.023; − 3.6%) for the width and − 1.9 cm (P = 0.001; − 7.2%) for the length. The change between 1 and 13 months was − 0.06 cm (P = 0.74; shrinkage = 0.3%) for the width, − 0.12 cm (P = 0.56; shrinkage = 0.5%) for the length, and − 4.0 cm2 (P = 0.20; shrinkage = 1.0%) for the surface area of the mesh. Conclusion: There is excellent inter-rater reliability between radiologists when measuring width, length, and surface area of visible intraperitoneal PVDF mesh with MRI. There is no significant shrinkage between 1 and 13 months of intraperitoneal PVDF mesh after laparoscopic ventral hernia repair.