Magnetic resonance-visible meshes for laparoscopic ventral hernia repair.

BACKGROUND AND OBJECTIVES: We aimed to evaluate the first human use of magnetic resonance-visible implants for intraperitoneal onlay repair of incisional hernias regarding magnetic resonance presentability.

METHODS: Ten patients were surgically treated with intraperitoneally positioned superparamagnetic flat meshes. A magnetic resonance investigation with a qualified protocol was performed on postoperative day 1 and at 3 months postoperatively to assess mesh appearance and demarcation. The total magnetic resonance-visible mesh surface area of each implant was calculated and compared with the original physical mesh size to evaluate potential reduction of the functional mesh surfaces.

RESULTS: We were able to show a precise mesh demarcation, as well as accurate assessment of the surrounding tissue, in all 10 cases. We documented a significant decrease in the magnetic resonance-visualized total mesh surface area after release of the pneumoperitoneum compared with the original mesh size (mean, 190 cm(2) vs 225 cm(2); mean reduction of mesh area, 35 cm(2); P < .001). At 3 months postoperatively, a further reduction of the surface area due to significant mesh shrinkage could be observed (mean, 182 cm(2) vs 190 cm(2); mean reduction of mesh area, 8 cm(2); P < .001).

CONCLUSION: The new method of combining magnetic resonance imaging and meshes that provide enhanced signal capacity through direct integration of iron particles into the polyvinylidene fluoride base material allows for detailed mesh depiction and quantification of structural changes. In addition to a significant early postoperative decrease in effective mesh surface area, a further considerable reduction in size occurred within 3 months after implantation.