Innovative materials and preventative medication can help reduce long-term complications following abdominal surgery. I researched the use of new methods and materials in abdominal surgery in a study for the Department of Surgery at Maastricht UMC+, headed by Professor N.D. Bouvy. The study aimed to prevent the development of adhesions and promote the recovery of the abdominal wall after surgery.
By using mesh implants with a coating layer during abdominal surgery, long-term complications can be reduced to a minimum
Extensive research is being conducted on the short-term complications following surgery, such as abdominal wall, lung, and bladder infections. Less attention is paid to common long-term complications that can lead to problems further down the road. Important long-term complications following abdominal surgery include incisional hernia and adhesions. Incisional hernias are defects in the abdominal muscles at or near the scar site, causing the intestines to push through the abdominal wall. Adhesions are bands of scar tissue that form inside the abdomen and cause hollow organs, like the intestines, to adhere to each other or to the abdominal wall. This can cause a myriad of problems, such as infertility and intestinal obstructions.
The best method for repairing abdominal hernias is to stitch a plastic-like mesh implant onto the abdominal wall. This reinforces the abdominal wall and promotes wound healing. The disadvantage of these mesh implants is that they can cause adhesions. We researched more effective materials and treatment methods to prevent these adhesions from developing. We found that mesh implants with a coating layer resulted in fewer adhesions. There are so many materials out there that work in theory, but don't lead to optimal results in practice. We spent a lot of time searching for the right materials. Based on our findings, we were able to offer preventative treatment to several patients by using mesh implants to prevent incisional hernias. Two years later, this approach proved successful.
In addition to researching innovative materials, we also uncovered new insights into the development of adhesions and the body's inflammatory response to the mesh implants. The research shows that certain medications, particularly cromolyne, help prevent adhesions from developing when taken before the operation. They're not sure exactly how this works, but in a lab setting it seems to have a positive effect on early inflammatory response. Further applied and clinical research is needed, however.
By using mesh implants with a coating layer during abdominal surgery, long-term complications can be reduced to a minimum.
Dr. Marc Schreinemacher obtained his PhD in april 2015 for his dissertation: 'Abdominal Wall Hernia Repair: Intraperitoneal Mesh and Adhesions,' written under the supervision of Professor N.D. Bouvy at Maastricht University. They published an influential article entitled “Prophylactic intraperitoneal mesh placement to prevent incisional hernia after stoma reversal: a feasibility study.” in Surgical Endoscopy 2013; 28: 1522-7. At the moment Dr. Schreinemacher is a resident in general surgery at the Academic Medical Centre in Amsterdam.
Vascular Surgery , Incisional Hernia, Surgical Mesh, Postoperative Adhesions