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Validating the mesh integration (MINT) index: a 3-month porcine study.

Edward Young1,2,3, Alex Karatassas4,5,6, Jean Wong5

  • 1School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia. e.young@adelaide.edu.au.

Surgical Endoscopy
|November 11, 2025
PubMed
Summary

The Mesh Integration (MINT) Index provides a valid framework for assessing hernia mesh integration in vivo. This study validated the MINT Index over three months in a porcine model, showing its potential for evaluating mesh behavior and predicting outcomes.

Keywords:
HerniaIndexMeshPigTissue integrationTranslational research

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Area of Science:

  • Biomaterials Science
  • Surgical Innovation
  • Preclinical Research

Background:

  • Hernia repair failures are often linked to poor mesh tissue integration.
  • The Mesh Integration (MINT) Index was developed to standardize the evaluation of in vivo mesh behavior.
  • A porcine model was utilized to validate the MINT Index over a three-month period.

Purpose of the Study:

  • To validate the Mesh Integration (MINT) Index in a preclinical setting.
  • To assess the reliability and applicability of the MINT Index for evaluating mesh integration.
  • To establish a standardized method for analyzing mesh behavior post-implantation.

Main Methods:

  • Twelve mesh brands were implanted in twelve pigs, randomized to retrorectus or intraperitoneal placement.
  • Post-mortems were conducted at 2, 3, 4, 8, and 12 weeks.
  • Standardized testing according to the MINT Index was performed on all mesh tissue samples.

Main Results:

  • The MINT Index demonstrated a strong model fit across all four domains.
  • Time positively correlated with mesh integration and fibrosis (p=0.025, p=0.038).
  • Intraperitoneal mesh showed greater degradation (p=0.008), while retrorectus placement suggested better numerical integration over time.

Conclusions:

  • The MINT Index is a valid and objective framework for assessing in vivo mesh behavior.
  • Further research is necessary to achieve the full clinical utility of the MINT Index.
  • The study provides a foundation for objective mesh evaluation in hernia repair.