Reduction of postoperative adhesions to Marlex mesh using experimental adhesion barriers in rats

Polypropylene mesh (Marlex) is commonly used to reinforce the abdominal wall during hernia repair. Recently, hernia repair has been performed using laparoscopic techniques. Marlex used for reinforcement is placed directly onto the peritoneum (i.e. transperitoneal) in some repairs. This practice of placing Marlex mesh directly onto the peritoneum may, however, lead to clinically significant bowel adhesions. This study tests whether three different adhesion barriers (Gore-Tex, Interceed, and poloxamer) can reduce bowel adhesion formation when placed directly over the fixed Marlex mesh in the rat. Interceed and poloxamer significantly reduced adhesion formation to Marlex mesh. Gore-Tex had the greatest amount of adhesion formation but this was not significantly different from Marlex control. Poloxamer treatment appeared to significantly reduce tensile strength and Marlex mesh incorporation. The Interceed treatment also appeared to reduce tensile strength as compared to Marlex alone, however, this difference was not significant. The use of Marlex mesh with an Interceed barrier reduces intraabdominal adhesions while not reducing the tensile strength of the Marlex mesh incorporation.