Objective: This study evaluated the incidence and persistence of adhesions following intraperitoneal
onlay mesh fixation with tissue soldering in an experimental model.
Methods: Anesthetized New Zealand white rabbits (n = 21), weighing 2.8–3.2 kg, underwent laparotomy.
Controls (group 1 [n = 3]) had 2 × 2 cm Mersilene™ (Ethicon, Somerville, New Jersey)
polyester mesh segments fixed to the peritoneum with staples (USSC, Norwalk, Connecticut). Group
2 (n = 7) rabbits had Mersilene mesh affixed by melting 55% collagen solder using a prototype laser
(1.43µ, 2.5W CW, 4 mm spot size, 60°C set temperature) over mesh. Group 3 (n = 6) rabbits had
Vicryl™ (Ethicon, Somerville, New Jersey) polyglactin mesh embedded in 60% collagen solder
placed onto the peritoneum and fixed with identical laser parameters as group 2. Group 4 (n = 5)
rabbits had 55% collagen solder placed and Mersilene pressed into it after melting. Four segments
were placed in each experimental animal. Animals were euthanized at 2, 4, or 6 weeks. Adhesions
were graded (0 = none; I = filmy adhesions; II = omental; III = bowel adhesions gently lysed; IV =
dense adhesions requiring sharp dissection).
Results: Grade III adhesions were observed in both control and group 4 animals at 2 weeks, persisting
in group 4 animals at 6 weeks, but having lysed in controls at 6 weeks. No adhesions were
present in group 3 specimens at any interval. Grade I adhesions were present in group 2 at 2 weeks
at exposed mesh areas, and declined in frequency at 6 weeks. Evidence of reabsorption of the
polyglactin mesh-solder composite was apparent in the group 3 specimens at 4 weeks, and complete
resorption had occurred by 6 weeks postoperatively.
Discussion: Laser-assisted solder fixation caused minimal adhesion formation when mesh was covered
by solder. Adhesions were observed if Mersilene mesh material was exposed to the abdominal
contents. Vicryl mesh-solder composites reabsorbed without inflammation, scarring, or adhesions
at the sites of mesh fixation.
Conclusion: Further development of this technology is warranted.
