Assessment of a Light-Activated Adhesive for Hernia Mesh Repair

Abstract: Background and objectives: TISSIUM light-activated adhesive was investigated as an alternative to tissue-penetrating products to fix meshes in intraperitoneal laparoscopic ventral hernia repair. The objective of this study was to ensure efficient polymer light activation through commercial meshes and to assess the acute and chronic fixation strength of the light-activated adhesive in a porcine model in comparison to commercial fixation products. Methods: A spectroscopic analysis was conducted on the light-activated adhesive through three different meshes (1, 2, and 3) to quantify the acrylate conversion associated with the level of polymer cross-linking. Two setups were implemented: a static (light source fixed over a drop of polymer) and a dynamic (light source rotated around a pattern of polymer to mimic the surgical procedure). Hernia defects were created in porcine models and repaired either using the light-activated adhesive or a commercial product (A, B, C, and D) to fix a mesh. For each tested condition, the acute and chronic (3 months) fixation strength performances were assessed using burst ball and t-peel mechanical tests. Results: The light activation proved to be effective (more than 90% of the acrylates converted) in static in 7 seconds through the three meshes and in dynamic between 3 min and 5 min 32 sdepending on the considered mesh. In a burst ball test, the light-activated adhesive reached between 42 and 84% of the commercial products’ acute performance with the three meshes (between 75,9 and 95,9 N) and reached 88% of the commercial product A’s chronic performance with mesh 1 (610,1 N). A t-peel test demonstrated similar strength of ingrowth for the repairs using the light-activated adhesive or the commercial product A at the 3-month timepoint with mesh 1 (2,55 and 2,37 N/cm respectively). Conclusions: Data suggest the light-activated adhesive has the potential to be used in intraperitoneal laparoscopic ventral hernia repair. In a reasonable time, the adhesive is efficiently light-activated through commercial meshes. The light-activated adhesive’s performances to fix commercial meshes, both acute and chronic, are similar to commercial products, but with a strong advantage of not being tissue penetrating.