The Experts below are selected from a list of 1053 Experts worldwide ranked by ideXlab platform

Alejandro Nieponice - One of the best experts on this subject based on the ideXlab platform.

  • urinary bladder matrix scaffolds strengthen Esophageal Hiatus repair
    Journal of Surgical Research, 2016
    Co-Authors: Juan Martin Riganti, Franco Ciotola, Alfredo Amenabar, Damian Craiem, Sebastian Graf, Adolfo Badaloni, Thomas W Gilbert, Alejandro Nieponice
    Abstract:

    Abstract Background Laparoscopic repair of the hiatal hernia is associated with a recurrence rate between 12% and 42% depending on the defect size. Although the impact of hiatal reinforcement on long-term recurrence remains controversial, the main limitation of this approach has been the risk of adverse events related with the use of synthetic materials in the vicinity of the esophagus. Methods A total of 14 female domestic pigs underwent laparoscopic primary hiatal hernia repair of a simulated defect in the Esophageal Hiatus. Seven of the hiatal repairs were reinforced with an extracellular matrix (ECM) scaffold, whereas the remaining seven served as primary repair controls. Animals were survived for 8 wk. At necropsy, after gross morphologic evaluation, samples were sent for mechanical testing and histology. Results The repaired defect site reinforced with ECM scaffolds showed a robust closure of the crura in all cases with a smooth peritoneal-like structure covering the entire repair. Average load at failure of the treated group was found to be significantly stronger than that of the controls (185.8 ± 149.7 g versus 57.5 ± 57.5 g, P versus 19.1 ± 17.5 g/mm; P versus 7.87 ± 3.28 mm; P  = 0.44). Conclusions In our animal survival model, we have provided evidence that the addition of an ECM to augment a primary hiatal repair leads to tissue characteristics that may decrease the possibility of early failure of the repair. This may translate to decreased recurrence rates. Further study is necessary.

Juan Martin Riganti - One of the best experts on this subject based on the ideXlab platform.

  • biomechanical features of reinforced Esophageal Hiatus repair in a porcine model
    Journal of Surgical Research, 2020
    Co-Authors: Natalia Amigo, Juan Martin Riganti, Damian Craiem, Cecilia Zubieta, Mauricio Ramirez, Pedro Renda, Romina Lovera, Ariel Pascaner, Carlos Vigliano, Adam D Young
    Abstract:

    Abstract Recurrence rates in the laparoscopic repair of the hiatal hernia range from 12% to 59%. Limitation of reinforcement has been principally the risk of adverse events caused by synthetic materials. Biologic and resorbable synthetic materials are valid alternatives. This study compares the host response to all these materials after hiatal hernia repair. A total of 20 Landrace pigs, underwent laparoscopic primary hiatal hernia repair and reinforced with a polypropylene mesh (PROLENE: polypropylene [PP]), an absorbable synthetic scaffold (GOREBIO-A: polyglycolic acid [PGA]), a urinary bladder matrix scaffold, (Gentrix: urinary bladder matrix [UBM]), or without reinforcement, control group (C). Animals were survived for 3 months. Endpoints included gross morphology, biomechanical testing, and histology. Pigs in PP and PGA groups showed fibrosis at the repair site, with robust adhesions. In UBM and C groups, only mild adhesions were found. Load at failure (gr) and stiffness (gr/mm) of PP were higher than C group (PP:2103 ± 548.3 versus C:951.1 ± 372.7, P = 0.02; PP:643.3 ± 301 versus C:152.6 ± 142.7, P = 0.01). PGA and UBM values for both parameters were in between PP and C samples. However, stiffness in UBM was tended to be lower than PP group, and approached a significant difference (643.3 ± 301 versus 243 ± 122.1, P = 0.0536). In UBM group, the histology resembled native tissue. By contrast, PP and PGA groups showed mononuclear infiltrates, fibroencapsulation, necrosis, remnants of mesh, and disorganized tissue that was validated with a histologic score. In this setting, UBM scaffolds showed the most appropriate features for hiatal hernia repair, recovering the tissue properties that can help reduce the possibility of early failure and prevent complications associated with the implanted material.

  • urinary bladder matrix scaffolds strengthen Esophageal Hiatus repair
    Journal of Surgical Research, 2016
    Co-Authors: Juan Martin Riganti, Franco Ciotola, Alfredo Amenabar, Damian Craiem, Sebastian Graf, Adolfo Badaloni, Thomas W Gilbert, Alejandro Nieponice
    Abstract:

    Abstract Background Laparoscopic repair of the hiatal hernia is associated with a recurrence rate between 12% and 42% depending on the defect size. Although the impact of hiatal reinforcement on long-term recurrence remains controversial, the main limitation of this approach has been the risk of adverse events related with the use of synthetic materials in the vicinity of the esophagus. Methods A total of 14 female domestic pigs underwent laparoscopic primary hiatal hernia repair of a simulated defect in the Esophageal Hiatus. Seven of the hiatal repairs were reinforced with an extracellular matrix (ECM) scaffold, whereas the remaining seven served as primary repair controls. Animals were survived for 8 wk. At necropsy, after gross morphologic evaluation, samples were sent for mechanical testing and histology. Results The repaired defect site reinforced with ECM scaffolds showed a robust closure of the crura in all cases with a smooth peritoneal-like structure covering the entire repair. Average load at failure of the treated group was found to be significantly stronger than that of the controls (185.8 ± 149.7 g versus 57.5 ± 57.5 g, P versus 19.1 ± 17.5 g/mm; P versus 7.87 ± 3.28 mm; P  = 0.44). Conclusions In our animal survival model, we have provided evidence that the addition of an ECM to augment a primary hiatal repair leads to tissue characteristics that may decrease the possibility of early failure of the repair. This may translate to decreased recurrence rates. Further study is necessary.

Damian Craiem - One of the best experts on this subject based on the ideXlab platform.

  • biomechanical features of reinforced Esophageal Hiatus repair in a porcine model
    Journal of Surgical Research, 2020
    Co-Authors: Natalia Amigo, Juan Martin Riganti, Damian Craiem, Cecilia Zubieta, Mauricio Ramirez, Pedro Renda, Romina Lovera, Ariel Pascaner, Carlos Vigliano, Adam D Young
    Abstract:

    Abstract Recurrence rates in the laparoscopic repair of the hiatal hernia range from 12% to 59%. Limitation of reinforcement has been principally the risk of adverse events caused by synthetic materials. Biologic and resorbable synthetic materials are valid alternatives. This study compares the host response to all these materials after hiatal hernia repair. A total of 20 Landrace pigs, underwent laparoscopic primary hiatal hernia repair and reinforced with a polypropylene mesh (PROLENE: polypropylene [PP]), an absorbable synthetic scaffold (GOREBIO-A: polyglycolic acid [PGA]), a urinary bladder matrix scaffold, (Gentrix: urinary bladder matrix [UBM]), or without reinforcement, control group (C). Animals were survived for 3 months. Endpoints included gross morphology, biomechanical testing, and histology. Pigs in PP and PGA groups showed fibrosis at the repair site, with robust adhesions. In UBM and C groups, only mild adhesions were found. Load at failure (gr) and stiffness (gr/mm) of PP were higher than C group (PP:2103 ± 548.3 versus C:951.1 ± 372.7, P = 0.02; PP:643.3 ± 301 versus C:152.6 ± 142.7, P = 0.01). PGA and UBM values for both parameters were in between PP and C samples. However, stiffness in UBM was tended to be lower than PP group, and approached a significant difference (643.3 ± 301 versus 243 ± 122.1, P = 0.0536). In UBM group, the histology resembled native tissue. By contrast, PP and PGA groups showed mononuclear infiltrates, fibroencapsulation, necrosis, remnants of mesh, and disorganized tissue that was validated with a histologic score. In this setting, UBM scaffolds showed the most appropriate features for hiatal hernia repair, recovering the tissue properties that can help reduce the possibility of early failure and prevent complications associated with the implanted material.

  • urinary bladder matrix scaffolds strengthen Esophageal Hiatus repair
    Journal of Surgical Research, 2016
    Co-Authors: Juan Martin Riganti, Franco Ciotola, Alfredo Amenabar, Damian Craiem, Sebastian Graf, Adolfo Badaloni, Thomas W Gilbert, Alejandro Nieponice
    Abstract:

    Abstract Background Laparoscopic repair of the hiatal hernia is associated with a recurrence rate between 12% and 42% depending on the defect size. Although the impact of hiatal reinforcement on long-term recurrence remains controversial, the main limitation of this approach has been the risk of adverse events related with the use of synthetic materials in the vicinity of the esophagus. Methods A total of 14 female domestic pigs underwent laparoscopic primary hiatal hernia repair of a simulated defect in the Esophageal Hiatus. Seven of the hiatal repairs were reinforced with an extracellular matrix (ECM) scaffold, whereas the remaining seven served as primary repair controls. Animals were survived for 8 wk. At necropsy, after gross morphologic evaluation, samples were sent for mechanical testing and histology. Results The repaired defect site reinforced with ECM scaffolds showed a robust closure of the crura in all cases with a smooth peritoneal-like structure covering the entire repair. Average load at failure of the treated group was found to be significantly stronger than that of the controls (185.8 ± 149.7 g versus 57.5 ± 57.5 g, P versus 19.1 ± 17.5 g/mm; P versus 7.87 ± 3.28 mm; P  = 0.44). Conclusions In our animal survival model, we have provided evidence that the addition of an ECM to augment a primary hiatal repair leads to tissue characteristics that may decrease the possibility of early failure of the repair. This may translate to decreased recurrence rates. Further study is necessary.

Franco Ciotola - One of the best experts on this subject based on the ideXlab platform.

  • urinary bladder matrix scaffolds strengthen Esophageal Hiatus repair
    Journal of Surgical Research, 2016
    Co-Authors: Juan Martin Riganti, Franco Ciotola, Alfredo Amenabar, Damian Craiem, Sebastian Graf, Adolfo Badaloni, Thomas W Gilbert, Alejandro Nieponice
    Abstract:

    Abstract Background Laparoscopic repair of the hiatal hernia is associated with a recurrence rate between 12% and 42% depending on the defect size. Although the impact of hiatal reinforcement on long-term recurrence remains controversial, the main limitation of this approach has been the risk of adverse events related with the use of synthetic materials in the vicinity of the esophagus. Methods A total of 14 female domestic pigs underwent laparoscopic primary hiatal hernia repair of a simulated defect in the Esophageal Hiatus. Seven of the hiatal repairs were reinforced with an extracellular matrix (ECM) scaffold, whereas the remaining seven served as primary repair controls. Animals were survived for 8 wk. At necropsy, after gross morphologic evaluation, samples were sent for mechanical testing and histology. Results The repaired defect site reinforced with ECM scaffolds showed a robust closure of the crura in all cases with a smooth peritoneal-like structure covering the entire repair. Average load at failure of the treated group was found to be significantly stronger than that of the controls (185.8 ± 149.7 g versus 57.5 ± 57.5 g, P versus 19.1 ± 17.5 g/mm; P versus 7.87 ± 3.28 mm; P  = 0.44). Conclusions In our animal survival model, we have provided evidence that the addition of an ECM to augment a primary hiatal repair leads to tissue characteristics that may decrease the possibility of early failure of the repair. This may translate to decreased recurrence rates. Further study is necessary.

Alfredo Amenabar - One of the best experts on this subject based on the ideXlab platform.

  • urinary bladder matrix scaffolds strengthen Esophageal Hiatus repair
    Journal of Surgical Research, 2016
    Co-Authors: Juan Martin Riganti, Franco Ciotola, Alfredo Amenabar, Damian Craiem, Sebastian Graf, Adolfo Badaloni, Thomas W Gilbert, Alejandro Nieponice
    Abstract:

    Abstract Background Laparoscopic repair of the hiatal hernia is associated with a recurrence rate between 12% and 42% depending on the defect size. Although the impact of hiatal reinforcement on long-term recurrence remains controversial, the main limitation of this approach has been the risk of adverse events related with the use of synthetic materials in the vicinity of the esophagus. Methods A total of 14 female domestic pigs underwent laparoscopic primary hiatal hernia repair of a simulated defect in the Esophageal Hiatus. Seven of the hiatal repairs were reinforced with an extracellular matrix (ECM) scaffold, whereas the remaining seven served as primary repair controls. Animals were survived for 8 wk. At necropsy, after gross morphologic evaluation, samples were sent for mechanical testing and histology. Results The repaired defect site reinforced with ECM scaffolds showed a robust closure of the crura in all cases with a smooth peritoneal-like structure covering the entire repair. Average load at failure of the treated group was found to be significantly stronger than that of the controls (185.8 ± 149.7 g versus 57.5 ± 57.5 g, P versus 19.1 ± 17.5 g/mm; P versus 7.87 ± 3.28 mm; P  = 0.44). Conclusions In our animal survival model, we have provided evidence that the addition of an ECM to augment a primary hiatal repair leads to tissue characteristics that may decrease the possibility of early failure of the repair. This may translate to decreased recurrence rates. Further study is necessary.