Speaker
Description
Introduction
Surgical mesh implantation represents the current standard of care in inguinal hernia repair; however, conventional fixation using sutures is associated with risks of chronic neuralgia-type pain and local tissue irritation. Alternative fixation methods employing fibrin or cyanoacrylate-based adhesives have been introduced, but each presents inherent limitations in terms of mechanical stability, biocompatibility, and long-term performance. Thus, a novel UV-curable, biodegradable adhesive resin (PhotoBioCure) [1,2] has been developed for soft tissue repair. It was employed for the fixation of a mesh in inguinal hernia repair to reduce tissue trauma and increase the accuracy of a mesh fixation. Following intraoperative placement, the mesh was secured using the adhesive instead of tacks or sutures.
Methods
The first procedure using PhotoBioCure was performed in Poland, at Clinical Hospital in Police (2022-2024). It was employed for the mesh fixation in inguinal hernia repair in patients (n=5) to collect safety and effectiveness data. The mesh was secured using the UV-light activated adhesive instead of tacks or sutures. Patients were monitored over a 24-months follow-up period with comprehensive clinical evaluations, including ultrasonography, thermal imaging, and standardized assessments focusing on whether new biomaterial can reduce postoperative pain and trauma compared to traditional fixation methods: Visual Analog Scale (VAS) for pain, Carolina Comfort Scale (CCS), European Registry for Abdominal Wall Hernias Quality of Life (EuraHS QoL), and the SF-36 Health Survey.
Results
Application of a new biodegradable material does not provoke adverse tissue reactions or impair in wound healing, making it a promising alternative to conventional absorbable sutures for hernia mesh fixation. It significantly reduced operative time relative to conventional suture fixation. Postoperative pain scores (VAS) rapidly declined, with complete resolution of pain by 6 weeks. A progressive reduction in foreign body sensation decreased in 30% at 6 weeks. Throughout the 24-month surveillance, no cases of hernia recurrence, hematoma, infection, or other complications were observed. Patient-reported health-related quality of life (SF-36) improved up to 92.4 at 24 months postoperatively.
Conclusions
PhotoBioCure is an innovative, UV-light activated biomaterial which demonstrated effectiveness for atraumatic surgical mesh fixation in inguinal hernia repair. Its use is associated with reduced operative duration, simplified surgical technique, and favorable postoperative outcomes, without an increased incidence of adverse events.
References
1. US Patent, US 9,267,001B2 (23.02.2016),; El Fray M., Skrobot J., „Telechelic macromer, method for producing telechelic macromer, and composition containing telechelic macromer”.
2. Demirci G., Goszczyńska A., Sokołowska M., Żwir M., Gorący K., El Fray M., Synthesis and characterization of photocurable difunctional monomers for medical applications, Polymers 2024, 16, 3584.