DynaMesh®

Tailored Implants made of PVDF

DynaMesh®-CICAT

For repair and prophylaxis of abdominal wall hernia with extraperitoneal mesh position

and/or

For repair of umbilical hernia with extraperitoneal mesh position.


Abdominal wall hernia and Umbilical hernia

Optimally adapted tri-elasticity
Because of its tri-elasticity, which is adapted to the anatomical and biomechanical properties (dynamometry) of the human abdominal wall, DynaMesh®-CICAT provides the highest possible degree of patient comfort.

Cicat-diagramm-de

Cicat-elastizitaet

Optimal incorporation of the mesh
Following in-vivo incorporation, mesh implants have a tendency to “shrinkage”.DynaMesh®-CICAT has a high effective porosity of 61 %, enabling excellent incorporation of the mesh implant.Moreover, in the course of incorporation the use of the proven and highly biocompatible polymer PVDF contributes to a low degree of scarring.The optimal incorporation of the DynaMesh®-CICAT implant post-operatively,reduces the risk of shrinkage and recurrence.

cicat-netzinkorporation

MILOS technique

The MILOS technique to repair abdominal wall and umbilical hernias with DynaMesh®-CICAT and EndoTORCH

  1. Skin incision 2 to max. 5 cm via hernial orifice (Fig. A).
  2. Display of hernial defect and preparation of the hernia sac.
  3. Optional: minimal opening of the hernia sac allowing for manual probing, followed by open or laparoscopic adhesiolysis.
  4. The peritoneum is freed up approx. 2 cm from the linea alba in a circular pattern and the posterior layer of the rectus muscle is freed.
  5. The posterior layer of the rectus muscle is opened laterally on both sides (instrument: EndoTORCH ) (Fig. B) about 1 cm from the medial border of the rectus muscle (Fig. C).
  6. Using long slim retractors and under endoscopic monitoring, the posterior layer of the rectus sheath is freed laparoscopically from the rectus muscle. In the midline endoscopically assisted dissection is performed in the preperitoneal plane: The peritoneum is freed up from the linea alba.
  7. The further totally extraperitoneal preparation is performed through the hernia, either under direct vision with laparoscopic instruments or with endoscopic assistance.
  8. The posterior layer of the rectus sheath generally remains open with a completely closed midline peritoneum.
  9. Placement and spreading of the DynaMesh®-CICAT mesh implant in the extraperitoneal cavity as a double roll and without skin contact.
  10. Closure of the hernia defect over the mesh implant under minimal tension (Fig. D).11. Fixation of the DynaMesh®-CICAT me
  11. Fixation of the DynaMesh®-CICAT mesh implant is only required if the hernia defect cannot be completely closed and there is bridging of the hernia defect.

BI-milos-logo

more Information: https://milos-hernia-repair.com

Animation and video of entire procedure:

(en) – Animation & Operation:
MILOS OPERATION with DynaMesh®-CICAT (Dr. Reinpold)

BI-milos-technik

Optimal handling

  • The special anti-slip surface of the DynaMesh®-CICAT ensures the mesh stays in position and enables optimal handling.
  • DynaMesh®-CICAT is marked with green lines, which indicate the required orientation (cranio-caudal)
  • The light tube for the MILOS technique (Mini Less Open Sublay technique) was developed with Mr Wolfgang Reinpold, consultant at the Wilhelmsburger Groß-Sand Hospital, Hamburg, specially for laparoscopic-assisted treatment of abdominal wall hernias.

BI-milos-lichtrohr


EndoTorch® – Light tube for MILOS technique (Mini Less Open Sublay technique)


Abdominal wall hernia

For repair and prophylaxis of abdominal wall hernia with extraperitoneal mesh position.


Umbilical hernia

For repair of umbilical hernia with extraperitoneal mesh position.

PUMP technique

Umbilical hernia in PUMP technique with DynaMesh®-CICAT
Preperitoneal Umbilical Mesh Plasty –

  1. Semi-circular infraumbilical skin incision
  2. The hernia sac or base of navel is dissected and encircled with a tape (Fig.2)
  3. Detachment of base of navel approx. 1 cm above the fascia by circular division of the hernia sac (Fig.3) – ATTENTION: Check contents of hernia sac
  4. Circular dissection of the peritoneum from the fascia (Fig.4)
  5. Closure of the peritoneum with continuous absorbable suture
  6. Adequate dissection of the preperitoneal cavity in all directions (Fig. 6)
  7. Digital check of the preperitoneal cavity
  8. Insertion and positioning of mesh on the peritoneum (subfascia) (Fig. 8)
  9. Digital check that the mesh position is fold-free
  10. Closure of the midline with continuous absorbable suture
  11. Fixation of the base of the navel to the fascia with absorbable interrupted suture
  12. Skin closure with absorbable interrupted sutures subcutaneously and intracutaneously
  13. Wound closure with steristrips

Animation and video of entire procedur:

(en) Animation & Operation:
Umbilical hernia in PUMP technique (Dr. Volmer)

BI-PUMP-technik

A Danish register study was able to demonstrate that the risk of recurrence of small mesh-repaired umbilical hernias with hernia gaps ≤ 2 cm is 50% lower compared to repair with sutures.*
Preperitoneal Umbilical Mesh Plasty (PUMP technique) combined with the new DynaMesh®-CICAT 05 cm x 06 cm enables safe and efficient repair of small umbilical hernias with hernia gaps up to approximately 2 cm. The PUMP technique can also be used for larger defects with up to 4 cm hernia gap. DynaMesh®-CICAT 10 cm x 10 cm is available for such cases, cut to size during the procedure to fit the hernia gap.

* Christoffersen MW, Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T:
Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study.
Am J Surg 2014. DOI: 10.1016/j.amjsurg.2014.05.021


Product range
Abdominal wall hernia

Allow for sufficient overlap when selecting mesh size. – (P) Prophylaxis

DynaMesh®-CICAT Size: d 10 cm round PV090010F3 Unit = 1 EA / BX
DynaMesh®-CICAT Size: 15 cm x 15 cm PV091515F3 Unit = 3 EA / BX

longitudinal:

DynaMesh®-CICAT Size: 10 cm x 35 cm(P) PV091035F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 15 cm x 25 cm PV091525F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 15 cm x 25 cm PV091525F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: 15 cm x 30 cm PV091530F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 18 cm x 40 cm PV091840F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 20 cm x 30 cm PV092030F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 20 cm x 30 cm PV092030F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: 30 cm x 45 cm PV093045F1 Unit = 1 EA / BX
DynaMesh®-CICAT Size: 30 cm x 45 cm PV093045F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 45 cm x 60 cm PV094560F1 Unit = 1 EA / BX

transversal:

DynaMesh®-CICAT Size: 40 cm x 20 cm PV094020F1 Unit = 1 EA / BX

DynaMesh®-CICAT visible Size: 20 cm x 30 cm PV162030F1 Unit = 1 EA / BX

 

Umbilical hernia

Allow for sufficient overlap when selecting mesh size.

DynaMesh®-CICAT Size: 05 cm x 06 cm PV090506F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: d 10 cm round PV090010F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 10 cm x 10 cm PV091010F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 15 cm x 15 cm PV091515F3 Unit = 3 EA / BX
DynaMesh®-CICAT visible Size: 05 cm x 06 cm PV160506F5 Unit = 5 EA / BX
Use and properties
Product DynaMesh®-CICAT DynaMesh®-CICAT
Field of application abdominal wal umbilicus
Surgical approach open / mini-open open / mini-open
Surgical technique MILOS PUMP / MILOS
Mesh position extraperitoneal (sublay/onlay/inlay) extraperitoneal (subfascial / sublay)
Fixation suture / bonding none / suture / bonding
Optimal handling
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Optimal patient safety
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Optimal patient comfort
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Green line marker
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Tri-elasticity
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visible technology
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gruene_punkte Applies to all product sizes
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Technical data

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Legends for the technical data

(a) Ratio of implant reactive surface area (thread surface) to implant surface area
(b) measured in the strip tensile test
(c) modified trouser tear test
(d) the Mühl method [6]
(e) Klinge’s classification [8]