Surgical mesh damage can be measured in simple lab experiments
Posted on: 16 September 2019
New research from bioengineers in Trinity suggests it is easy, via a simple lab experiment, to simulate the damage caused by using surgical mesh in different medical procedures.
Such experiments should have been conducted before surgical mesh was used to operate on people – many of whom are now living with serious, debilitating consequences.
Hundreds of women in Ireland are currently suffering as a result of problems with surgical mesh, which has been used to treat conditions such as urinary stress incontinence and pelvic organ prolapse. Complications arise in up to 10% of cases.
As a result, a ban has been imposed on the use of certain products in Ireland until the issues are resolved. The mesh, made from fibres of a hard, stiff polymer called polypropylene, rubs against body parts and can literally saw through organs such as the vagina or bladder. This causes intense pain and, in the worst cases, the mesh cannot be removed safely.
The new research, just published in the Journal of the Mechanical Behavior of Biomedical Materials, shows how this “mesh erosion” can be assessed and quantified in a relatively simple lab experiment.
David Taylor, Professor of Materials Engineering at Trinity, was the lead researcher on the project. He said:
This type of testing, which is known as in vitro testing, is a necessary first step in the design of any medical device. In our research, we showed that it’s very easy to set up an experiment in which mesh can be made to cut through soft tissues so as to assess the risk associated with its use in certain settings.
The preliminary data from our experiments showed rates of erosion similar to those known to occur in patients. As a result – if appropriate and relatively simple research had been conducted properly to begin with – the many debilitating problems of mesh erosion that we are seeing would have been identified and could perhaps have been avoided completely.
The bioengineers found significant differences in the rate of mesh erosion depending on the applied force and the direction of loading and on the presence or absence of connective tissue (perimysium), indicating that using mesh in certain procedures and areas of the body is riskier than in others.
They conclude that mesh erosion should be investigated more extensively, and that different mesh products should be characterised to prevent future clinical complications.