Scientists from the University of Alcalá (UAH) have designed a prosthesis made of silicon and polypropylene shaped like an “upside down T” that substantially reduces cases of incisional hernias.

Primary hernias are produced by structural defects in tissues, while the incisional hernias arise from a previous aperture in the abdominal wall, usually the scar of a previous surgery. Irrespective of the techniques used, different types of sutures or medical devices used to hold the abdominal wall, the number of incisional hernias has been constant over the last decade.

One of the most susceptible areas for their appearance is the linea alba, especially when oblique-transverse fibres are sectioned, which is what occurs in the longitudinal laparotomy procedures. The likelihood of a patient developing incisional hernias increases with associated risks, such as advanced age, neoplasia related surgery, obesity and related chronic pathologies.

Presented with these circumstances, a research group from the University of Alcalá managed by Professor Juan Manuel Bellón from the department of surgery of the UAH has developed and patented a new device to prevent the occurrence of incisional hernias. This prevention is carried out by the incorporation of prosthesis into the suture of the abdominal wall which is designed to increase the cohesive forces of the scar. The new design and concept of the prosthesis, named Laparomesh has the shape of a upside down T and is made with silicone and polypropylene, which are biomaterials that will not be absorbed by the body.

The goal of the Laparomesh is to create a reinforcement much like a tendon in the linea alba that would efficiently consolidate the suture of the laparotomy and significantly reduce the cases of incisional hernias. Different to the other prostheses of its type, the design by Professor Bellon and his team is placed neither above nor below, but it encloses both apertures of the abdominal wall, attaching itself to the different anatomical planes by means of a polypropylene suture.

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Professor Bellón, stated that the current average number of cases of incisional hernias is around 15% to 20%, and it is estimated to reduce these numbers to 3%-4% using this newly patented mesh.

A specially coated metal tube, no larger than a cigarette, could be the key to developing an artificial pancreas to help millions of people with diabetes avoid insulin injections, according to an article scheduled for the May 5 issue of Chemical & Engineering News.

Written by Associate Editor Bethany Halford, the C&EN article points out that researchers have been trying to develop an artificial pancreas for years. Most approaches involve encapsulating healthy islet cells — the pancreatic cells that detect glucose and release insulin — and transplanting them into diabetic patients. But enclosing a large collection of cells has been difficult because the materials designed to hold them are not biocompatible, or optimal for use in the body, Halford notes.

The new device, developed by Joseph P. Kennedy and colleagues at the University of Akron in Ohio, is coated with a permeable polymer membrane that is key to its success. In addition to improving the exchange of insulin and glucose between the islet cells and the blood, the polymer membrane helps increase the supply of oxygen to the cells for improved function and lifespan. The device itself has already shown promise in preliminary animal studies and researchers are looking ahead to clinical trials in humans, the article notes.

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If you’re constantly reaching for antacids to control your heartburn, you may have a more serious problem called reflux disease. Some 25 million Americans have it* and now they have a new option to treat it. Using a newly-approved device for the first time in the U.S., doctors have performed surgery to fix reflux problems without making a single incision.

Developing the technology took decades, but the operation only took an hour. When it was over, doctors at Ohio State University Medical Center may have ushered in a new era of surgery when it comes to fixing reflux problems. Experts at OSUMC say they’re the first in the U.S. to use recently approved remote control instruments to repair the valve between the esophagus and stomach without using a scalpel.

“This device eliminates the need for any incisions whatsoever. The entire reconstruction, or rebuilding of the valve, can be done from the inside all with an instrument through the mouth,” says Scott Melvin, MD, at Ohio State University Medical Center.

By going entirely through a patient’s mouth, doctors don’t have to cut into the body. That can dramatically cut down on recovery time and the risk of complications. Gertrude Green was one of the first patients in the country to try the procedure, after 20 years of trying nearly everything else to control her reflux.

“Over the last 20 years I’ve taken over-the-counter medications, prescriptions and seen more than one doctor,” says Green.

Gertrude has known for years that surgery was an option, but in the past, it was more invasive and would require more time to recover. Now this new technique can change that and possibly more.

“Reflux can give people heartburn, but it also has been associated with an increased risk of esophageal cancer. Right now in North America, esophageal cancer has increased dramatically over the last decade – doubling even tripling the number of cases,” says Melvin.

It’s too early to tell if this surgery will impact the number of cancer cases, but it’s clear to patients like Gertrude that it’s already addressed the burning issue of reflux.

Doctors say getting heartburn once in a while is normal. If you get it 3 or 4 times a week, you should get it checked. Right now, through-the-mouth surgery is only available at certain hospitals. It is expected to become more common in the coming years.

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