-
Phasix Mesh
I’ve been trying to do some homework on absorbable synthetic meshes and just watched the following video from the 2019 Sages conference. The doctor is a speaker for Gore, who makes the Phasix mesh. Although she is a Gore speaker, the following information was taken from studies. She goes into the rundown of 4 different absorbable synthetics starting at the 3 minute mark.
She starts with Vicryl, but my impression was that this has a usage for closures, maybe less for hernias.. It has a fairly rapid resorption rate. 23% mechanical strength at 2 weeks and complete resorption in 2 to 3 months.
Next, she covers Bio-a, a Gore product. Has a 6 months resorption rate. Is better than biologics for collagen deposition and ingrowth. In the study she cites, depending on which type of (ventral?)hernia, had a 17% recurrence or 14%.
Next was tiger matrix, which had 13% recurrence rate. It had better collagen deposition than polypropylene. Is composed of two different fibers, with the strongest resorbed in 3 year.
I read in a separate study that this mesh is not suggested for direct inguinal hernias (indirect only).
Last, of course, is Phasix, which seems, according to this presentation by a Gore speaker, to be superior to the others. She mentions two different studies. In one study of 31 patients, there were no recurrences. In the other study of slightly over one hundred patients, there was a recurrence rate of 9% (11 patients). This material loses tensile strength in 26 weeks and is fully resorbed in 18 months.
-
11 Replies
-
Thanks for the clarification!
-
I’m puzzling over what is meant by “no study has shown that the absorption is inconsequential.” Are you referring to possible consequences due to the products of the chemical breakdown of the mesh?
-
Yes, the five year follow up in this study was completed. Sort of. The biggest problem is that there were fewer than half of the initial people in the study who they were able to follow up. Plus, for the layman, and probably even for the doctors, there is a ton of ambiguity. There were 20 recurrences, but some how they came up with a figure of 22% recurrence, even though there was a small amount of people who they were able to follow up.
At any rate, although this type of mesh seems interesting and possibly promising, it’s hard to see whether this is available for more normal hernias.
-
The three year follow up linked above was published online in Dec of 2020 and in a journal the following month. So the 5 year follow up should be out or out shortly, it would seem.
-
I think that the study referenced by Dr Towfigh and her guest in the above post is the same study listed in the first video, the difference being the follow up time. In the first video, it appears that the 9% recurrence rate was at 18 months, with that number growing to 17% after 3 years.
Here is the link to the 3 year follow up.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750179/
-
This reply was modified 1 year, 9 months ago by David M.
-
This reply was modified 1 year, 9 months ago by
-
Dr Towfigh and her guest talk about Phasix at the 13 minute mark in the following video. In whatever study they reference, the recurrence rate at three years was 17%, which they say was a little higher than permanent synthetic, but not a lot higher.
-
Because the plug is in such disrepute, I havent bothered to research it much, but isnt it used for inguinal hernias, and does this mean that BD expects for the Phasix products to sell in that market?
-
Thanks for the corrections. Indeed, I flubbed the fact that Gore is independent from BD. I had read previous posts about phasix and confused Gore with Bard. I will edit that if it is still possible.
Also, it does sound like the complex hernia study may have been some kind of combined surgery.
Wish there was more info on(or availability for?) Phasix for inguinal hernias.
-
So, two basic questions.
How common is the use of Phasix for inguinal hernia repair?
Does insurance even cover the use of Phasix in inguinal hernia repair?
-
This reply was modified 1 year, 9 months ago by David M.
-
This reply was modified 1 year, 9 months ago by
-
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434400/
This is a study that the authors claim was the first for Phasix in inguinal hernia. Only 15 patients with no recurrences. Done lap with TAPP. Surgeon(s) used tacks because of concern of glue not sticking to pelvic bone.They reported that it was technically difficult to do requiring a patented technique. (?)
-
In this study of complex big hernias, the recurrence rate was 4 out of 70.
https://journals.lww.com/prsgo/fulltext/2019/11000/when_the_mesh_goes_away__an_analysis_of.21.aspx
Log in to reply.