News Feed Discussions Strive for the ideal non-mesh open repair and hernia mesh

  • Strive for the ideal non-mesh open repair and hernia mesh

    Posted by Jimbohen on June 9, 2018 at 10:39 pm

    Dr. Kang, you posted the following under the topic: “Marcy repair in adults with inguinal hernia”:

    Looking at the active discussions, I understand that many people have deep interest in minimal laparoscopic repair. I can feel the sense of fear that people have towards existing inguinal hernia repair methods; starting from mesh repair. However, I believe more than necessary fear can result into looking at only the trees instead of the whole forest.”

    “If it succeeds, it is definitely delightful but only 1~2% at most, I believe, of the total number of inguinal hernia patients are subject to so called minimal laparoscopic repair. Most inguinal hernia patients will not be able to undergo this surgery. Therefore it will not be of much needed help looking into this technique excessively.”

    “The real question here is which technique is practical for the majority of inguinal hernia patients. So, in my opinion, we need to concentrate our discussion on mesh repair and non-mesh open repair. I believe there are two directions we can take. The first is developing the ideal mesh with no side effects; though I do not know if it is possible or not. The second is finding or developing a new minimal non-mesh open repair different from existing ones and then educating it. It is an issue that each and one of us have to decide on. Every doctor may have different opinions but I personally believe the second direction is the best way.”

    Thanks for your good advice that the discussion should focus on mesh repair and non-mesh open repair rather than laparoscopic non-mesh repair since very few adults will ever be candidates for this. Regarding your belief that there are two directions we can take with the first of these being developing the ideal mesh with no side effects. This recent press release from Purdue University seems to hold some real promise. Korean researchers there and in Korea have engineered a silk hybrid material that can attack bacteria when illuminated with green light.

    https://www.purdue.edu/newsroom/rele…al-remedy.html

    Here’s a summary of some of the points from this article and another source. I don’t fully understand it all but it seems like it could lead to “the ideal mesh with no side effects” that’s so desperately needed:

    These Korean researchers have found a way to fuse a far-red fluorescent protein into silk. When exposed to green light, the resulting material will release molecules that kill bacteria and other dangerous pathogens.
    The new all-natural organic biomaterial offers an alternative way to sterilize pathogens. Whereas current hernia meshes are often toxic to humans.
    They claim this silk hybrid has several uses including wound treatment.
    Young Kim, an associate professor of biomedical engineering at Purdue, said that silk is one of the oldest and best-understood biomaterials. Harvested from the cocoons of silkworms, the material generally does not cause any ill effects in humans aside from the rare allergy.
    Likewise, green light is not dangerous like ultraviolet light. Green is the strongest wavelength of the visible spectrum, but it’’s still safe for humans since it’’s found in natural sunlight.
    To create a material that featured the benefits of these two, the Purdue-NAAS research team fused the “mKate2” gene into a silk host. A fluorescent protein in the far-red spectrum, mKate2 creates reactive oxygen species (ROS) in the presence of green light.
    ROS are radical molecules that react to any organic contaminants they encounter. They attack the membrane and genetic information of bacteria and other pathogens.
    The researchers tested the new silk using E. coli bacteria. When they shone a weak green light on the light-reactive biomaterial, they determined that the survival rate of bacteria on the silk hybrid plummeted to 45 percent.
    In addition, the new material appeared to be very versatile. The hybrid silk could be turned into a bandage, FABRIC, FILM, and SOLUTION. (injectable)
    Fluorescent silk is eco-friendly and bio-compatible with humans.
    Kim’s fellow researcher Jung Woo Leem explained that they made fluorescent silk so that it could be disinfected or decontaminated with just normal light instead of UV light. Kim added that their team’s product is superior to competing plasmonic photocatalysts in terms of efficiency and ability to be scaled up.
    Plasmonic photocatalysts use metal nanoparticles from semiconductor materials. While these nanoparticles can react with normal light, they may have hazardous effects on the environment, humans, and animals.
    Kim pointed out that silkworms create the host material for the ROS-generating proteins of their fluorescent biomaterials. The manufacturing process of their silk photocatalysts is very easy and environment-friendly compared to industrial processes that create plasmonic photocatalysts.
    He and his team are already considering other uses for the hybrid silk. Kim talked about IMPLANTABLE and INJECTABLE bandages that will NOT be REJECTED by the HUMAN BODY and will NATURALLY BREAK DOWN after the wound has healed up.
    The hybrid silk was genetically engineered to accommodate the fluorescent protein, but it is an organic product and technically not a GMO. The silkworms that produced it are normal; the protein is added to the silk after harvesting.

    Dr. Kang, of course this new biotechnology may take some time if it ever comes to fruition for hernia mesh. Especially here in the USA where the powers that be will bog down the process largely out of greed. Perhaps you can help expedite the process for hernia mesh with your fellow countrymen.

    Regarding your belief that the discussion should also focus on the second direction of finding or developing a new minimal non-mesh open repair different from existing ones and then educating it. Respectfully, your posts under “Marcy repair in adults with inguinal hernia” as well as the information on your website have led me to believe that you have essentially achieved that goal. Correct me if I’m wrong, but isn’t your “Kang non-mesh minimal open repair” for indirect hernias a method that you developed and refined over just the past few years? Therefore, please describe the specific nuances and the advantages of it in even greater detail to the extent that this is practical. Informing and educating all of us, who are very interested, is a big step in the right direction towards having other surgeons perform it for the benefit of their patients. I’m not a doctor but for what it’s worth, like you I also “personally believe (that this) the second direction is the best way.”

    Jimbohen replied 5 years, 8 months ago 1 Member · 0 Replies
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