van den Hil et al reported the META (MEsh Tissue Adhesio) score to describe adhesions associated with postoperative adhesions between mesh and adjacent tissues. The authors are from multiple institutions from around the world.
Patient selection: hernia repair with mesh placement at least 6 months before evaluation
Parameters:
(1) percent of mesh surface covered with adhesions, from 0 to 100
(2) tenacity of adhesions
(3) thickness of adhesions
(4) organ involvement
Parameter
Finding
Points
percent of mesh surface
0%
0
1 to 25%
1
26 to 50%
2
51 to 75%
3
76 to 100%
4
tenacity of adhesions
no adhesions
0
loose, easily released with traction only
1
adhesions requiring sharp dissection; no organ or serosal damage
2
adhesions requiring sharp dissection; organ or serosal damage unavoidable
3
thickness of adhesions
no adhesions
0
single, thin, filmy
1
mutliple, thin, filmy
2
single dense adhesion
3
multiple dense adhesions
4
organ involvement
no adhesions
0
adhesions to omentum or solid organ
1
adhesions to intestines
2
adhesions to intestines with enteric fistulas or bowel erosion
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• Several combinations are incompatible. There should be no scores for 1 to 3.
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