Silvia Todros1, Paola Pachera2, Nicola Baldan3, Piero G Pavan2, Silvia Pianigiani2, Stefano Merigliano4, Arturo N Natali2. 1. Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, 35131, Padua, Italy. silvia.todros@unipd.it. 2. Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, 35131, Padua, Italy. 3. Padova General Hospital, via Giustiniani 2, 35128, Padua, Italy. 4. Department of Surgery, Oncology and Gastroenterology, III Surgical Clinic, University of Padova, via Giustiniani 2, 35131, Padua, Italy.
Abstract
PURPOSE: Although new techniques and prostheses have been introduced in ventral hernia surgery, abdominal hernia repair still presents complications, such as recurrence, pain, and discomfort. Thus, this work implements a computational method aimed at evaluating biomechanical aspects of the abdominal hernia laparoscopic repair, which can support clinical research tailored to hernia surgery. METHODS: A virtual solid model of the abdominal wall is obtained from MRI scans of a healthy subject. The mechanical behavior of muscular and fascial tissues is described by constitutive formulations with specific parameters. A defect is introduced to reproduce an incisional hernia. Laparoscopic repair is mimicked via intraperitoneal positioning of a surgical mesh. Numerical analyses are performed to evaluate the mechanical response of the abdominal wall in healthy, herniated and post-surgery configurations, considering physiological intra-abdominal pressures. RESULTS: During the deformation of the abdominal wall at increasing pressures, a percentage displacement increment up to 6% is found in the herniated condition, while the mechanical behavior of the repaired abdomen is similar to the healthy one. In the pressure range between 8 mmHg and 55 mmHg, the herniated abdomen shows an incremental stiffness differing of 7% with respect to the healthy condition, while the post-surgery condition shows an increase of the incremental stiffness up to 58%. CONCLUSIONS: This computational approach may be exploited to investigate different aspects of abdominal wall surgical repair, including mesh mechanical characteristics and positioning. Numerical modeling offers a helpful support for selecting the best-fitting prosthesis for customize pre-surgery planning.
PURPOSE: Although new techniques and prostheses have been introduced in ventral hernia surgery, abdominal hernia repair still presents complications, such as recurrence, pain, and discomfort. Thus, this work implements a computational method aimed at evaluating biomechanical aspects of the abdominal hernia laparoscopic repair, which can support clinical research tailored to hernia surgery. METHODS: A virtual solid model of the abdominal wall is obtained from MRI scans of a healthy subject. The mechanical behavior of muscular and fascial tissues is described by constitutive formulations with specific parameters. A defect is introduced to reproduce an incisional hernia. Laparoscopic repair is mimicked via intraperitoneal positioning of a surgical mesh. Numerical analyses are performed to evaluate the mechanical response of the abdominal wall in healthy, herniated and post-surgery configurations, considering physiological intra-abdominal pressures. RESULTS: During the deformation of the abdominal wall at increasing pressures, a percentage displacement increment up to 6% is found in the herniated condition, while the mechanical behavior of the repaired abdomen is similar to the healthy one. In the pressure range between 8 mmHg and 55 mmHg, the herniated abdomen shows an incremental stiffness differing of 7% with respect to the healthy condition, while the post-surgery condition shows an increase of the incremental stiffness up to 58%. CONCLUSIONS: This computational approach may be exploited to investigate different aspects of abdominal wall surgical repair, including mesh mechanical characteristics and positioning. Numerical modeling offers a helpful support for selecting the best-fitting prosthesis for customize pre-surgery planning.
Authors: William S Cobb; Justin M Burns; Kent W Kercher; Brent D Matthews; H James Norton; B Todd Heniford Journal: J Surg Res Date: 2005-09-02 Impact factor: 2.192
Authors: Joachim E Wildberger; Andreas H Mahnken; Thomas Flohr; Rainer Raupach; Claudia Weiss; Rolf W Günther; Stefan Schaller Journal: Eur Radiol Date: 2002-10-26 Impact factor: 5.315