A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

• Autorzy: Lubowiecka I. , Szepietowska K. , Szymczak C. , Tomaszewska A.

Identyfikatory

DOI

10.15632/jtam-pl.54.2.411

• Języki publikacji: EN

Abstrakty

EN

This paper addresses the problem of ventral hernia repair. The main goals are to find an optimal surgical mesh for hernia repair and to define its optimal orientation in the abdominal wall to minimise the maximum force at the tissue-implant juncture. The optimal mesh is chosen from a set of orthotropic meshes with different stiffness ratios for typical hernia placement in the abdominal area. The implant is subjected to an anisotropic displacement field, different for the selected hernia placements. The assumed displacement fields correspond to regular human activity. Proper implantation of the mesh may determine the success of hernia repair and/or the postoperative comfort of patients. The proposed solution is based on FEM simulations of different surgical meshes behaviour. In typical hernia placements, the optimal orientation of the stiffer direction of the implant is perpendicular to the spine. However, the presented results show some cases that an oblique direction may be the optimum one.

Słowa kluczowe

EN

biomechanics; surgical mesh; finite element modelling; optimisation

• Wydawca: Polskie Towarzystwo Mechaniki Teoretycznej i Stosowanej
• Czasopismo: Journal of Theoretical and Applied Mechanics
• Rocznik: 2016
• Tom: Vol. 54 nr 2
• Strony: 411--421
• Opis fizyczny: Bibliogr. 18 poz., rys., tab.

Twórcy

autor

Lubowiecka I.

• Gdansk University of Technology, Faculty of Civil and Environmental Engineering, Gdańsk, Poland

autor

Szepietowska K.

• Gdansk University of Technology, Faculty of Civil and Environmental Engineering, Gdańsk, Poland

autor

Szymczak C.

• Gdansk University of Technology, Faculty of Ocean Engineering and Ship Technology, Gdańsk, Poland

autor

Tomaszewska A.

• Gdansk University of Technology, Faculty of Civil and Environmental Engineering, Gdańsk, Poland

Bibliografia

• 1. Anurov M.V, Titkova S.M., Oettinger, A.P., 2012, Biomechanical compatibility of surgical mesh and fascia being reinforced: dependence of experimental hernia defect repair results on anisotropic surgical mesh positioning, Hernia, 16,
• 2, 199-210 2. Bensley R.P., Schermerhorn M.L., Hurks R., Sachs T., Boyd C.A., O’Malley A.J., Cotterill P., Landon B.E., 2013, Risk of late-onset adhesions and incisional hernia repairs after surgery, Journal of the American College of Surgeons, 216, 6, 1159-1167
• 3. Gu´erin G., Turquier F., 2013, Impact of the defect size, the mesh overlap and the fixation depth on ventral hernia repairs: a combined experimental and numerical approach, Hernia, 17, 5, 647-655
• 4. Hernandez-Gascón B., Esp ´ ´es N., Pena E., Pascual G., Bellón J.M., Calvo B. ˜ , 2012, Computational framework to model and design surgical meshes for hernia repair, Computer Methods in Biomechanics and Biomedical Engineering, 1-15, doi:10.1080/10255842.2012.736967
• 5. Hernandez-Gascón B., Pe ´ na E., Grasa J., Pascual G., Bellón J.M., Calvo B. ˜ , 2013,Mechanical response of the herniated human abdomen to the placement of different prostheses, Journal of Biomechanical Engineering, 135, 5, p. 051004
• 6. Junge K., Klinge U., Prescher A., Giboni P., Niewiera M., Schumpelick V., 2001, Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants, Hernia, 5, 3, 113-118
• 7. Kirilova M., Pashkouleva D., Kavardzhikov V., 2012, A selection of hernia meshes on the basis of experimental results for abdominal layers, Biotechnology and Biotechnological Equipment, 26, 5, 3292-3295
• 8. Li X., Kruger J.A., Jor J.W.Y., Wong V., Dietz H.P., Nash M.P., Nielsen P.M.F., 2014, Characterizing the ex vivo mechanical properties of synthetic polypropylene surgical mesh, Journal of the Mechanical Behavior of Biomedical Materials, 37, 48-55
• 9. Lubowiecka I., 2015, Mathematical modelling of implant in an operated hernia for estimation of the repair persistence, Computer Methods in Biomechanics and Biomedical Engineering, 18, 4, 438-445
• 10. Lubowiecka I., Szepietowska K., Tomaszewska A., Szymczak C., 2014, Mechanical compatibility of implants used in hernia repair with abdominal wall, [In:] Shell Structures. Theory and Applications, Vol. 3., W. Pietraszkiewicz, J. Górski (Eds.), Taylor & Franics Group, London, 351-354
• 11. Lubowiecka I., Tomaszewska A., Szymczak C., Śmietański M., 2010, A FEM membrane model of human fascia-synthetic implant system in a case of a stiff ventral hernia orifice, [In:] Shell Structures. Theory and Applications, Vol. 2, W. Pietraszkiewicz, I. Kreja (Eds.), Taylor & Franics Group, London, 311-314
• 12. Muysoms F., Vander Mijnsbrugge G., Pletinckx P., Boldo E., Jacobs I., Michiels M., Ceulemans R., 2013, Randomized clinical trial of mesh fixation with “double crown” versus “sutures and tackers” in laparoscopic ventral hernia repair, Hernia, 17, 5, 603-612
• 13. Oettinger A.P., Anurov M., Titkova S., Polivoda M., Shapovaliants S., 2013, Comparison of biomechanical properties of light meshes with different structural characteristics, Hernia, 17 (supplement 2), S7
• 14. Podwojewski F., Ott´enio M., Beillas P., Gu´erin G., Turquier F., Mitton D., 2013, Mechanical response of animal abdominal walls in vitro: evaluation of the influence of a hernia defect and a repair with a mesh implanted intraperitoneally, Journal of Biomechanics, 46, 3, 561-566
• 15. Qadri S.J.F., Khan M., Wani S.N., Nazir S.S., Rather A., 2010, Laparoscopic and open incisional hernia repair using polypropylene mesh – a comparative single centre study, International Journal of Surgery, 8, 6, 479-483
• 16. Sommer T., Friis-Andersen H., 2013, DynaMesh(OR ) in the repair of laparoscopic ventral hernia: a prospective trial, Hernia, 17, 5, 613-618
• 17. Szymczak C., Lubowiecka I., Tomaszewska A., Smietański M., 2010, Modeling of the fascia-mesh system and sensitivity analysis of a junction force after a laparascopic ventral hernia repair, Journal of Thoretical and Applied Mechanics, 48, 4, 933-950
• 18. Szymczak C., Lubowiecka I., Tomaszewska A., Smietański M., 2012, Investigation of abdomen surface deformation due to life excitation: Implications for implant selection and orientation in laparoscopic ventral hernia repair, Clinical Biomechanics, 27, 2,105-110

Uwagi

PL

Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniajacą naukę.