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Computational modeling of abdominal hernia laparoscopic repair with a surgical mesh.

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.

journal_name

Int J Comput Assist Radiol Surg

journal_title

International journal of computer assisted radiology and surgery

authors

Todros S,Pachera P,Baldan N,Pavan PG,Pianigiani S,Merigliano S,Natali AN

doi

10.1007/s11548-017-1681-7

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

73-81

issue

eissn

1861-6410

issn

1861-6429

pii

10.1007/s11548-017-1681-7

journal_volume

pub_type

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Computational modeling of abdominal hernia laparoscopic repair with a surgical mesh.