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HERNIA
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EXPERIMENTS AND SIMULATIONS FOR LAPAROSCOPICVENTRAL HERNIA REPAIR IMPROVEMENT
PublicationThe authors conducted a wide experimental and numerical study in order to determine effective approaches in the laparoscopic VH repair. At first the study covered identification of mechanical properties of the abdominal fascia, implants, tacks and transabdominalsutures. Basis on these data, the one and two-dimensional mathematical models were formulated and a number of numerical static and dynamic analyses were carried out. Then...
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Revista Hispanoamericana de Hernia
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Mechanical properties of mosquito nets in the context of hernia repair
PublicationThe paper deals with issue of applying mosquito nets as implants in hernia repair, which have already been used in resource-poor developing countries. Uniaxial tensile tests have been conducted on polyester mosquito meshes in two orthogonal directions. Non-linear elastic constitutive laws parameters have been identified to be applied in dense net material models. Mechanical performance of tested mosquito nets has been compared...
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Two-criteria optimisation problem for ventral hernia repair
PublicationTwo-criteria optimisation problem related to laparoscopic ventral hernia repair is formulated in this paper. An optimal implant from a given set and its orientation is sought. The implant is subjected to kinematic extortions due to a patient’s body movement and intra-abdominal pressure. The first criterion of the optimisation problem deals with the reaction force in the implant fastener, while the deflection of the implant constitutes...
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Mechanical compatibility of implants used in hernia repair with abdominal wall
PublicationThe paper deals with a membrane model of a synthetic surgical mesh for treatment of abdominal hernia. The authors analyse the compatibility of two implant types with the human wall: Dualmesh Gore and Proceed. The finite element method is applied to simulate tjhe behavior of the proposed model. Due fact that recurrences are usually caused by connection failure, this study is focused on reaction forces in supports representing the...
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Assessment of usefulness of different tacks in laparoscopic ventral hernia repair
PublicationLaparoscopic ventral hernia repair is becoming a popular technique with good results and fast postoperative recovery. The mesh is placed directly under the peritoneum and anchored with transabdominal sutures and tacks. However, the ideal size of the mesh covering the hernia orifice is know, nor the ideal type or amount of tacks has to be described.
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Mathematical modelling of implant in an operated hernia for estimation of the repair persistence
PublicationThis paper presents mathematical modelling of an implanted surgical mesh used in the repair process of the abdominal hernia. The synthetic implant is simulated by a membrane structure. The author provides a material modelling of the implant based on the dense net model appropriate for technical fabrics. The accuracy of the proposed solution is evaluated by comparing the simulations of the dynamic behaviour of the system with the...
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SIMULATION OF PROCEED® SURGICAL MESH APPLIED TO VENTRAL HERNIA REPAIR
PublicationIn the present research, Proceed® implant is considered. The system is subjected to short-time dynamic pressure load, similar to post-operative cough naturally occurring in human abdomen. The model refers to a clinical case of 5cm of hernia operated by Proceed implant fixed by 15 joints every 3cm around the orifice. The simulations of the implanted mesh are performed by means of the Finite Element Method. The implant is modelled...
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Mechanical behaviour of knit synthetic mesh used in hernia surgery
PublicationPurpose: There is a discussion in literature concerning mechanical properties and modelling of surgical meshes. An important feature of elastic modulus dependency on load history is taken into account in this paper, as implants are subjected to variable loading during human activity. The example of DynaMesh®-IPOM surgical implant is studied. Methods: The analysis is based on failure tension tests and cyclic loading and unloading...
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Mechanical Modelling of Human Fascia in the Problem of Ventral Hernia Repair
PublicationPraca dotyczy badań doświadczalnych tkanki ludzkiej oraz symulacji numerycznej zachowania tej tkanki. Na podstawie eksperymentu dokonuje się identyfikacji modelu materiałowego tkanki a następnie w celu wweryfikacji przeprowadza się symulacje numeryczną zachowania modelowanej struktury. Celem badań jest uzyskanie informacji przydatnych podczas leczenia przepuklin brzusznych u ludzi.
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Orthotropic membrane as a mechanical model of surgical implant in abdominal hernia repair
PublicationEven though the incisional hernia repair surgery is a well known procedure, mechanical properties of the tissue-implant system are unknown so the implantation of the repairing mesh is quite intuitive and, recurrences of the illness still take place. The main objective of the study is to define an operated hernia model that can be used for surgery planning and the assessment of the repair persistence. The load applied to the structure...
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IMPLANT USED IN HERNIA REPAIR UNDER PHYSIOLOGICAL MOVEMENTS OF HUMAN ABDOMEN
PublicationThe study deals with the mechanical behaviour of implant used in repair of abdominal hernia. The influence of orientation of the orthotropic implants in different areas of abdominal wall is studied.
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Dynamics of mechanical model of implant-tissue system in ventral hernia repair
PublicationThe paper deals with a finite element modelling of implants in the problem of ventral hernia repair. The synthetic mesh implanted in the abdomen during surgery is here modelled as a membrane structure. Thesystem undergoes the internal abdominal pressure that occurs during the postoperative cough, the load identified in the literature as the main cause of the connection failure and hernia recurrence. The model can be used to estimate...
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In vivo performance of intraperitoneal onlay mesh after ventral hernia repair
PublicationBackground: Ventral hernia repair needs to be improved since recurrence, postoperative pain and other complications are still reported in many patients. The behavior of implants in vivo is not sufficiently understood to design a surgical mesh mechanically compatible with the human abdominal wall. Methods: This analysis was based on radiological pictures of patients who underwent laparoscopic ventral hernia repair. The pictures...
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A PRELIMINARY STUDY ON THE OPTIMAL CHOICE OF AN IMPLANT AND ITS ORIENTATION IN VENTRAL HERNIA REPAIR
PublicationThis 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...
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Cough influence on fascia-mesh system built for a hernia repair - an experimental research
PublicationAn experimental approach to identify stronger and weaker fixation schemes in laparoscopic ventral hernia repair is presented in the paper. Two types of implants, whose mechanical properties are significantly different and five kinds of connectors are considered. Physical models of operated hernia have been built using those materials and porcine abdominal tissue. The models have been subjected to dynamic impulse load, similar to...
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Constitutive Modelling of Knitted Abdominal Implants in Numerical Simulations of Repaired Hernia Mechanics
PublicationThe paper presents a numerical approach to describe mechanical behavior of anisotropic textile material, which is a selected abdominal prosthesis. Two constitutive nonlinear concepts are compared. In the first one the material is considered composed from two families of threads (dense net model) and in the second one the material is homogeneous but anisotropic (as proposed by Gassel, Ogden, Holzapfel). Parameters of both models...
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Mechanical behaviour of the implant used in human hernia repair under physiological loads
PublicationIn laparoscopic operations of abdominal hernias some recurrences still take place, even when applying a surgical mesh. This is usually caused by a failure of the connection between the tissue and the implant. The study deals with the influence of an implant’s orientation on forces in joints, which connect the mesh to human tissues. In the paper, the implant is modelled as a membrane structure within framework of the Finite Element...
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Surgical implant used in ventral hernia repair subjected to physiological pressure - computer simulation
PublicationW streszczeniu przedstawiono matemayczny model implantu wszczepionego pacjentowi podczas laparoskopowej naprawy przepukliny brzusznej. Wykonano go z użyciem metody elementów skończonych. Przyjęto ortotropowy model materiałowy implantu.
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Biomechanics of the front abdominal wall as a potential factorleading to recurrence with laparoscopic ventral hernia repair
PublicationThis study investigated the front abdominal wallto describe its elasticity in vivo and searched for elongationsthat possibly stretched an implanted mesh, therebycausing fixation failure and subsequent recurrence.To measure front abdominal wall elongations, amodel of fascia movements was created. Eight healthyvolunteers were measured during exercise to determine theextent of elongations in their front abdominal wall. Videoswere...
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International Journal of Abdominal Wall and Hernia Surgery
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Physical and mathematical modelling of implant-fascia system in order to improve laparoscopic repair of ventral hernia
PublicationThis paper describes an investigation of biomechanical behaviour of hernia repair, which is focused on the selection of safe linking of certain type of implant with fascia in laparoscopic operation. The strength of various fixations of the implant to the fascia is analysed. Methods: The research is based on experimental observations of operated hernia model behaviour during a dynamic impulse load corresponding to post-operative...
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Towards Understanding of Mechanics of Hernia Managed by Synthetic Mesh in Laparoscopic Operation: A Single Case Study
PublicationIn this paper a research towards understanding of mechanics of ventral hernia operated with the use of Physiomesh Open image in new window implant and SecureStrap Open image in new window staples is described. Experimental and numerical studies are conducted for that purpose. Experimental works cover uni-axial tension tests of the implant samples and of the implant-staples-tissue system. Also experiments on implant-staples-tissue...
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Behaviour of orthotropic surgical implant in hernia repair due to the material orientation and abdomen surface deformation
Publicationrelation to the different range of typical deformations observed in different directions and zones of abdomen surface due to the patients’ life activities, has a significant influence on the extreme junction forces in the mesh–tissue connections and hence the repair persistence. The finite element model of the orthotropic implant was developed, and the junction forces in the connections of tissue and mesh were studied. The kinematical...
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A FEM membrane model of human fascia-synthetic implant system in a case of a stiff ventral hernia orifice
PublicationPraca prezdstawia model matematyczny układu tkanka ludzka - implant syntetyczny w postaci tzw. siatki w leczeniu przepuklin brzusznych. Implant jest tu moelowany jako struktura membranowa. Ocena wpływu danych materiałowych oraz wstępnego napięcia na zachowanie pracującej membrany po implantacji została przedstawiona na podstawie analizy wrażliwości. Pracę podsumowują pewne wskazówki dla chirurgów implantujących siatki.
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Modeling of the fascia-mesh system and sensitivity analysis of a junction force after a laparoscopic ventral hernia repair
PublicationW pracy rozpatrywano prosty model cięgnowy układu powięż-siatka do oszacowania siły połączenia siatki z powięzią po operacji laparoskopowej przepukliny brzusznej. Cięgno obciążone jest ciśnieniem wewnątrz brzusznym, symulującym kaszel, oraz przemieszczeniami jego końców wywołanymi skłonami pacjenta. Wpływ poszczególnych parametrów cięgna na siłę połączenia określono za pomocą analizy wrażliwości. Sformułowano pewne wnioski ważne...
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Investigation of abdomen surface deformation due to life excitation: implications for implant selection and orientation in laparoscopic ventral hernia repair
PublicationVentral hernia is a common medical problem. Statistically there are around 10% recurrences of the sickness. The authors' former investigation proved edges of the hernia orifice displacements to be one of the factors causing recurrence. Thus, experimental investigation of the abdomen surface deformation due to some normal activities of people is studied.The extreme strains, their localization and directions are identified. The acquired...
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Safety and efficacy of a Ventralight ST echo ps implant for a laparoscopic ventral hernia repair – a prospective cohort study with a one-year follow-up
Publicationing new products Thus, every mesh prior to introduction in clinical settings should be tested with a dedicated tacker to discover the proper fixation algorithm. The aim of the study was to assess the safety and efficacy of the Ventralight ST implant with an ECHO positioning system and a dedicated fixation device, the SorbaFix stapler, in a prospective cohort of patients. Material and methods. The study was a prospective single...
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Mathematical study of a tissue-implant connection in a ventral herniarepair in a context of the system's parameters
PublicationW pracy przedstawiono problem operowania przepuklin brzusznych u ludzi. Zaproponowano jednowymiarowy model układu powieź-implant. Na podstawie analizy wrażliwości zidentyfikowano najważniejsze parametry problemu.
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Mechanics of mesh implanted into abdominal wall under repetitive load. Experimental and numerical study
PublicationThere are a number of papers discussing medical and mechanical aspects of ventral hernia management. Despite intensive work on the problem understanding, recurrences of the sickness still happen too often. For that reason new aspects of the problem must be considered. In this paper, a change in the abdominal implant’s stiffness is discussed, which is caused by cyclic loading. Such loading influence abdominal implant e.g. while...
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Global sensitivity analysis of membrane model of abdominal wall with surgical mesh
PublicationThe paper addresses the issue of ventral hernia repair. Finite Element simulations can be helpful in the optimization of hernia parameters. A membrane abdominal wall model is proposed in two variants: a healthy one and including hernia defect repaired by implant. The models include many uncertainties, e.g. due to variability of abdominal wall, intraabdominal pressure value etc. Measuring mechanical properties with high accuracy...
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Sensitivity analysis based on non-intrusive regression-based polynomial chaos expansion for surgical mesh modelling
PublicationThe modelling of a system containing implants used in ventral hernia repair and human tissue suffers from many uncertainties. Thus, a probabilistic approach is needed. The goal of this study is to define an efficient numerical method to solve non-linear biomechanical models supporting the surgeon in decisions about ventral hernia repair. The model parameters are subject to substantial variability owing to, e.g., abdominal wall...
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Combined numerical and experimental approach to determine numerical model of abdominal scaffold
PublicationA proper junction of the prosthesis and the abdominal wall is important in successful hernia repair. The number of tacks should be balanced to assure appropriate mesh fixation and not to induce post-operative pain. Numerical simulations help to find this balance. The study is aimed at creating a proper numerical model of a knitted surgical mesh subjected to boundary conditions and load occurring in the abdominal cavity. Continuous,...
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Regression points in non-intrusive polynomial chaos expansion method and D-optimal design
PublicationThe paper addresses selected issues of uncertainty quantification in the modelling of a system containing surgical mesh used in ventral hernia repair. Uncertainties in the models occur e.g. due to variability of abdominal wall properties among others. In order to include them, a non-intrusive regression-based polynomial chaos expansion method is employed. Its accuracy depends on the choice of regression points. In the study a relation...
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Biomechanical causes for failure of the Physiomesh/Securestrap system
PublicationThis study investigates the mechanical behavior of the Physiomesh/Securestrap system, a hernia repair system used for IPOM procedures associated with high failure rates. The study involved conducting mechanical experiments and numerical simulations to investigate the mechanical behavior of the Physiomesh/Securestrap system under pressure load. Uniaxial tension tests were conducted to determine the elasticity modulus of the Physiomesh...
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Stiffness change of abdominal prosthesis Optomesh™ under cyclic loading
PublicationAbdominal prostheses are used in humans for abdominal wall strengthening or reconstruction. From the mechanical point of view they are membranes, so their basic mechanical property is tensile stiffness. This property is experimentally identified for a selected implant, OptomeshTM. The obtained results are described herein. Uni-axial simple and cyclic tension tests are a basis for the analysis. Both kinds of tests allowed to distinguish...
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Modelling of Abdominal Wall Under Uncertainty of Material Properties
PublicationThe paper concerns abdominal wall modelling. The accurate prediction and simulation of abdominal wall mechanics are important in the context of optimization of ventral hernia repair. The shell Finite Element model is considered, as the one which can be used in patient-specific approach due to relatively easy geometry generation. However, there are uncertainties in this issue, e.g. related to mechanical properties since the properties...
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Material Identification of the Human Abdominal Wall Based On the Isogeometric Shell Model
PublicationThe human abdominal wall is an object of interest to the research community in the context of ventral hernia repair. Computer models require a priori knowledge of constitutive parameters in order to establish its mechanical response. In this work, the Finite Element Model Updating (FEMU) method is used to identify an heterogeneous shear modulus distribution for a human abdominal wall model, which is based on nonlinear isogeometric...
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Full-field in vivo experimental study of the strains of a breathing human abdominal wall with intra-abdominal pressure variation
PublicationThe presented study aims to assess the mechanical behaviour of the anterior abdominal wall based on an in vivo experiment on humans. Full-field measurement of abdominal wall displacement during changes of intra-abdominal pressure is performed using a digital image correlation (DIC) system. Continuous measurement in time enables the observation of changes in the strain field during breathing. The understanding of the mechanical...
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Is mesh fixation necessary in laparoendoscopic techniques for M3 inguinal defects? An experimental study.
Publicationrepairs, in case of large direct hernias (M3) mesh fixation is recommended to reduce recurrence risk. Despite lack of highquality evidence, the recommendation was upgraded to strong by expert panel. The authors conducted a research experiment to verify the hypothesis that it is possible to preserve the mesh in the operating field in large direct hernias (M3) without the need to use fixing materials. Method The authors conducted...
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Evaluating the risk of endometriosis based on patients’ self-assessment questionnaires
PublicationBackground Endometriosis is a condition that significantly affects the quality of life of about 10 % of reproductive-aged women. It is characterized by the presence of tissue similar to the uterine lining (endometrium) outside the uterus, which can lead lead scarring, adhesions, pain, and fertility issues. While numerous factors associated with endometriosis are documented, a wide range of symptoms may still be undiscovered. Methods In...
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BJS-03 DO WE NEED FIXATION OF THE MESH IN LAPAROENDOSCOPIC TECHNIQUES FOR M3 INGUINAL DEFECTS? AN EXPERIMENTAL STUDY
PublicationThe authors conducted a research experiment to verify the hypothesis that it is possible to preserve the mesh in the operating field in large direct hernias (M3) without the need to use fixing materials. The results showed that mesh fixation is not the only alternative to preventing recurrence in complex defects and that the type of implant seems to be a key factor from the point of view of mechanics and biophysics.