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Végleur A, Le Ruyet A. Study of the biomechanical response of a prosthetic mesh secured with penetrating and non-penetrating fixations in IPOM ventral hernia repair. Hernia 2024; 28:75-84. [PMID: 37964087 DOI: 10.1007/s10029-023-02915-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/14/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Sutures or tacks are commonly used to secure a mesh in intraperitoneal onlay mesh (IPOM) hernia repair, but such penetrating fixations can cause local damage, that can be associated with pain. The use of an adhesive could be an alternative to reduce complications. However, a risk associated with this approach has been identified, particularly when the defect cannot be closed. A mesh glued to the peritoneum only might not provide as much mechanical reinforcement to the abdominal wall (AW) as a mesh anchored to the myofascial structure with penetrating fixations, which could lead to an increased recurrence rate. Additionally, the high elasticity of the peritoneum may increase mesh bulging. Leveraging an ex vivo approach, the objective of this study was to investigate the impact of mesh fixation using glue versus barbed sutures, on its biomechanical response for IPOM surgery. METHODS An experimental method was developed using ex vivo porcine abdominal wall samples (n = 12). A 4-cm centered circular defect was created by dissecting the skin and the subcutaneous tissue and removing muscle and extraperitoneal fat, while keeping the peritoneum intact. A 14-cm diameter mesh was secured (Dermabond™ cyanoacrylate adhesive or V-Loc™ barbed sutures) to the AW. The mesh was placed on the peritoneum to remain consistent with the IPOM placement. The sample was then subjected to some inflation tests to simulate increased levels of intra-abdominal pressure (IAP) representing daily activities. For each test, mesh bulging into the defect was assessed as a function of the pressure using Digital Image Correlation (DIC) analysis. RESULTS Mesh bulging was studied for 2 configurations: suture fixation and glue. Glued meshes exhibited significantly higher bulging values than when sutured with a significant difference (p = 0.013) observed at 252 mmHg and a certain trend for statistical difference (p < 0.1) for stair climbing or coughing activities. Additionally, the stiffness of the repair was also significantly higher when the mesh was sutured compared to when it was glued to the peritoneum (p < 0.05). CONCLUSION This study demonstrated that a mesh glued to the peritoneum exhibited higher bulging and a behavior of the repair less stiff compared to when it was sutured to the myofascial structure of the AW, particularly for high intra-abdominal pressures. However, the impact of these differences remains to be evaluated over time. Further preclinical investigations are needed to quantify their impact post-operatively.
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Affiliation(s)
- A Végleur
- Medtronic, Sofradim Production, Trévoux, France
| | - A Le Ruyet
- Medtronic, Sofradim Production, Trévoux, France.
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Lizarazo-Fonseca L, Correa-Araujo L, Prieto-Abello L, Camacho-Rodríguez B, Silva-Cote I. In vitro and in vivo evaluation of electrospun poly (ε-caprolactone)/collagen scaffolds and Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) constructs as potential alternative for skin tissue engineering. Regen Ther 2023; 24:11-24. [PMID: 37284730 PMCID: PMC10239703 DOI: 10.1016/j.reth.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/08/2023] [Accepted: 05/20/2023] [Indexed: 06/08/2023] Open
Abstract
Dermal substitutes bear a high clinical demand because of their ability to promote the healing process of cutaneous wounds by reducing the healing time the appearance and improving the functionality of the repaired tissue. Despite the increasing development of dermal substitutes, most of them are only composed of biological or biosynthetic matrices. This demonstrates the need for new developments focused on using scaffolds with cells (tissue construct) that promote the production of factors for biological signaling, wound coverage, and general support of the tissue repair process. Here, we fabricate by electrospinning two scaffolds: poly(ε-caprolactone) (PCL) as a control and poly(ε-caprolactone)/collagen type I (PCol) in a ratio lower collagen than previously reported, 19:1, respectively. Then, characterize their physicochemical and mechanical properties. As we bear in mind the creation of a biologically functional construct, we characterize and assess in vitro the implications of seeding human Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) on both scaffolds. Finally, to determine the potential functionality of the constructs in vivo, their efficiency was evaluated in a porcine biomodel. Our findings demonstrated that collagen incorporation in the scaffolds produces fibers with similar diameters to those in the human native extracellular matrix, increases wettability, and enhances the presence of nitrogen on the scaffold surface, improving cell adhesion and proliferation. These synthetic scaffolds improved the secretion of factors by hWJ-MSCs involved in skin repair processes such as b-FGF and Angiopoietin I and induced its differentiation towards epithelial lineage, as shown by the increased expression of Involucrin and JUP. In vivo experiments confirmed that lesions treated with the PCol/hWJ-MSCs constructs might reproduce a morphological organization that seems relatively equivalent to normal skin. These results suggest that the PCol/hWJ-MSCs construct is a promising alternative for skin lesions repair in the clinic.
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Affiliation(s)
| | | | | | | | - Ingrid Silva-Cote
- Corresponding author. Secretaría Distrital de Salud, Carrera 32 # 12-81, Bogotá, Colombia
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Karkhaneh Yousefi AA, Pierrat B, Le Ruyet A, Avril S. Patient-specific computational simulations of wound healing following midline laparotomy closure. Biomech Model Mechanobiol 2023; 22:1589-1605. [PMID: 37024600 DOI: 10.1007/s10237-023-01708-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/01/2023] [Indexed: 04/08/2023]
Abstract
In the current study, we developed a new computational methodology to simulate wound healing in soft tissues. We assumed that the injured tissue recovers partially its mechanical strength and stiffness by gradually increasing the volume fraction of collagen fibers. Following the principles of the constrained mixture theory, we assumed that new collagen fibers are deposited at homeostatic tension while the already existing tissue undergoes a permanent deformation due to the effects of remodeling. The model was implemented in the finite-element software Abaqus® through a VUMAT subroutine and applied to a complex and realistic case: simulating wound healing following midline laparotomy closure. The incidence of incisional hernia is still quite significant clinically, and our goal was to investigate different conditions hampering the success of these procedures. We simulated wound healing over periods of 6 months on a patient-specific geometry. One of the outcomes of the finite-element simulations was the width of the wound tissue, which was found to be clinically correlated with the development of incisional hernia after midline laparotomy closure. We studied the impact of different suturing modalities and the effects of situations inducing increased intra-abdominal pressure or its intermittent variations such as coughing. Eventually, the results showed that the main risks of developing an incisional hernia mostly depend on the elastic strains reached in the wound tissue after degradation of the suturing wires. Despite the need for clinical validation, these results are promising for establishing a digital twin of wound healing in midline laparotomy incision.
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Affiliation(s)
| | - Baptiste Pierrat
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U1059 SAINBIOSE, 42023, Saint-Étienne, France
| | | | - Stéphane Avril
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U1059 SAINBIOSE, 42023, Saint-Étienne, France.
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He W, Shen F, Xu Z, Pei B, Xie H, Li X. The effect of mesh orientation, defect location and size on the biomechanical compatibility of hernia mesh. Ing Rech Biomed 2023. [DOI: 10.1016/j.irbm.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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A novel in vivo approach to assess strains of the human abdominal wall under known intraabdominal pressure. J Mech Behav Biomed Mater 2021; 125:104902. [PMID: 34717119 DOI: 10.1016/j.jmbbm.2021.104902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/23/2022]
Abstract
The study concerns mechanical behaviour of a living human abdominal wall. A better mechanical understanding of a human abdominal wall and recognition of its material properties is required to find mechanically compatible surgical meshes to significantly improve the treatment of ventral hernias. A non-invasive methodology, based on in vivo optical measurements is proposed to determine strains of abdominal wall corresponding to a known intraabdominal pressure. The measurement is performed in the course of a standard procedure of peritoneal dialysis. A dedicated experimental stand is designed for the experiment. The photogrammetric technique is employed to recover the three-dimensional surface geometry of the anterior abdominal wall at the initial and terminal instants of the dialysis. This corresponds to two deformation states, before and after filling the abdominal cavity with dialysis fluid. The study provides information on strain fields of living human abdominal wall. The inquiry is aimed at principal strains and their directions, observed at the level from -10% to 17%. The intraabdominal pressure related to the amount of introduced dialysis fluid measured within the medical procedure covers the range 11-18.5 cmH2O. The methodology leads to the deformation state of the abdominal wall according to the corresponding loading conditions. Therefore, the study is a step towards an identification of mechanical properties of living human abdominal wall.
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Sednieva Y, Viste A, Naaim A, Bruyère-Garnier K, Gras LL. Strain Assessment of Deep Fascia of the Thigh During Leg Movement: An in situ Study. Front Bioeng Biotechnol 2020; 8:750. [PMID: 32850692 PMCID: PMC7403494 DOI: 10.3389/fbioe.2020.00750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022] Open
Abstract
Fascia is a fibrous connective tissue present all over the body. At the lower limb level, the deep fascia that is overlying muscles of the outer thigh and sheathing them (fascia lata) is involved in various pathologies. However, the understanding and quantification of the mechanisms involved in these sheathing effects are still unclear. The aim of this study is to observe and quantify the strain field of the fascia lata, including the iliotibial tract (ITT), during a passive movement of the knee. Three fresh postmortem human subjects were studied. To measure hip and knee angles during knee flexion-extension, passive movements from 0° to around 120° were recorded with a motion analysis system and strain fields of the fascia were acquired using digital image correlation. Strains were computed for three areas of the fascia lata: anterior fascia, lateral fascia, and ITT. Mean principal strains showed different strain mechanisms depending on location on the fascia and knee angle. For the ITT, two strain mechanisms were observed depending on knee movement: compression is observed when the knee is extended relative to the reference position of 47°, however, tension and pure shear can be observed when the knee is flexed. For the anterior and lateral fascia, in most cases, minor strain is higher than major strain in absolute value, suggesting high tissue compression probably due to microstructural fiber rearrangements. This in situ study is the first attempt to quantify the superficial strain field of fascia lata during passive leg movement. The study presents some limitations but provides a step in understanding strain mechanism of the fascia lata during passive knee movement.
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Affiliation(s)
- Yuliia Sednieva
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Anthony Viste
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
- Hospices Civils de Lyon, Hôpital Lyon Sud, Chirurgie Orthopédique, Pierre-Bénite, France
| | - Alexandre Naaim
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Karine Bruyère-Garnier
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Laure-Lise Gras
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
- *Correspondence: Laure-Lise Gras,
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A numerical method for guiding the design of surgical meshes with suitable mechanical properties for specific abdominal hernias. Comput Biol Med 2020; 116:103531. [DOI: 10.1016/j.compbiomed.2019.103531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/18/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022]
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8
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Tomaszewska A, Lubowiecka I, Szymczak C. Mechanics of mesh implanted into abdominal wall under repetitive load. Experimental and numerical study. J Biomed Mater Res B Appl Biomater 2018; 107:1400-1409. [DOI: 10.1002/jbm.b.34232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/25/2018] [Accepted: 08/18/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Agnieszka Tomaszewska
- Gdańsk University of TechnologyFaculty of Civil and Environmental Engineering, Department of Structural Mechanics Narutowicza 11/12, 80‐233, Gdańsk Poland
| | - Izabela Lubowiecka
- Gdańsk University of TechnologyFaculty of Civil and Environmental Engineering, Department of Structural Mechanics Narutowicza 11/12, 80‐233, Gdańsk Poland
| | - Czesław Szymczak
- Gdańsk University of TechnologyFaculty of Ocean Engineering and Ship Technology, Department of Structural Mechanics Narutowicza 11/12, 80‐233, Gdańsk Poland
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Astruc L, De Meulaere M, Witz JF, Nováček V, Turquier F, Hoc T, Brieu M. Characterization of the anisotropic mechanical behavior of human abdominal wall connective tissues. J Mech Behav Biomed Mater 2018; 82:45-50. [PMID: 29567529 DOI: 10.1016/j.jmbbm.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 11/30/2022]
Abstract
Abdominal wall sheathing tissues are commonly involved in hernia formation. However, there is very limited work studying mechanics of all tissues from the same donor which prevents a complete understanding of the abdominal wall behavior and the differences in these tissues. The aim of this study was to investigate the differences between the mechanical properties of the linea alba and the anterior and posterior rectus sheaths from a macroscopic point of view. Eight full-thickness human anterior abdominal walls of both genders were collected and longitudinal and transverse samples were harvested from the three sheathing connective tissues. The total of 398 uniaxial tensile tests was conducted and the mechanical characteristics of the behavior (tangent rigidities for small and large deformations) were determined. Statistical comparisons highlighted heterogeneity and non-linearity in behavior of the three tissues under both small and large deformations. High anisotropy was observed under small and large deformations with higher stress in the transverse direction. Variabilities in the mechanical properties of the linea alba according to the gender and location were also identified. Finally, data dispersion correlated with microstructure revealed that macroscopic characterization is not sufficient to fully describe behavior. Microstructure consideration is needed. These results provide a better understanding of the mechanical behavior of the abdominal wall sheathing tissues as well as the directions for microstructure-based constitutive model.
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Affiliation(s)
- Laure Astruc
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France.
| | - Maurice De Meulaere
- Laboratoire d'Anatomie, CHRU de Lille, 1 Place de Verdun, 59045 Lille, France
| | - Jean-François Witz
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France
| | - Vit Nováček
- Medtronic, Sofradim Production, 116 avenue du Formans, 01600 Trévoux, France
| | - Frédéric Turquier
- Medtronic, Sofradim Production, 116 avenue du Formans, 01600 Trévoux, France
| | - Thierry Hoc
- LTDS, UMR CNRS 5513, Université de Lyon, École Centrale de Lyon, 36 av Guy de Collongue, 69134 Écully Cedex, France
| | - Mathias Brieu
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France
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10
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Deeken CR, Lake SP. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater 2017; 74:411-427. [DOI: 10.1016/j.jmbbm.2017.05.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/26/2017] [Accepted: 05/04/2017] [Indexed: 12/29/2022]
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Kahan LG, Lake SP, McAllister JM, Tan WH, Yu J, Thompson D, Brunt LM, Blatnik JA. Combined in vivo and ex vivo analysis of mesh mechanics in a porcine hernia model. Surg Endosc 2017; 32:820-830. [DOI: 10.1007/s00464-017-5749-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/14/2017] [Indexed: 12/29/2022]
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12
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Kahan LG, Guertler C, Blatnik JA, Lake SP. Validation of Single C-Arm Fluoroscopic Technique for Measuring In Vivo Abdominal Wall Deformation. J Biomech Eng 2017; 139:2633404. [DOI: 10.1115/1.4037073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Indexed: 11/08/2022]
Abstract
Hernia meshes significantly reduce the recurrence rates in hernia repair. It is known that they affect the abdominal wall postimplantation, yet the understanding of in vivo mechanics in the mesh placement area is lacking. We established a single C-arm biplane fluoroscopic system to study strains at the interface between the mesh and repaired abdominal tissues. We aimed to validate this system for future porcine hernia repair studies. Custom matlab programs were written to correct for pincushion distortion, and direct linear transformation (DLT) reconstructed objects in 3D. Using a custom biplane-trough setup, image sets were acquired throughout the calibrated volume to evaluate a radio-opaque test piece with known distances between adjacent beads. Distances were measured postprocessing and compared to known measurements. Repeatability testing was conducted by taking image sets of the test piece in a fixed location to determine system movement. The error in areal stretch tracking was evaluated by imaging a square plate with fixed radio-opaque beads and using matlab programs to compare the measured areal stretch to known bead positions. Minor differences between measured and known distances in the test piece were not statistically different, and the system yielded a 0.01 mm bias in the XY plane and a precision of 0.61 mm. The measured areal stretch was 0.996, which was not significantly different than the expected value of 1. In addition, preliminary stretch data for a hernia mesh in a porcine model demonstrated technique feasibility to measure in vivo porcine abdominal mechanics.
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Affiliation(s)
- Lindsey G. Kahan
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO 63130 e-mail:
| | - Charlotte Guertler
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO 63130 e-mail:
| | - Jeffrey A. Blatnik
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO 63130 e-mail:
| | - Spencer P. Lake
- Mem. ASME Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1185, St. Louis, MO 63130
- Department of Orthopaedic Surgery, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1185, St. Louis, MO 63130
- Department of Biomedical Engineering, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1185, St. Louis, MO 63130 e-mail:
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Kroese LF, Harlaar JJ, Ordrenneau C, Verhelst J, Guérin G, Turquier F, Goossens RHM, Kleinrensink GJ, Jeekel J, Lange JF. The 'AbdoMAN': an artificial abdominal wall simulator for biomechanical studies on laparotomy closure techniques. Hernia 2017; 21:783-791. [PMID: 28429087 PMCID: PMC5608802 DOI: 10.1007/s10029-017-1615-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 04/04/2017] [Indexed: 11/25/2022]
Abstract
Purpose Incisional hernia remains a frequent complication after abdominal surgery associated with significant morbidity and high costs. Animal and clinical studies have exhibited some limitations. The purpose of this study was to develop an artificial human abdominal wall (AW) simulator in order to enable investigations on closure modalities. We hypothesized that a physical model of the human AW would give new insight into commonly used suture techniques representing a substantial complement or alternative to clinical and animal studies. Methods The ‘AbdoMAN’ was developed to simulate human AW biomechanics. The ‘AbdoMAN’ capacities include measurement and regulation of intra-abdominal pressure (IAP), generation of IAP peaks as a result of muscle contraction and measurements of AW strain patterns analyzed with 3D image stereo correlation software. Intact synthetic samples were used to test repeatability. A laparotomy closure was then performed on five samples to analyze strain patterns. Results The ‘AbdoMAN’ was capable of simulating physiological conditions. AbdoMAN lateral muscles contract at 660 N, leading the IAP to increase up to 74.9 mmHg (range 65.3–88.3). Two strain criteria were used to assess test repeatability. A test with laparotomy closure demonstrated closure testing repeatability. Conclusions The ‘AbdoMAN’ reveals as a promising enabling tool for investigating AW surgery-related biomechanics and could become an alternative to animal and clinical studies. 3D image correlation analysis should bring new insights on laparotomy closure research. The next step will consist in evaluating different closure modalities on synthetic, porcine and human AW. Electronic supplementary material The online version of this article (doi:10.1007/s10029-017-1615-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L F Kroese
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - J J Harlaar
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | | | - J Verhelst
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | - R H M Goossens
- Department Industrial Design Engineering, University of Technology, Delft, The Netherlands
| | - G-J Kleinrensink
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Jeekel
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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Szymczak C, Lubowiecka I, Szepietowska K, Tomaszewska A. Two-criteria optimisation problem for ventral hernia repair. Comput Methods Biomech Biomed Engin 2017; 20:760-769. [DOI: 10.1080/10255842.2017.1300658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Czesław Szymczak
- Department of Theory and Ship Design, Faculty of Ocean Engineering and Ship Technology, Gdańsk University of Technology, Gdańsk, Poland
| | - Izabela Lubowiecka
- Department of Structural Mechanics, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Katarzyna Szepietowska
- Department of Structural Mechanics, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Agnieszka Tomaszewska
- Department of Structural Mechanics, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
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Bridging with reduced overlap: fixation and peritoneal grip can prevent slippage of DIS class A meshes. Hernia 2017; 21:455-467. [DOI: 10.1007/s10029-017-1583-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
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16
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Tran D, Podwojewski F, Beillas P, Ottenio M, Voirin D, Turquier F, Mitton D. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities. J Mech Behav Biomed Mater 2016; 60:451-459. [DOI: 10.1016/j.jmbbm.2016.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/19/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
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Liao A, Harris HW, Maharbiz MM. Towards a full-field strain sensor for guiding hernia repairs. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:1243-6. [PMID: 26736492 DOI: 10.1109/embc.2015.7318592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Each year, approximately 400,000 ventral hernia repairs are performed in the United States [1], [2]. Large ventral hernias (hernias that occur in the abdominal wall) are typically treated by suturing in a surgical mesh to cover and overlap the hernia defect. However, in 10-20% of patients, the hernia repair fails, resulting in recurrence of the hernia, along with other complications including infection and intestinal obstruction [3], [4]. One potential cause of hernia recurrence is the unequal distribution of stress across the mesh resulting in high stress concentrations at the tissue-mesh interface, particularly at the site of mesh fixation to the abdominal wall muscles[5], [6]. Strain across the mesh can be used as an indicator for how evenly stress is distributed across the surface of the mesh. To this end, we have built a full-field, 3D strain measurement system to enable physicians to actively identify and address areas of high strain during the surgery, thus decreasing the rate of hernia recurrence. The strain sensor uses an optical technique, called the grid method, in conjunction with the defocused particle image velocimetry (DPIV) technique to measure the 3D strain distribution across the mesh. The system can achieve a limit of detection down to 0.4% strain and across a 50 cm range z-axis displacement using a Canon EOS 7D camera with a pinhole aperture mask.
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Biaxial Mechanical Evaluation of Absorbable and Nonabsorbable Synthetic Surgical Meshes Used for Hernia Repair: Physiological Loads Modify Anisotropy Response. Ann Biomed Eng 2015; 44:2181-8. [DOI: 10.1007/s10439-015-1503-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
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Simón-Allué R, Montiel J, Bellón J, Calvo B. Developing a new methodology to characterize in vivo the passive mechanical behavior of abdominal wall on an animal model. J Mech Behav Biomed Mater 2015. [DOI: 10.1016/j.jmbbm.2015.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Acosta Santamaría V, Siret O, Badel P, Guerin G, Novacek V, Turquier F, Avril S. Material model calibration from planar tension tests on porcine linea alba. J Mech Behav Biomed Mater 2015; 43:26-34. [DOI: 10.1016/j.jmbbm.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/30/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022]
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Guérin G, Bourges X, Turquier F. Biomechanical evaluation of three fixation modalities for preperitoneal inguinal hernia repair: a 24-hour postoperative study in pigs. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2014; 7:437-44. [PMID: 25525396 PMCID: PMC4267587 DOI: 10.2147/mder.s71035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Tacks and sutures ensure a strong fixation of meshes, but they can be associated with pain and discomfort. Less invasive methods are now available. Three fixation modalities were compared: the ProGrip™ laparoscopic self-fixating mesh; the fibrin glue Tisseel™ with Bard™ Soft Mesh; and the SorbaFix™ absorbable fixation system with Bard™ Soft Mesh. MATERIALS AND METHODS Meshes (6 cm ×6 cm) were implanted in the preperitoneal space of swine. Samples were explanted 24 hours after surgery. Centered defects were created, and samples (either ten or eleven per fixation type) were loaded in a pressure chamber. For each sample, the pressure, the mesh displacement through the defect, and the measurements of the contact area were recorded. RESULTS At all pressures tested, the ProGrip™ laparoscopic self-fixating mesh both exhibited a significantly lower displacement through the defect and retained a significantly higher percentage of its initial contact area than either the Bard™ Soft Mesh with Tisseel™ system or the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system. Dislocations occurred with the Bard™ Soft Mesh with Tisseel™ system and with the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system at physiological pressure (,225 mmHg). No dislocation was recorded for the ProGrip™ laparoscopic self-fixating mesh. CONCLUSION At 24 hours after implantation, the mechanical fixation of the ProGrip™ laparoscopic self-fixating mesh was found to be significantly better than the fixation of the Tisseel™ system or the SorbaFix™ absorbable fixation system.
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Affiliation(s)
- Gaëtan Guérin
- Covidien-Surgical Solutions, Research and Development, Trévoux, France
| | - Xavier Bourges
- Covidien-Surgical Solutions, Research and Development, Trévoux, France
| | - Frédéric Turquier
- Covidien-Surgical Solutions, Research and Development, Trévoux, France
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Podwojewski F, Otténio M, Beillas P, Guérin G, Turquier F, Mitton D. Mechanical response of human abdominal walls ex vivo: Effect of an incisional hernia and a mesh repair. J Mech Behav Biomed Mater 2014; 38:126-33. [DOI: 10.1016/j.jmbbm.2014.07.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 11/15/2022]
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Contribution of the skin, rectus abdominis and their sheaths to the structural response of the abdominal wall ex vivo. J Biomech 2014; 47:3056-63. [DOI: 10.1016/j.jbiomech.2014.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 06/12/2014] [Accepted: 06/27/2014] [Indexed: 11/17/2022]
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Lubowiecka I. Behaviour of orthotropic surgical implant in hernia repair due to the material orientation and abdomen surface deformation. Comput Methods Biomech Biomed Engin 2013; 18:223-32. [DOI: 10.1080/10255842.2013.789102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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