Mechanical behaviour of synthetic surgical meshes: Finite element simulation of the herniated abdominal wall

Hernández-Gascón, Belén; Peña, Estefanía; Melero, H.; Pascual, Gemma; Doblaré, M.; Ginebra, Maria‐Pau; Calvo, Begoña

doi:10.1016/j.actbio.2011.06.033

Cited by 90 publications

(51 citation statements)

References 23 publications

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“…When extracted, abdominal muscles exhibited a retraction that means a difference between the in vivo and the sample thicknesses. This fact has not been considered in the model due to the aim of validating only in vitro tests but in a more realistic model, this should be implemented in a similar way of previous works (Grasa et al, 2011). Furthermore, as mentioned in the text, the optimum length selected for the experiments was that of the maximum twitch force.…”

Section: Discussionmentioning

confidence: 97%

“…The Finite Element Method (FEM) is a powerful tool to find good numerical solutions for these equations (Oomens et al, 2003). FEM has been successfully implemented for studying skeletal muscles with complex shapes for both active and passive behaviour (Böl and Reese, 2008;Tang et al, 2009;Grasa et al, 2011Grasa et al, , 2014Webb et al, 2014). The abdominal wall biomechanics has been studied by means of this technique assuming the presence of hernia defects (Hernández-Gascón et al, 2011) and the influence of different prostheses (Hernández-Gascón et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Active behavior of abdominal wall muscles: Experimental results and numerical model formulation

Grasa

Sierra

Lauzeral

et al. 2016

Journal of the Mechanical Behavior of Biomedical Materials

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In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Active behavior of abdominal wall muscles: Experimental results and numerical model formulation

Grasa

Sierra

Lauzeral

et al. 2016

Journal of the Mechanical Behavior of Biomedical Materials

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“…Moreover, various authors have suggested that the elastic properties of the human fascia must be better described to assess the potential elongation profile of an implanted prosthesis, as well as the junction forces that affect the fascia-mesh connection [21][22][23]. The optimal number of tacks and trans-abdominal sutures (TAS) used to fix the mesh is not known.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Comparison of two different concepts of mesh and fixation technique in laparoscopic ventral hernia repair: a randomized controlled trial

et al. 2015

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Although this clinical trial was terminated prior to the preplanned recruitment goal, the obtained results from the enrolled patients indicate that the PH system associated with significantly greater hernia recurrences and postoperative pain compared with the VS system. This confirms the superiority of the elastic mesh concept, which may be a safer and more efficacious option for laparoscopic ventral hernia repairs.

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“…Due to its material characteristics usually varying from human tissue, the implanted mesh affects significantly the mechanical behaviour of the repaired abdominal wall (Klosterhalfen et al 1998;Junge et al 2001;Grassel et al 2005;Cobb et al 2006;Hernández-Gascón et al 2011). Moreover, the anisotropy of the human abdomen (Song et al 2006), together with different deformation range identified in its different areas within normal life activities identified by Szymczak et al (2012), also contribute in its postrepair mechanics that can be a major factor in the risk for hernia recurrence, chronic pain and general patient discomfort.…”

Section: Introductionmentioning

confidence: 99%

Behaviour of orthotropic surgical implant in hernia repair due to the material orientation and abdomen surface deformation

Lubowiecka

2013

Computer Methods in Biomechanics and Biomedical Engineering

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Surgical implants used in hernia repair reveal isotropic as well as orthotropic properties. In particular, its orthotropy, in relation 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 extortions representing the abdomen surface deformations identified in specific zones of hernia placement were applied to the model. The sensitive analysis was applied to specify the influence of the orthotropy (implant orientation) direction to the repair persistence. Due to the anisotropy of the human abdomen and also the different range of deformations observed in different areas of abdomen surface, the behaviour of the implant differs significantly depending on the hernia placement and the implant orientation. Especially, it is observed in the values of the implant-tissue junction forces which determinate considerably the repair persistence. The provided results and conclusions may be useful in some clinical recommendations for implantation of orthotropic surgical mesh specifying the hernia placement as well as the orthotropic implant orientation. This can also be considered in the design of new synthetic implants with more physiologic tissue-like properties also taking into account the human abdomen anisotropy.

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Mechanical behaviour of synthetic surgical meshes: Finite element simulation of the herniated abdominal wall

Cited by 90 publications

References 23 publications

Active behavior of abdominal wall muscles: Experimental results and numerical model formulation

Active behavior of abdominal wall muscles: Experimental results and numerical model formulation

Comparison of two different concepts of mesh and fixation technique in laparoscopic ventral hernia repair: a randomized controlled trial

Behaviour of orthotropic surgical implant in hernia repair due to the material orientation and abdomen surface deformation

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