Understanding the Passive Mechanical Behavior of the Human Abdominal Wall

Hernández-Gascón, Belén; Mena, A.; Peña, Estefanía; Pascual, Gemma; Calvo, Begoña

doi:10.1007/s10439-012-0672-7

Cited by 56 publications

(30 citation statements)

References 32 publications

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“…1 and 2) by creating a large 120 x 200 mm incisional hernia [3]. This FE model was based on a model of the human abdomen obtained using DICOM files generated by magnetic resonance imaging (MRI) of a healthy 38-year-old man [15]. Different anatomical structures including muscles and aponeuroses were considered, whereas skin and fat were not included since their stiffness is negligible compared to that of the former structures (see Fig.…”

Section: Model Of the Herniated Humanmentioning

confidence: 99%

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Mechanical Response of the Herniated Human Abdomen to the Placement of Different Prostheses

Hernández-Gascón

Peña²,

Grasa

et al. 2013

Journal of Biomechanical Engineering

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This paper describes a method designed to model the repaired herniated human abdomen just after surgery and examine its static mechanical response to the maximum intra-abdominal pressure provoked by a physiological movement (standing cough). The model is based on the real geometry of the human abdomen bearing a large incisional hernia with several anatomical structures differentiated by MRI. To analyze the outcome of hernia repair, the surgical procedure was simulated by modeling a prosthesis placed over the hernia. Three surgical meshes with different mechanical properties were considered: an isotropic heavy-weight mesh (Surgipro®), a slightly anisotropic light-weight mesh (Optilene®), and a highly anisotropic medium-weight mesh (Infinit®). Our findings confirm that anisotropic implants need to be positioned such that the most compliant axis of the mesh coincides with the craneo-caudal direction of the body.

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Section: Model Of the Herniated Humanmentioning

confidence: 99%

“…Two methods were used to include the direction of anisotropy in a previous model of the healthy human abdomen [15]. First, when the angle a is obtained by the fitting procedure, it is taken to represent a PDA.…”

Section: Materials Properties and Preferential Direction Of Anisotropymentioning

confidence: 99%

Mechanical Response of the Herniated Human Abdomen to the Placement of Different Prostheses

Hernández-Gascón

Peña²,

Grasa

et al. 2013

Journal of Biomechanical Engineering

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“…Hernández-Gascón et al 2012), longitudinal and transversal to the human torso. Here, the author analyses different orientations in different hernia placements and shows that the optimal orientation depends on the zone of implantation.…”

Section: Discussionmentioning

confidence: 99%

“…Two main orientations of implant, longitudinal and transversal to the human torso, have been already studied and presented by Hernández-Gascón et al (2012). Although, here five different ventral hernia zones and mesh placements and seven orientations of implant are considered to present the influence of the material orientation in relation to the extreme abdominal deformations identified and shown in Szymczak et al (2012).…”

Section: Introductionmentioning

confidence: 98%

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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“…The mechanical behaviour and the stiffness of the abdominal wall are not a well-documented issue and only a few studies such as e.g Junge et al (2001),Grässel et al (2005),Song et al (2006),Hollinsky and Sandberg (2007),Wolloscheck et al (2004),Szymczak et al (2012). andHernández-Gascón et al (2013) refer to this problem.…”

mentioning

confidence: 97%

Mathematical modelling of implant in an operated hernia for estimation of the repair persistence

Lubowiecka

2013

Computer Methods in Biomechanics and Biomedical Engineering

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This 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 experiments carried out on physical models of implanted mesh. The model can be used to estimate the repair persistence for different mesh materials, fixing systems and different numbers of tacks to be provided during the surgery in order to resist the cough pressure and required action to avoid hernia recurrence. The persistence of the repaired hernia is assessed on the basis of the values of the forces in the tissue-implant joints because the usual form of the repair failure is due to as the joint disconnection or tissue failure.

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Understanding the Passive Mechanical Behavior of the Human Abdominal Wall

Cited by 56 publications

References 32 publications

Mechanical Response of the Herniated Human Abdomen to the Placement of Different Prostheses

Mechanical Response of the Herniated Human Abdomen to the Placement of Different Prostheses

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

Mathematical modelling of implant in an operated hernia for estimation of the repair persistence

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