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

Hernández-Gascón, Belén; Peña, Estefanía; Grasa, J.; Pascual, Gemma; Bellón, Juan M.; Calvo, Begoña

doi:10.1115/1.4023703

Cited by 29 publications

(7 citation statements)

References 36 publications

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“…6). This observation corresponds to the results obtained experimentally by Anurov et al (2012) and numerically by Hernández-Gascón et al (2013), who investigated only two orientations of a surgical mesh in the central area of the abdominal wall. However, also a frequent solution of our optimisation scheme is 75 deg especially for hernia located in zone 4.…”

Section: Discussionsupporting

confidence: 90%

“…The principle that the properties of surgical meshes should match the properties of the abdominal wall and that implants should be oriented in the human body in accordance with the mechanics of the abdominal wall has been reported in the literature since 2001 (Junge et al, 2001). This issue was discussed e.g., by Kirilova et al (2012), Hernández-Gascón et al (2013), Anurov et al (2012). All these studies are limited to just one position of hernia orifice and two perpendicular orientations of implants.…”

Section: Introductionmentioning

confidence: 99%

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A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

Lubowiecka

Szepietowska

Szymczak

et al. 2016

jtam

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This 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 displacement field, different for the selected hernia placements. The assumed displacement fields correspond to regular human activity. Proper implantation of the mesh may determine the success of hernia repair and/or the postoperative comfort of patients. The proposed solution is based on FEM simulations of different surgical meshes behaviour. In typical hernia placements, the optimal orientation of the stiffer direction of the implant is perpendicular to the spine. However, the presented results show some cases that an oblique direction may be the optimum one.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

Lubowiecka

Szepietowska

Szymczak

et al. 2016

jtam

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“…It is shown that inappropriate positioning of anisotropic biomesh causes violation of endoprosthesis structure . The placement of an isotropic prosthesis reduce the influence on the mechanical behaviour . In this point of view, genipin is the most suitable agent for the cross‐linking DBP.…”

Section: Discussionmentioning

confidence: 99%

Chemical cross‐linking of xenopericardial biomeshes: A bottom‐up study of structural and functional correlations

Grebenik

Истранов

Истранова

et al. 2019

Xenotransplantation

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Decellularized bovine pericardium (DBP)-based biomeshes are the gold standard in reconstructive surgery. In order to prolong their stability after the transplantation, various chemical cross-linking strategies are employed. However, structural and functional properties of the biomeshes differ in dependence on the cross-linker used. Here, we performed a bottom-up study of structural and functional alterations of DBP-based biomeshes following cross-linking with hexamethylene diisocyanate (HMDC), ethylene glycol diglycidyl ether (EGDE), 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) and genipin. The in vitro cytotoxicity tests supported their clinical applicability. Their structural differences (eg roughness, fibre thickness, pore morphology) were evaluated using the two-photon confocal laser scanning, atomic force, scanning electron and polarized light microscopies. HMDC and EDC samples appeared to be the roughest. Complex mechanical trials indicated the tendency to reduced Young's Modulus and mechanical anisotropy values of DBP upon cross-linking. The lowest mechanical anisotropy was found in EDC and genipin sample groups.In vitro collagenase susceptibility was the highest for EDC samples and the lowest for EGDE samples. The comparative analysis of the results allowed us to recognize the strengths and weaknesses of each cross-linker in relation to a particular clinical application. K E Y W O R D Sbiomechanics, bovine pericardium, cross-linking, decellularization, reconstructive surgery

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“…In another work, Hernández‐Gascón et al developed a numerical model of the repaired herniated abdomen based on an MRI solid model of the human abdomen with a large incisional hernia [Figure 7(a)]. They included different anatomical components, such as muscles and aponeuroses.…”

Section: Computational Modelingmentioning

confidence: 99%

Synthetic surgical meshes used in abdominal wall surgery: Part II—Biomechanical aspects

et al. 2015

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This work reports the second part of a review on synthetic surgical meshes used for abdominal hernia repair. While material and structural characteristics, together with mesh-tissue interaction, were considered in a previous article (Part I), biomechanical behavior is described here in more detail. The role of the prosthesis is to strengthen the impaired abdominal wall, mimicking autologous tissue without reducing its compliance. Consequently, mesh mechanical properties play a crucial role in a successful surgical repair. The main available techniques for mechanical testing, such as uniaxial and biaxial tensile testing, ball burst, suture retention strength, and tear resistance testing, are described in depth. Among these methods, the biaxial tensile test is the one that can more faithfully reproduce the physiological loading condition. An outline of the most significant results documented in the literature is reported, showing the variety of data on mesh mechanical properties. Synthetic surgical meshes generally follow a non-linear stress-strain behavior, with mechanical characteristics dependant on test direction due to mesh anisotropy. Ex-vivo tests revealed an increased stiffness in mesh explants due to the gradual ingrowth of the host tissue after implant. In general, the absence of standardization in test methods and terminology makes it difficult to compare results from different studies. Numerical models of the abdominal wall interacting with surgical meshes were also discussed representing a potential tool for the selection of suitable prostheses. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 892-903, 2017.

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

Cited by 29 publications

References 36 publications

A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

Chemical cross‐linking of xenopericardial biomeshes: A bottom‐up study of structural and functional correlations

Synthetic surgical meshes used in abdominal wall surgery: Part II—Biomechanical aspects

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