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Hernia

, Volume 8, Issue 3, pp 233–241 | Cite as

Inguinal hernia: Measurement of the biomechanics of the lower abdominal wall and the inguinal canal

  • T. Wolloscheck
  • A. Gaumann
  • A. Terzic
  • A. Heintz
  • Th. Junginger
  • M. A. KonerdingEmail author
Original Article

Abstract

Background. The stability of the lower abdominal wall may play a considerable role in the development of inguinal hernia. Therefore, the strength of the individual wall layers needs to be quantified. Despite numerous advances in hernia repair, comparatively few systematic biomechanic and morphometric analyses have been performed. Our aim was to establish and apply a standardised procedure for testing the abdominal wall layers’ stability. Methods. After dissecting the abdominal walls of 16 cadavers into separate layers, we used a spherical punch and a force transducer to investigate the forces necessary to foraminate the layer. In addition, maximum tensile-strength and suction tests and histologic morphometry were performed. Results. The transversalis fascia was torn up on an average of 10.5 N, the peritoneum including pre- and subperitoneal tissue on 46.6 N, the aponeurosis of obliquus internus abdominis muscle on 51.7 N, and the aponeurosis of obliquus externus abdominis muscle on 92.6 N. Tensile tests of tissue strips obtained from defined areas showed comparable results. In contrast, surgical mesh revealed values between 60 and 150 N in punching tests. Left-right comparisons, as well as comparisons of the individual areas, revealed considerable intra- and inter-individual differences. Conclusions. Biological hernia repair should focus on a reinforcement of the tissue layers with the highest biomechanic stability. Reinforcement of the transversal fascia must be questioned according to our results of poor mechanical resistance.

Keywords

Abdominal wall Biomechanics Fascia Hernia Inguinal 

Notes

Acknowledgements

The authors thank Dipl. Ing. Klaus Wolloscheck for the design of the tensile-strength test device, Hugo Bockius and Wolfgang Kern, University of Mainz, for the precision mechanical construction of the tensile and punching-test device, and Courage & Khazaka Electronics (Cologne, Germany), who kindly provided a skin-elasticity meter (Cutometer SEM 575).

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • T. Wolloscheck
    • 1
  • A. Gaumann
    • 1
  • A. Terzic
    • 2
  • A. Heintz
    • 2
  • Th. Junginger
    • 2
  • M. A. Konerding
    • 1
    Email author
  1. 1.Department of AnatomyJohannes Gutenberg-Universität MainzMainzGermany
  2. 2.Department of SurgeryJohannes Gutenberg-University of MainzGermany

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