Towards Understanding of Mechanics of Hernia Managed by Synthetic Mesh in Laparoscopic Operation: A Single Case Study
In this paper a research towards understanding of mechanics of ventral hernia operated with the use of Physiomesh Open image in new window implant and SecureStrap Open image in new window staples is described. Experimental and numerical studies are conducted for that purpose. Experimental works cover uni-axial tension tests of the implant samples and of the implant-staples-tissue system. Also experiments on implant-staples-tissue models, representing operated hernia, subjected to impulse pressure loading are performed. Based on that, constitutive model of the mesh has been identified and failure load of the staples has been determined. In the experiments on the operated hernia systems subjected to pressure loading safe loading level has been determined and failure modes connected to higher pressure values have been observed. Finally, in the numerical simulations of the operated hernia model, built according to FEM rules, it has been proved that failures observed experimentally result from exceeding of the load bearing capacity of the staples considered in this study.
KeywordsMechanics in medicine Mechanical properties Hernia management
Calculations have been carried out at the Academic Computer Centre in Gdańsk. This work has been partially supported by the National Science Centre (Poland) [grant No. UMO-2017/27/B/ST8/02518].
- 2.Burger, J.W., Luijendijk, R.W., Hop, W.C., Halm, J.A., Verdaasdonk, E.G., Jeekel, J.: Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Trans. Meet. Am. Surg. Assoc. CXXII, 176–183 (2004). https://doi.org/10.1097/01.sla.0000141193.08524.e7CrossRefGoogle Scholar
- 3.Sauerland, S., Walgenbach, M., Habermalz, B., Seiler, C.M., Miserez, M.: Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst. Rev. (2011). https://doi.org/10.1002/14651858.cd007781.pub2
- 6.Pawlak, M., Hilgers, R.D., Bury, K., Lehmann, A., Owczuk, R., Śmietański, M.: Comparison of two different concepts of mesh and fixation technique in laparoscopic ventral hernia repair: a randomized controlled trial. Surg. Endosc. 30(3), 1188–1197 (2015). https://doi.org/10.1007/s00464-015-4329-0CrossRefGoogle Scholar
- 8.Branicki, C., Kłosowski, P.: Static analysis of hanging textile membranes in nonlinear approach. Arch. Civ. Eng. 29(3), 189–220 (1983)Google Scholar
- 10.Ambroziak, A., Kłosowski, P.: Review of constitutive models for technical woven fabrics in finite element analysis. AATCC Rev. 11(3), 58–67 (2011)Google Scholar
- 11.Tomaszewska, A., Lubowiecka, I., Szymczak, C., Śmietański, M., Meronk, B., Kłosowski, P., Bury, K.: Physical and mathematical modelling of implant-fascia system in order to improve laparoscopic repair of ventral hernia. Clin. Biomech. 28(7), 743–751 (2013). https://doi.org/10.1016/j.clinbiomech.2013.06.009CrossRefGoogle Scholar
- 16.Szymczak, C., Lubowiecka, I., Tomaszewska, A., Smietanski, M.: Modeling of the fascia-mesh system and sensitivity analysis of a junction force after a laparoscopic ventral hernia repair. J. Theor. Appl. Mech. 48(4), 933–950 (2010). http://ptmts.org.pl/jtam/index.php/jtam/article/view/v48n4p933/283Google Scholar