title: Physical and mathematical modelling of implant-fascia system in order to improve laparoscopic repair of ventral hernia.
abstract: BACKGROUND
  This paper describes an investigation of biomechanical behaviour of hernia repair, which is focused on the selection of safe linking of certain type of implant with fascia in laparoscopic operation. The strength of various fixations of the implant to the fascia is analysed.
  
  
  METHODS
  The research is based on experimental observations of operated hernia model behaviour during a dynamic impulse load corresponding to post-operative cough. Fifty seven different types of models of implanted mesh are considered. Five types of implants and five types of connectors are used. Mechanical properties of the implants as well as limit tearing forces of joints are identified in uni-axial tensile tests. Mathematical model of implanted mesh based on finite element method is proposed. The identified mechanical properties of the materials are applied and the model is calibrated using quantities measured during experiments.
  
  
  RESULTS
  The presented results point at trans-abdominal sutures and ProTacks (connectors) and at DynaMesh (implant) as the most reliable materials used in ventral hernia operation, in the tested materials group. Desired properties of implants seem to be: elastic properties similar to the properties of tissues and high local strength, as fixation have a local character. The proposed mathematical model can be applied to simulate real behaviour of an implant with appropriate accuracy and to estimate the number of tacks for the implantation of hernia meshes.
  
  
  CONCLUSIONS
  The presented results may help in the deeper understanding of the fascia-mesh system behaviour, and thus may lead to improve the fixation methods.
authors.affiliation: Gdańsk University of Technology, Faculty of Civil and Environmental Engineering, Department of Structural Mechanics and Bridge Structures, Narutowicza 11/12, 80-233 Gdańsk, Poland. Electronic address: atomas@pg.gda.pl.
authors.forename: A
authors.initials: A
authors.lastname: Tomaszewska
authors.forename: I
authors.initials: I
authors.lastname: Lubowiecka
authors.forename: C
authors.initials: C
authors.lastname: Szymczak
authors.forename: M
authors.initials: M
authors.lastname: Smietański
authors.forename: B
authors.initials: B
authors.lastname: Meronk
authors.forename: P
authors.initials: P
authors.lastname: Kłosowski
authors.forename: K
authors.initials: K
authors.lastname: Bury
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D002138:Calibration; D000071938:Fasciotomy; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008962:Models, Theoretical; D019736:Prostheses and Implants; D013526:Surgical Mesh; D013537:Sutures; D016474:Weight-Bearing
keywords: Biomechanics; Experiment; Mathematical modelling; Physical modelling; Ventral hernia