title: Mobility and stress analysis of different surgical simulations during a sacral colpopexy, using a finite element model of the pelvic system.
abstract: OBJECTIVE
  We aim to analyze the combined influence of the size of the mesh, the number of sutures, the combined use of an anterior and posterior mesh, and the tension applied to the promontory, on the mobility of the pelvic organs and on the sutures, using a Finite Element (FE) model of the female pelvic system during abdominal sacral colpopexy.
  
  
  METHODS
  We used a FE model of the female pelvic system, which allowed us to simulate the mobility of the pelvic system and to evaluate problems related to female prolapse. The meshes were added to the geometrical model and then transferred to computing software. This analysis allowed us to compare the stress and mobility during a thrust effort in different situations.
  
  
  RESULTS
  The bigger the mesh, the less mobility of both anterior and posterior organs there would be. This is accompanied by an increase in stress at the suture level. The combination of a posterior mesh with an anterior one decreases mobility and stress at the suture level. There is a particularly relevant stressing zone on the suture at the cervix. The increase in the number of sutures induces a decrease in the tension applied at each suture zone and has no impact on organ mobility.
  
  
  CONCLUSIONS
  Our model enables us to simulate and analyze an infinite number of surgical hypotheses. Even if these results are not validated at a clinical level, we can observe the importance of the association of both an anterior and a posterior mesh or the number of sutures.
authors.affiliation: Hopital Jeanne de Flandre, CHRU de Lille, University Lille-Nord de France, 1 rue Eugène Avinée, 59037, Lille Cedex, France. estelle.jdg@gmail.com.|Laboratoire Mécanique de Lille, UMR CNRS 8107, Ecole Centrale de Lille, 59651, Villeneuve d'Ascq, France. estelle.jdg@gmail.com.
authors.forename: Estelle
authors.initials: E
authors.lastname: Jeanditgautier
authors.affiliation: Laboratoire Mécanique de Lille, UMR CNRS 8107, Ecole Centrale de Lille, 59651, Villeneuve d'Ascq, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mayeur
authors.affiliation: Laboratoire Mécanique de Lille, UMR CNRS 8107, Ecole Centrale de Lille, 59651, Villeneuve d'Ascq, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Brieu
authors.affiliation: Hopital Mere-enfant, CHRU Lyon, Lyon, France.
authors.forename: Gery
authors.initials: G
authors.lastname: Lamblin
authors.affiliation: Hopital Jeanne de Flandre, CHRU de Lille, University Lille-Nord de France, 1 rue Eugène Avinée, 59037, Lille Cedex, France.|Laboratoire Mécanique de Lille, UMR CNRS 8107, Ecole Centrale de Lille, 59651, Villeneuve d'Ascq, France.
authors.forename: Chrystele
authors.initials: C
authors.lastname: Rubod
authors.affiliation: Hopital Jeanne de Flandre, CHRU de Lille, University Lille-Nord de France, 1 rue Eugène Avinée, 59037, Lille Cedex, France.|Laboratoire Mécanique de Lille, UMR CNRS 8107, Ecole Centrale de Lille, 59651, Villeneuve d'Ascq, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Cosson
mesh_terms: D003198:Computer Simulation; D005260:Female; D020342:Finite Element Analysis; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008954:Models, Biological; D010388:Pelvis / Q000502:physiology*; D013526:Surgical Mesh; D013537:Sutures
keywords: Finite element model; Sacral colpopexy