title: Prostheses size dependency of the mechanical response of the herniated human abdomen.
abstract: BACKGROUND
  Hernia repairs still exhibit clinical complications, i.e. recurrence, discomfort and pain and mesh features are thought to be highly influent. The aim of this study is to evaluate the impact of the defect size and mesh type in an herniated abdominal wall using numerical models.
  
  
  METHODS
  To do so, we have started from a FE model based on a real human abdomen geometry obtained by MRI, where we have provoked an incisional hernia of three different sizes. The surgical procedure was simulated by covering the hernia with a prostheses, and three surgical meshes with distinct mechanical properties were used for the hernia repair: an isotropic heavy-weight mesh (Surgipro@), a slightly anisotropic light-weight mesh (Optilene@) and a highly anisotropic medium-weight mesh (Infinit@). The mechanical response of the wall to a high intraabdominal pressure (corresponding to a coughing motion) was analyzed here.
  
  
  RESULTS
  Our findings suggest that the anisotropy of the mesh becomes more relevant with the increase of the defect size. Additionally, according to our results Optilene@showed the closest deformation to the natural distensibility of the abdomen while Infinit@should be carefully used due to its excessive compliance.
authors.affiliation: Applied Mechanics and Bioengineering, Aragón Institute of Engineering Research, University of Zaragoza, Saragossa, Spain. rsimon@unizar.es.|CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain. rsimon@unizar.es.
authors.forename: R
authors.initials: R
authors.lastname: Simón-Allué
authors.affiliation: Applied Mechanics and Bioengineering, Aragón Institute of Engineering Research, University of Zaragoza, Saragossa, Spain.|CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Hernández-Gascón
authors.affiliation: Ecole Centrale de Centrale Nantes, Nantes, France.
authors.forename: L
authors.initials: L
authors.lastname: Lèoty
authors.affiliation: CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.|Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Bellón
authors.affiliation: Applied Mechanics and Bioengineering, Aragón Institute of Engineering Research, University of Zaragoza, Saragossa, Spain.|CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Peña
authors.affiliation: Applied Mechanics and Bioengineering, Aragón Institute of Engineering Research, University of Zaragoza, Saragossa, Spain.|CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Calvo
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D016880:Anisotropy; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D020342:Finite Element Analysis; D046449:Hernia, Abdominal / Q000503:physiopathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D000069290:Incisional Hernia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008422:Materials Testing; D016062:Porosity; D011474:Prosthesis Design; D013526:Surgical Mesh / Q000009:adverse effects*
keywords: Failure; Finite element analysis; Hernia; Polypropylene mesh; Repair