Publicación: An approach to evaluating and benchmarking the mechanical behavior of a surgical mesh prototype designed for the repair of abdominal wall defects
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2021-10-28
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info:eu-repo/semantics/openAccess
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Elsevier
Resumen
Ventral hernia repair is a common surgical procedure in abdominal surgery in which surgical mesh has become an essential tool to improve outcomes. To avoid recurrences the mesh needs to mimic the mechanical behavior of the abdominal wall. In this scenario the mechanical properties at the interface between the mesh and its surrounding tissue is critical for the performance of the device and, therefore, the success after surgery.
We aimed to characterize and compare the mechanical behavior of the patented prototype mesh Spider and four commercial meshes at the mesh-tissue interface. The prototype mesh was designed based on the hypothesis that the best performance for a large-sized defect in a ventral hernia is obtained when the mesh presents an isotropic behavior. In contrast, commercial meshes presented significant anisotropic behavior.
Mechanical properties of the meshes were characterized through uniaxial tensile tests. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus in each axis was determined. The degree
of anisotropy was calculated as the ratio between the elastic modulus in each axis.
An in silico model of the ventral hernia defect was designed to simulate the mesh-tissue interface behavior via finite element method. Meshes were modelled by an hyperelastic orthotropic constitutive model, which allowed isotropic symmetry as particular case for the prototype mesh. Abdominal wall was modelled using a Neo-Hookean model. Once the simulations were launched, mesh-tissue interface behavior was evaluated through the difference between Von Mises stress values on either size of the interface, both on the external and the internal face of the mesh and abdominal wall.
Mechanical response was anisotropic for all commercial meshes and isotropic for the Spider prototype. Among commercial, Ultrapro® was highly anisotropic. Tests revealed Gore-Tex® to be the stiffest, followed by Repol Angimesh® , Spider and Ultrapro®; Duramesh was found to be the most compliant.
Concerning mesh-tissue behavior, simulation results revealed the Spider prototype and Duramesh to be the best; Spider due to its uniformity and lower stress difference thanks to its nearly isotropic behavior, and Duramesh due to its compliant behavior.
Our results suggest that the compromise between stiffness and anisotropy must be considered in order to improve the mechanical performance of the meshes, bearing in mind that for large-sized ventral defects, nearly isotropic mesh ensures better performance.
Descripción
The registered version of this article, first published in Journal of the Mechanical Behavior of Biomedical Materials, is available online at the publisher's website: Elsevier, https://doi.org/10.1016/j.jmbbm.2021.104909
La versión registrada de este artículo, publicado por primera vez en Journal of the Mechanical Behavior of Biomedical Materials, está disponible en línea en el sitio web del Elsevier: EDITOR, https://doi.org/10.1016/j.jmbbm.2021.104909
La versión registrada de este artículo, publicado por primera vez en Journal of the Mechanical Behavior of Biomedical Materials, está disponible en línea en el sitio web del Elsevier: EDITOR, https://doi.org/10.1016/j.jmbbm.2021.104909
Categorías UNESCO
Palabras clave
hernia repair, mesh repair, abdominal wall, anisotropy, FE simulation
Citación
C. García-García, M.T. Carrascal-Morillo, J.T. Castell Gómez, C. Bernal Guerrero, J.C. García Prada, An approach to evaluating and benchmarking the mechanical behavior of a surgical mesh prototype designed for the repair of abdominal wall defects, Journal of the Mechanical Behavior of Biomedical Materials, Volume 125, 2022, 104909, ISSN 1751-6161, https://doi.org/10.1016/j.jmbbm.2021.104909.
Centro
Facultades y escuelas::E.T.S. de Ingenieros Industriales
Departamento
Mecánica