Mechanical modelling of the abdominal wall and biomaterials for hernia surgery

Hernández Gascón, Belén
Calvo Calzada, Begoña (dir.) ; Peña Baquedano, Estefanía (dir.)

Universidad de Zaragoza, 2013

Abstract: Abdominal surgery for hernia repair is based on the implantation of a synthetic mesh in the defect area which aims at reinforcing the damaged wall. This clinical intervention is common in today's society and, in unfavorable cases such as obese patients or patients with large defects, could lead to a number of problems that reduce the quality of life of patients. The most common problems are the appearance of fibrosis, the hernia recurrence and occurrence of abdominal discomfort due to poor compliance between the host tissue and the prosthesis. Currently, surgeons have no definitive and universally accepted guidelines for the selection of the appropriate prosthesis for each patient and type of defect. Therefore, the choice of one or another mesh, and their placement in case of anisotropic meshes, is a decision to be taken by the surgeons according to their experience. This thesis aims to study the abdominal hernia surgery from the continuum mechanics point of view. However, for the supply and validation of the generated models, it is necessary to perform an experimental study in an animal model. Since this is a multidisciplinary problem, the study approached was developed in collaboration with the Translational Research Group in Biomaterials and Tissue Engineering at the University of Alcalá de Henares (Madrid). The final goal of hernia surgery is that the prosthesis ensures adequate tissular integration, being capable, among other things, to reproduce the mechanical behaviour of the healthy abdominal wall and to absorb the stresses due to the physiological loads to which the abdomen is subjected. Therefore, in addition to addressing the study in animal models to analyze the integration on the wall, the mechanical modelling of the abdominal wall and the biomaterials used in hernia repair is essential. For this, the construction of an ``in silico'' model of the human abdomen has been developed. Due to the diversity of commercial products on the market, this thesis focusses on the study of three representative prostheses, specifically Surgipro, Optilene and Infinit. These meshes are characterized by different geometric parameters and are made of different materials. In this work, the mechanical properties of the prostheses have been determined experimentally and different constitutive models, that reproduce the patterns of the mechanical behaviour observed in both, the abdominal muscle and implanted biomaterials, have been proposed. Specifically, the numerical modelling of the response of the abdominal muscle, including both active and passive responses, and prostheses have been approached within the framework of the nonlinear hyperelasticity in large deformations. The latter approach of this thesis aims to model, using the finite element method, the mechanical response of the wall with the implanted mesh. A complete model of the human abdomen has been defined from nuclear magnetic resonance imaging. This complete model allows differentiating the main anatomical units of the abdomen and it is used to simulate the passive and active responses. Furthermore, this model allows the study of the response of the healthy wall and the analysis of the final mechanical response of the herniated human abdomen to the placement of different prostheses. In summary, this thesis establishes a methodology to the automation of computational models for personalized surgical procedures in order to select the most appropriate mesh for each patient as well as the appropriate placement on the defect in the case of anisotropic prostheses.

Pal. clave: biomecánica ; simulación ; ensayo de materiales ; cirugía abdominal

Knowledge area: Ingeniería mecánica

Department: Ingeniería Mecánica

Nota: Presentado: 01 03 2013
Nota: Tesis-Univ. Zaragoza, Ingeniería Mecánica, 2013


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 Record created 2014-11-20, last modified 2019-02-19

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