Authors: Maciej Śmietański Kamil Bury Agnieszka Tomaszewska Izabela Lubowiecka Czesław Szymczak
Publish Date: 2011/12/15
Volume: 26, Issue: 5, Pages: 1461-1467
Abstract
Intraabdominal pressure often is blamed as the cause of mesh–fascia junction failure after laparoscopic ventral hernia repair Stretching of the mesh during a cough or defecation may lead to recurrence Little is known about the movements of mesh in the abdominal cavity after this operation This study investigated the front abdominal wall to describe its elasticity in vivo and searched for elongations that possibly stretched an implanted mesh thereby causing fixation failure and subsequent recurrenceTo measure front abdominal wall elongations a model of fascia movements was created Eight healthy volunteers were measured during exercise to determine the extent of elongations in their front abdominal wall Videos were analyzed in three positions to create a mathematical shell structure A computerized model based on the net movement of nodes was calculated to determine the axes and values for maximum elongationsThe largest average elongations were measured for the upper midline 3208 and the transverse line in the low lateral area 3406 The maximum values for these lines were larger than 100 for the middle line 13378 and exceeded 50 for the entire middle line The values for the horizontal lines did not reach 10 at any level According to these data areas of both high and low elasticity were definedMaciej Śmietański received a consulting fee for serving on the Advisory Committee of Johnson Johnson Medical Products 20082010 and honoraria by Ethicon Poland Covidien Poland Covimed Poland And WL Gore for speaking and teaching Kamil Bury Agnieszka Tomaszewska Izabela Lubowiecka and Czesław Szymczak have no conflicts of interests or financial ties to disclosure
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