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    Item type:Publication, Access status: without files ,
    Dynamic intermittent strain can rapidly impair ventral hernia repair
    (2015-11-26)
    Kallinowski, Friedrich
    ;
    Baumann, Elena
    ;
    Harder, Felix
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    Siassi, Michael
    ;
    Mahn, Axel
    Ventral hernia repair fails frequently despite advanced mesh inserting surgery. A model for dynamic intermittent straining (DIS) of ventral hernia repairs was developed. The influence of phospholipids, position, overlap, fixation and tissue quality of various meshes on the durability of hernia repair was studied.DIS comprises the repetition of submaximal impacts delivered via a hydraulically driven plastic containment. Pig tissues simulate a ventral hernia with a standardized 5. cm defect. Commercially available meshes strengthened with tacks, glue and sutures were used to bridge this defect in an underlay (IPOM) or sublay (retromuscular) position starting with a 5. cm overlap in all directions. We tested 35 different ways of ventral hernia repair with up to 425 submaximal intermittent dynamic impacts until mesh dislocation occurred 10 times or a maximum of 4000 impacts each were withstood.The likelihood of a failing repair was related to the mesh, the lubricants, the position, the overlap, the fixation and the tissue quality. Most meshes dislocated easily and required fixation. One of the meshes tested was stable without fixation with a 5. cm overlap and failed after reducing the overlap. Phospholipids exerted a strong influence on the biomaterial tested. The sublay position was about 10% more durable in comparison to the IPOM position. DIS revealed distinct degrees of stability with primarily stable, intermediate and primarily unstable repairs.Based on the DIS results available, the currently used ventral hernia repair options can be classified. In the future, DIS investigations can improve the durability of hernia repair.
    Publicationtype: Journal Article
      146
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    Item type:Publication, Access status: with files ,
    Development of a dynamic model for ventral hernia mesh repair
    (Springer, 2014-08-21)
    Siassi, Michael
    ;
    Mahn, Axel
    ;
    Baumann, Elena
    ;
    Vollmer, Matthias
    ;
    Huber, Gerd
    Introduction: The adequate way of mesh fixation in laparoscopic ventral hernia repair is still subject to debate. So far, simulation has only been carried out in a static way, thereby omitting dynamic effects of coughing or vomiting. We developed a dynamic model of the anterior abdominal wall.
    Publicationtype: Journal Article
    Scopus© Citations 10  91  134