A preliminary study on the optimal choice of an implant and its orientation in ventral hernia repair

Abstract

This paper addresses the problem of ventral hernia repair. The main goals are to find an optimal surgical mesh for hernia repair and to define its optimal orientation in the abdominal wall to minimise the maximum force at the tissue-implant juncture. The optimal mesh is chosen from a set of orthotropic meshes with different stiffness ratios for typical hernia placement in the abdominal area. The implant is subjected to an anisotropic displacement field, different for the selected hernia placements. The assumed displacement fields correspond to regular human activity. Proper implantation of the mesh may determine the success of hernia repair and/or the postoperative comfort of patients. The proposed solution is based on FEM simulations of different surgical meshes behaviour. In typical hernia placements, the optimal orientation of the stiffer direction of the implant is perpendicular to the spine. However, the presented results show some cases that an oblique direction may be the optimum one.