Mechanical behaviour of the implant used in human hernia repair under physiological loads

In laparoscopic operations of abdominal hernias some recurrences still take place, even when applying a surgical mesh. This is usually caused by a failure of the connection between the tissue and the implant. The study deals with the influence of an implant's orientation on forces in joints, which connect the mesh to human tissues. In the paper, the implant is modelled as a membrane structure within framework of the Finite Element Method. Two models are analysed: in the first one interaction between the mesh and a fascia is taken into account, in the second this interaction is not considered. Computations are conducted for two different material types of the implants: one with isotropic properties and second one with orthotropic properties. The models are validated by comparing dynamic numerical analysis with experimental outcomes, where load was simulating intraabdominal pressure during postoperative cough. Due to displacements of joints during activities like bending sideways or torsion of an abdomen, influence of kinematic extortions on forces in the joints is analysed. The outcome shows that position of the orthotropic implants is crucial and may strongly change the level of forces in the joints.