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Computational Tools for the Reliability Assessment and the Engineering Design of Procedures and Devices in Bariatric
C Salmaso1,2, I Toniolo3,4, C G Fontanella1,2
1Centre for Mechanics of Biological Materials, University of Padova, Padua, Italy.
Annals of Biomedical Engineering
|May 31, 2020
Summary
Biomechanical analysis of bariatric surgery (BS) reveals how adjustable gastric banding and laparoscopic sleeve gastrectomy impact stomach function and satiety signals. This approach enhances understanding of BS efficacy and safety.
Area of Science:
- Biomechanical Engineering
- Gastroenterology
- Surgical Innovation
Background:
- Obesity is a global health concern, with bariatric surgery (BS) as a primary treatment for severe cases.
- Current BS efficacy assessment relies on empirical data, necessitating a more rational, mechanics-based approach.
- Understanding the biomechanical effects of BS is crucial for improving patient outcomes and procedure reliability.
Purpose of the Study:
- To evaluate stomach functionality post-bariatric procedures using experimental and computational biomechanics.
- To quantify the impact of adjustable gastric banding (AGB) and laparoscopic sleeve gastrectomy (LSG) on stomach capacity and tissue mechanics.
- To investigate how BS influences mechanical stimulation of gastric receptors, potentially affecting satiety signals.
Main Methods:
- Experimental: Insufflation tests on swine stomach samples to determine pressure-volume behavior before and after AGB and LSG.
- Computational: Development of a stomach model to validate experimental findings and simulate stress/strain fields during food ingestion.
- Integration: Combining experimental and computational data to analyze biomechanical responses across different surgical scenarios.
Main Results:
- Both AGB and LSG significantly reduced stomach capacity and increased stiffness, with LSG having a more pronounced effect.
- At 5 kPa pressure, stomach volume decreased from ~1000 mL pre-surgery to ~100 mL after LSG.
- Computational models showed AGB enhanced mechanical stimulation in the fundus, while LSG reduced overall stress/strain intensity.
Conclusions:
- Biomechanics offers a powerful tool for investigating the functional consequences of bariatric surgery.
- The study demonstrates distinct biomechanical impacts of AGB and LSG on stomach mechanics and receptor stimulation.
- Future biomechanical research can enhance the reliability, efficacy, and adoption of bariatric procedures, including novel hybrid techniques.
