In recent years, there has been a striking interest in the prevention of PH with prosthetic meshes 7– 13. Even though PH is a very frequent problem (with reported incidences as high as 78 % 1 or 86 % 2 when identified by computed tomography) it is difficult to treat and has a huge impact on the quality of life of patients who suffer from it 3– 6. One of the most common complications of ostomies is the appearance of a parastomal hernia (PH) after the construction of the stoma. The opening created is called stoma and it is placed on the abdominal wall.
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This procedure is used to treat certain diseases related to the digestive or urinary tract. The level of trephine deformation depends on stoma location with considerably higher trephine enlargements found in stomas laterally located with respect to the rectus abdominis muscle.Īn ostomy is the creation of an artificial opening into the abdominal wall (AW) through which bodily waste is rerouted outside of the body. Trephine perimeter and area respectively increased by as much as 44 % and 85 %. No significant dependence was found between stoma location and the levels of abdominal wall deformations or stress supported by tissues, except for the case with a stoma located on the linea alba. We focus on factors related to the risk of parastomal hernia development such as the deformation experienced by the abdominal wall, the stress levels supported by its tissues and the corresponding level of trephine enlargement. We consider seventeen different locations for the stoma incision (trephine) and we simulate the mechanical response of the abdominal wall when an intraabdominal pressure as high as 20 kPa is applied. Our simulation methodology is entirely based on open source software. We perform three-dimensional finite element simulations on an anatomy model which was generated on the basis of medical images.
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We assess the effects of stoma location on the abdominal wall mechanics. An ostomy is a surgical procedure by which an artificial opening in the abdominal wall, known as a stoma, is created.