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Pectopexy to repair vaginal vault prolapse: a finite element approach

  • The vaginal prolapse after hysterectomy (removal of the uterus) is often associated with the prolapse of the vaginal vault, rectum, bladder, urethra or small bowel. Minimally invasive surgery such as laparoscopic sacrocolpopexy and pectopexy are widely performed for the treatment of the vaginal prolapse with weakly supported vaginal vault after hysterectomy using prosthetic mesh implants to support (or strengthen) lax apical ligaments. Implants of different shape, size and polymers are selected depending on the patient’s anatomy and the surgeon’s preference. In this computational study on pectopexy, DynaMesh®-PRP soft, GYNECARE GYNEMESH® PS Nonabsorbable PROLENE® soft and Ultrapro® are tested in a 3D finite element model of the female pelvic floor. The mesh model is implanted into the extraperitoneal space and sutured to the vaginal stump with a bilateral fixation to the iliopectineal ligament at both sides. Numerical simulations are conducted at rest, after surgery and during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues and prosthetic meshes are modeled as incompressible, isotropic hyperelastic materials. The positions of the organs are calculated with respect to the pubococcygeal line (PCL) for female pelvic floor at rest, after repair and during Valsalva maneuver using the three meshes.

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Metadaten
Author:Aroj BhattaraiORCiD, Manfred StaatORCiD
Parent Title (English):Proceedings CMBBE 2018
Editor:P.R. Fernandes, J. M. Tavares
Document Type:Conference Proceeding
Language:English
Year of Completion:2018
Date of the Publication (Server):2018/04/03
Note:
15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization. CMBBE 2018. 26-29 March 2018, Lisbon, Portugal
Link:http://cmbbe2018.tecnico.ulisboa.pt/pen_cmbbe2018/pdf/WEB_PAPERS/CMBBE2018_paper_148.pdf
Zugriffsart:weltweit
Institutes:FH Aachen / Fachbereich Medizintechnik und Technomathematik
FH Aachen / IfB - Institut für Bioengineering