Int J CARS DOI 10.1007/s11548-017-1681-7 ORIGINAL ARTICLE Computational modeling of abdominal hernia laparoscopic repair with a surgical mesh Silvia Todros 1 · Paola Pachera 1 · Nicola Baldan 2 · Piero G. Pavan 1 · Silvia Pianigiani 1 · Stefano Merigliano 3 · Arturo N. Natali 1 Received: 22 May 2017 / Accepted: 20 October 2017 © CARS 2017 Abstract Purpose Although new techniques and prostheses have been introduced in ventral hernia surgery, abdominal her- nia repair still presents complications, such as recurrence, pain, and discomfort. Thus, this work implements a compu- tational method aimed at evaluating biomechanical aspects of the abdominal hernia laparoscopic repair, which can sup- port clinical research tailored to hernia surgery. Methods A virtual solid model of the abdominal wall is obtained from MRI scans of a healthy subject. The mechan- ical behavior of muscular and fascial tissues is described by constitutive formulations with specific parameters. A defect is introduced to reproduce an incisional hernia. Laparoscopic repair is mimicked via intraperitoneal positioning of a sur- gical mesh. Numerical analyses are performed to evaluate the mechanical response of the abdominal wall in healthy, herniated and post-surgery configurations, considering phys- iological intra-abdominal pressures. Results During the deformation of the abdominal wall at increasing pressures, a percentage displacement increment up to 6% is found in the herniated condition, while the mechanical behavior of the repaired abdomen is similar to the healthy one. In the pressure range between 8 mmHg and 55 mmHg, the herniated abdomen shows an incremental stiff- B Silvia Todros silvia.todros@unipd.it 1 Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, 35131 Padua, Italy 2 Padova General Hospital, via Giustiniani 2, 35128 Padua, Italy 3 Department of Surgery, Oncology and Gastroenterology, III Surgical Clinic, University of Padova, via Giustiniani 2, 35131 Padua, Italy ness differing of 7% with respect to the healthy condition, while the post-surgery condition shows an increase of the incremental stiffness up to 58%. Conclusions This computational approach may be exploited to investigate different aspects of abdominal wall surgical repair, including mesh mechanical characteristics and posi- tioning. Numerical modeling offers a helpful support for selecting the best-fitting prosthesis for customize pre-surgery planning. Keywords Abdominal wall · Laparoscopic hernia repair · Surgical mesh · Computational modeling Introduction Abdominal wall repair represents one of the most common surgical interventions performed every year worldwide [1]. The incisional hernia, which is a frequent complication of abdominal surgery, represents almost 80% of all ventral her- nias [2], and it is reported in up to 11% of patients who underwent previous surgery [3], with an incidence increas- ing up to 23% in case of postoperative infections [4]. Among surgical techniques for ventral and incisional hernia repair, laparoscopic approach with a surgical mesh has been well recognized since recent years [5–8]. However, the principles for the selection of a suitable prosthesis are still controversial [9] and currently based upon surgical experience [3, 4]. Dif- ferent solutions of prostheses may induce postoperative pain, discomfort and limited abdominal mobility, thus reducing life quality in patients [10]. However, the quantitative evaluation of these aspects for every available kind of mesh is difficult to be predicted. In this framework, this study aims at developing a compu- tational model of the abdominal wall, in healthy and herniated 123