Ventral Hernia Clinical Trial
Official title:
A Study of the Intra-operative Biomechanics in Complex Abdominal Wall Reconstruction: Do Changes in Abdominal Biomechanics Correlate With Significant Changes in Lung Compliance and Respiratory Function?
Background: A detailed study of the biomechanical changes before and after abdominal wall
reconstruction (AWR) has not been performed. Changes in abdominal wall tension and
intra-abdominal pressure have physiological consequences on respiratory and cardiology
function. AWR surgeons currently do not know if they are applying too much tension when
re-aligning the abdominal wall muscles during AWR. Too much tension is likely to cause
respiratory and cardiac post-operative complications. The investigators propose to study the
perioperative changes in abdominal biomechanics and cardiorespiratory physiology after AWR.
In addition, investigators will also analyze the pre-operative patient CT scan to see if
there any CT predictors of post-operative cardiorespiratory complications and hernia
recurrence. The researchers hypothesize that there is a threshold value or force at which
ventral hernias are repaired 'too tight' subjecting the patient to the increased risk of
recurrence and cardiorespiratory complications.
Method: An in depth biomechanical and physiological study of 18-22 participants with midline
ventral hernias will be carried out. Ventral hernias at least 5cm in width and only those in
which primary fascial closure have been achieved will be included. Any operative technique
used to achieve primary fascial closure will be included. Biomechanical and physiological
measurements will be taken at five separate stages during the course of the patients'
abdominal wall reconstruction. The final lung function tests, taken six weeks post op, will
be compared to the patients' pre-operative tests. Meticulous attention will be paid to the
study protocol making sure that in each patient the measurements are all taken at the same
time and under the same conditions.
Discussion: This full biomechanical and physiological work up will enable AWR surgeons to
assess when an AWR patient is subjected to too much biomechanical and physiological stress.
The abdominal wall tension and strain will be measured to see if this predicts post
complications and hernia recurrence.
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