A Biomechanics Study during complex Abdominal Wall Reconstruction
Research type
Research Study
Full title
A Study of the intra-operative Biomechanics in complex Abdominal Wall Reconstruction: Can we predict reconstruction technique, ventral hernia recurrence and other post-operative complications?
IRAS ID
225928
Contact name
Andrew Plumb
Contact email
Sponsor organisation
Univeristy College London
Clinicaltrials.gov Identifier
Z6364106/2017/08/08, UCL Data Registration number
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
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. We currently do not know if we 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. We propose to study the perioperative changes in abdominal biomechanics and cardiorespiratory physiology after AWR. In addition, we will also analyse the pre-operative patient CT scan to see if there any CT predictors of post-operative cardiorespiratory complications and hernia recurrence. We hypothesise 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
We will carry out an in depth biomechanical and physiological study of 18-22 participants with midline ventral hernias. 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 us to assess when we are subjecting an AWR patient to too much biomechanical and physiological stress. We will measure the abdominal wall tension and strain and see if this predicts post complications and hernia recurrence.REC name
London - Bromley Research Ethics Committee
REC reference
17/LO/1644
Date of REC Opinion
3 Nov 2017
REC opinion
Further Information Favourable Opinion