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Zhou R, Ding A, Lyu D, Wang C, Wang D. Shear Wave Elastography for Assessment of Changes in Abdominal Soft Tissues after Lipoabdominoplasty. Aesthetic Plast Surg 2024; 48:2668-2676. [PMID: 38148358 DOI: 10.1007/s00266-023-03794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND The changes in the elasticity of the abdominal skin, subcutaneous tissues and muscles after lipoabdominoplasty are still unknown. The aim of this study was to provide an objective assessment of tissue elasticity after lipoabdominoplasty using ultrasound elastography. METHODS A total of 21 female patients (31-41 years old) who underwent lipoabdominoplasty from Oct 2019 to Mar 2022 were included in this retrospective study. The elastography values of the skin, subcutaneous tissues and abdominal muscles were obtained with the ultrasound shear wave elasticity imaging system pre-operation (Pre) and 6 months post-operation (Post) at four different points. RESULTS Twenty-one female patients were included. The elasticity of the abdominal skin, subcutaneous tissues, rectus abdominis and external oblique abdominis significantly increased at 6 months post-operation. The improvements in abdominal soft tissue elasticity were not uniform across the examined points. CONCLUSIONS Significant changes in the elasticity of the abdominal skin, subcutaneous tissues and muscles were observed after lipoabdominoplasty. Ultrasound elastographic assessment was objective and feasible for evaluating the effect of lipoabdominoplasty on abdominal soft tissue. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Renpeng Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China
| | - Angang Ding
- Department of Ultrasonography, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China
| | - Chen Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
| | - Danru Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
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Gueroult P, Joppin V, Chaumoitre K, Di Bisceglie M, Masson C, Bege T. Linea alba 3D morphometric variability by CT scan exploration. Hernia 2024; 28:485-494. [PMID: 38177404 DOI: 10.1007/s10029-023-02939-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/26/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE The width of the Linea alba, which is often gauged by inter-rectus distance, is a key risk factor for incisional hernia and recurrence. Previous studies provided limited descriptions with no consideration for width, location variability, or curvature. We aimed to offer a comprehensive 3D anatomical analysis of the Linea alba, emphasizing its variations across diverse demographics. METHODS Using open source software, 2D sagittal plane and 3D reconstructions were performed on 117 patients' CT scans. Linea alba length, curvature assessed by the sagitta (the longest perpendicular segment between xipho-pubic line and the Linea alba), and continuous width along the height were measured. RESULTS The Linea alba had a rhombus shape, with a maximum width at the umbilicus of 4.4 ± 1.9 cm and a larger width above the umbilicus than below. Its length was 37.5 ± 3.6 cm, which increased with body mass index (BMI) (p < 0.001), and was shorter in women (p < 0.001). The sagitta was 2.6 ± 2.2 cm, three times higher in the obese group (p < 0.001), majorated with age (p = 0.009), but was independent of gender (p = 0.212). Linea alba width increased with both age and BMI (p < 0.001-p = 0.002), being notably wider in women halfway between the umbilicus and pubis (p = 0.007). CONCLUSION This study provides an exhaustive 3D description of Linea alba's anatomical variability, presenting new considerations for curvature. This method provides a patient-specific anatomy description of the Linea alba. Further studies are needed to determine whether 3D reconstruction correlates with pathologies, such as hernias and diastasis recti.
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Affiliation(s)
- P Gueroult
- Laboratoire de Biomécanique Appliquée, Aix Marseille Univ, IFSTTAR UMR T24, Marseille, France.
- Service de chirurgie viscérale et endocrinienne, Angers University Hospital, Rue Larrey, 49933, CEDEX 9, Angers, France.
| | - V Joppin
- Laboratoire de Biomécanique Appliquée, Aix Marseille Univ, IFSTTAR UMR T24, Marseille, France
| | - K Chaumoitre
- Department of Medical Imaging, Aix Marseille Univ, North Hospital, APHM, Marseille, France
- Anthropologie Biologique UMR 7268ADES, Aix Marseille Univ, Marseille, France
| | - M Di Bisceglie
- Department of Medical Imaging, Aix Marseille Univ, North Hospital, APHM, Marseille, France
| | - C Masson
- Laboratoire de Biomécanique Appliquée, Aix Marseille Univ, IFSTTAR UMR T24, Marseille, France
| | - T Bege
- Laboratoire de Biomécanique Appliquée, Aix Marseille Univ, IFSTTAR UMR T24, Marseille, France
- Department of General Surgery, Aix Marseille Univ, North Hospital, APHM, Marseille, France
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Jourdan A, Dhume R, Guérin E, Siegel A, Le Ruyet A, Palmer M. Numerical investigation of a finite element abdominal wall model during breathing and muscular contraction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 244:107985. [PMID: 38185041 DOI: 10.1016/j.cmpb.2023.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND OBJECTIVE Ventral hernia repair is faced with high recurrence rates. The personalization of the diagnosis, the surgical approach and the choice of the prosthetic implant seem relevant axes to improve the current results. Numerical models have the potential to allow this patient-specific approach, yet currently existing models lack validation. This work extensively investigated a realistic finite element abdominal wall model including the implementation of muscle activation. METHODS A parametric 3D finite element model composed of bone, muscle and aponeurotic structures was introduced. Hyperelastic anisotropic materials were implemented. Two loading scenarios were simulated: passive inflation of the abdominal cavity to represent, e.g., breathing, and passive inflation followed by muscular activation to simulate other daily activities such as cough. The impact of the inter-individual variability (e.g., BMI, tissue thickness, material properties, intra-abdominal pressure (IAP) and muscle contractility) on the model outputs was studied through a sensitivity analysis. RESULTS The overall model predictions were in good agreement with the experimental data in terms of shape variation, muscles displacements, strains and midline forces. A total of 34 and 41 runs were computed for the passive and active sensitivity analysis respectively. The regression model fits rendered high R-squared in both passive (84.0 ± 6.7 %) and active conditions (82.0 ± 8.3 %). IAP and muscle thickness were the most influential factors for the selected outputs during passive (breathing) activities. Maximum isometric stress, muscle thickness and pre-activation IAP were found to drive the response of the simulations involving muscular contraction. The material properties of the connective tissue were essential contributors to the behaviour of the medial part of the abdominal wall. CONCLUSIONS This work extensively investigated a realistic abdominal wall model and evaluated its robustness using experimental data from literature. Such a model could improve patient-specific simulation for ventral hernia surgical planning, prevention, and repair or implant evaluation. Further investigations will be conducted to evaluate the impact of the surgical technique and the mechanical characteristic of prosthetic meshes on the model outputs.
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Affiliation(s)
- Arthur Jourdan
- Medtronic, Surgical Operating Unit, General Surgical Technologies, 116 Avenue du Formans, BioTex 01600, Trévoux, France.
| | - Rohit Dhume
- Medtronic, Corporate Core Technologies, MN, USA
| | - Elisabeth Guérin
- Medtronic, Surgical Operating Unit, General Surgical Technologies, 116 Avenue du Formans, BioTex 01600, Trévoux, France
| | - Alice Siegel
- Medtronic, Surgical Operating Unit, General Surgical Technologies, 116 Avenue du Formans, BioTex 01600, Trévoux, France
| | - Anicet Le Ruyet
- Medtronic, Surgical Operating Unit, General Surgical Technologies, 116 Avenue du Formans, BioTex 01600, Trévoux, France
| | - Mark Palmer
- Medtronic, Corporate Core Technologies, MN, USA
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Sahiner Z, Mangır N, Güner M, Ceylan S, Hafizoglu M, Karaduman D, Atbas C, Bas AO, Özer YP, Balcı C, Dogu BB, Halil M, Cankurtaran M. The relationship between urinary incontinence and abdominal muscle thickness in community-dwelling older women undergoing comprehensive geriatric assessment. Eur Geriatr Med 2023; 14:1319-1325. [PMID: 37837573 DOI: 10.1007/s41999-023-00874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Urinary incontinence (UI) is one of the most common geriatric syndromes in older adults, especially in women. The aim of this study is to show the relationship between urinary incontinence and abdominal muscle thickness measured by muscle ultrasonography (US) in community-dwelling older women adults. METHODS Eighty-seven community-dwelling older women participated in our study. The presence and the type of UI were recorded. Clinical and demographic characteristics were collected, and a comprehensive geriatric assessment was performed on all participants. Abdominal muscle layer thicknesses were evaluated with muscle US. RESULTS The prevalence of UI was 55.2% (n = 48) of the study population. The median [IQR] age of the patients in the UI group was 73.0 [69.0-77.5] years and it was 69.0 [67.0-73.0] years in patients without UI (p = 0.007). Abdominal muscle thicknesses were measured smaller in patients with UI than those without UI except for internal oblique muscle thickness. The median [IQR] rectus abdominis muscle thickness was lower in patients with UI than in patients without UI, and the difference was statistically significant (p < 0.003). RA muscle was associated with UI regardless of age, polypharmacy, malnutrition, and frailty (OR: 0.58; 95% CI 0.38-0.89; p = 0.01). CONCLUSIONS We have shown that UI was independently related to the rectus abdominis muscle thickness, which may reflect the function and mass of the pelvic floor muscles.
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Affiliation(s)
- Zeynep Sahiner
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey.
| | - Naside Mangır
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Merve Güner
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Serdar Ceylan
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Merve Hafizoglu
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Didem Karaduman
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Cansu Atbas
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Arzu Okyar Bas
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Yasemin Polat Özer
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Cafer Balcı
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Burcu Balam Dogu
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Meltem Halil
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Mustafa Cankurtaran
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
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Soucasse A, Jourdan A, Edin L, Gillion JF, Masson C, Bege T. A better understanding of daily life abdominal wall mechanical solicitation: Investigation of intra-abdominal pressure variations by intragastric wireless sensor in humans. Med Eng Phys 2022; 104:103813. [DOI: 10.1016/j.medengphy.2022.103813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 02/01/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
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A novel in vivo approach to assess strains of the human abdominal wall under known intraabdominal pressure. J Mech Behav Biomed Mater 2021; 125:104902. [PMID: 34717119 DOI: 10.1016/j.jmbbm.2021.104902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/23/2022]
Abstract
The study concerns mechanical behaviour of a living human abdominal wall. A better mechanical understanding of a human abdominal wall and recognition of its material properties is required to find mechanically compatible surgical meshes to significantly improve the treatment of ventral hernias. A non-invasive methodology, based on in vivo optical measurements is proposed to determine strains of abdominal wall corresponding to a known intraabdominal pressure. The measurement is performed in the course of a standard procedure of peritoneal dialysis. A dedicated experimental stand is designed for the experiment. The photogrammetric technique is employed to recover the three-dimensional surface geometry of the anterior abdominal wall at the initial and terminal instants of the dialysis. This corresponds to two deformation states, before and after filling the abdominal cavity with dialysis fluid. The study provides information on strain fields of living human abdominal wall. The inquiry is aimed at principal strains and their directions, observed at the level from -10% to 17%. The intraabdominal pressure related to the amount of introduced dialysis fluid measured within the medical procedure covers the range 11-18.5 cmH2O. The methodology leads to the deformation state of the abdominal wall according to the corresponding loading conditions. Therefore, the study is a step towards an identification of mechanical properties of living human abdominal wall.
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Shear wave elastography of the lateral abdominal muscles in C-shaped idiopathic scoliosis: a case-control study. Sci Rep 2021; 11:6026. [PMID: 33727639 PMCID: PMC7966386 DOI: 10.1038/s41598-021-85552-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/03/2021] [Indexed: 01/09/2023] Open
Abstract
Considering that knowledge about lateral abdominal muscles (LAM) in idiopathic scoliosis (IS) is still very limited, the aims of this study were: (a) to compare LAM thickness and elasticity between C-shaped IS and non-scoliotic population; and (b) to compare LAM thickness and elasticity between C-shaped thoracic, thoracolumbar, and lumbar IS. A total of 259 adolescents were included in the final analysis; among these, 108 were IS and 151 were non-IS. LAM thickness and elasticity were measured at rest and during isometric contraction by an Aixplorer ultrasound scanner. Out of all LAM, only OE thickness was higher on the convex body side compared to the concave side in lumbar and thoracolumbar scoliosis. It may be related with muscle’s atrophy/hypertrophy or other tissues displacement rather than different force generated by the muscle on both body sides, because an asymmetry in the elasticity of the LAM between the convex and concave side was not presented. The only TrA was stiffer in lumbar scoliosis compared to thoracolumbar and thoracic scoliosis. LAM elasticity was similar in IS and non-IS adolescents.
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Fredon F, Hardy J, Germain M, Vincent-Viry E, Taïbi A, Monteil J, Mabit C, Valleix D, Durand-Fontanier S. Correlations of the rectus abdominis muscle anatomy with anthropometric measurements. Surg Radiol Anat 2021; 43:589-593. [PMID: 33399920 DOI: 10.1007/s00276-020-02655-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The anterior abdominal muscle wall has a strong aesthetic connotation, primarily because of the classical anatomical description of the rectus abdominis muscle in the collective consciousness. However, the morphological reality of the general population considerably deviates from this description. Therefore, we investigated the anthropometric characteristics correlated with the anatomy of the rectus abdominis muscle. METHODS We performed a computed tomography scan anatomical study of recti abdominis muscles in 86 patients with no history of abdominal surgery. We noted the transverse and anteroposterior measurements of the rectus abdominis muscle, the transverse measurement of the linea alba, and the cutaneous and muscular abdominal perimeters. We compared these morphological elements with anthropometric data (sex, age, weight, height, and body mass index [BMI]). RESULTS BMI was positively correlated with cutaneous abdominal perimeter (r = 0.89, p < 0.001) and muscular abdominal perimeter (r = 0.7, p < 0.001). The correlation of BMI with cutaneous abdominal perimeter was not influenced by sex (r = 0.90 and r = 0.89 in men and women, respectively). The correlation of BMI with muscular abdominal perimeter was greater in men than in women (r = 0.80 vs. r = 0.75). The muscular abdominal perimeter was more strongly correlated with the transverse measurement of the rectus abdominis muscle in men than in women (r = 0.75 vs. r = 0.59). The muscular abdominal perimeter was more strongly correlated with the linea alba in women than in men (r = 0.51 vs. r = 0.31). CONCLUSION The anatomy of the anterior abdominal wall correlated with anthropometric data, including BMI. Rectus abdominis muscles and linea alba structures differed between men and women.
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Affiliation(s)
- Fabien Fredon
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France. .,Visceral Surgery Department, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France. .,Service de Chirurgie Digestive, Générale et Endocrinienne, Centre Hospitalier Universitaire de Limoges, 2 Avenue Martin-Luther King, 87000, Limoges, France.
| | - Jérémy Hardy
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France
| | - Mélanie Germain
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France
| | - Emma Vincent-Viry
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France
| | - Abdelkader Taïbi
- Visceral Surgery Department, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France
| | - Jacques Monteil
- Department of Nuclear Medicine, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France
| | - Christian Mabit
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France
| | - Denis Valleix
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France.,Visceral Surgery Department, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France
| | - Sylvaine Durand-Fontanier
- Laboratoire d'Anatomie, Department of Human Anatomy, University of Limoges Faculty of Medicine, 2, Rue du Docteur Marcland, 87025, Limoges, France.,Visceral Surgery Department, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France
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