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Sample records for surgical mesh

  1. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  2. Hernia Surgical Mesh Implants

    Science.gov (United States)

    ... knitted mesh or non-knitted sheet forms. The synthetic materials used can be absorbable, non-absorbable or a combination of absorbable and non-absorbable materials. Animal-derived mesh are made of animal tissue, such as intestine or skin, that has been processed and disinfected to be ...

  3. Anisotropic evaluation of synthetic surgical meshes.

    Science.gov (United States)

    Saberski, E R; Orenstein, S B; Novitsky, Y W

    2011-02-01

    The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Six different polypropylene (Trelex(®), ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh(®), Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex(®), ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh(®) was the least anisotropic mesh, without marked difference between the axes. Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.

  4. Surgical excision of eroded mesh after prior abdominal sacrocolpopexy.

    Science.gov (United States)

    South, Mary M T; Foster, Raymond T; Webster, George D; Weidner, Alison C; Amundsen, Cindy L

    2007-12-01

    We previously described an endoscopic-assisted transvaginal mesh excision technique. This study compares surgical outcomes after transvaginal mesh excision vs endoscopic-assisted transvaginal mesh excision. In addition, we reviewed our postoperative outcomes with excision via laparotomy. This was an inclusive retrospective analysis of patients presenting to our institution from 1997 to 2006 for surgical management of vaginal erosion of permanent mesh after sacrocolpopexy. Three techniques were utilized: transvaginal, endoscopic-assisted transvaginal, and laparotomy. For the patients undergoing transvaginal excision, data recorded included number and type of excisions performed, number of prior excisions performed at outside facilities, intraoperative and postoperative complications (including blood transfusions, pelvic abscess, or bowel complications), use of postoperative antibiotics, persistent symptoms of vaginal bleeding and discharge at follow-up, and demographic characteristics. The intraoperative and postoperative complications and the postoperative symptoms were recorded for the laparotomy cases. Thirty-one patients underwent transvaginal mesh excision during this time period: 17 endoscopic-assisted transvaginal and 14 transvaginal without endoscope assistance. In addition, a total of 7 patients underwent abdominal excision via laparotomy. Comparison of the 2 vaginal methods revealed no difference in the demographics or success rate, with success defined as no symptoms at follow-up. Endoscopic-assisted transvaginal excision was successful in 7 of 17 patients and transvaginal without endoscopic assistance in 9 of 13 patients (1 patient excluded for lack of follow-up data) for a total vaginal success rate of 53.3%. No intraoperative and only minor postoperative complications occurred with either vaginal method. Three patients underwent 3 vaginal attempts to achieve complete symptom resolution. The average follow-up time for the entire vaginal group was 14

  5. Surgical management of lower urinary mesh perforation after mid-urethral polypropylene mesh sling: mesh excision, urinary tract reconstruction and concomitant pubovaginal sling with autologous rectus fascia.

    Science.gov (United States)

    Shah, Ketul; Nikolavsky, Dmitriy; Gilsdorf, Daniel; Flynn, Brian J

    2013-12-01

    We present our management of lower urinary tract (LUT) mesh perforation after mid-urethral polypropylene mesh sling using a novel combination of surgical techniques including total or near total mesh excision, urinary tract reconstruction, and concomitant pubovaginal sling with autologous rectus fascia in a single operation. We retrospectively reviewed the medical records of 189 patients undergoing transvaginal removal of polypropylene mesh from the lower urinary tract or vagina. The focus of this study is 21 patients with LUT mesh perforation after mid-urethral polypropylene mesh sling. We excluded patients with LUT mesh perforation from prolapse kits (n = 4) or sutures (n = 11), or mesh that was removed because of isolated vaginal wall exposure without concomitant LUT perforation (n = 164). Twenty-one patients underwent surgical removal of mesh through a transvaginal approach or combined transvaginal/abdominal approaches. The location of the perforation was the urethra in 14 and the bladder in 7. The mean follow-up was 22 months. There were no major intraoperative complications. All patients had complete resolution of the mesh complication and the primary symptom. Of the patients with urethral perforation, continence was achieved in 10 out of 14 (71.5 %). Of the patients with bladder perforation, continence was achieved in all 7. Total or near total removal of lower urinary tract (LUT) mesh perforation after mid-urethral polypropylene mesh sling can completely resolve LUT mesh perforation in a single operation. A concomitant pubovaginal sling can be safely performed in efforts to treat existing SUI or avoid future surgery for SUI.

  6. Surface orientation effects on bending properties of surgical mesh are independent of tensile properties.

    Science.gov (United States)

    Simon, David D; Andrews, Sharon M; Robinson-Zeigler, Rebecca; Valdes, Thelma; Woods, Terry O

    2018-02-01

    Current mechanical testing of surgical mesh focuses primarily on tensile properties even though implanted devices are not subjected to pure tensile loads. Our objective was to determine the flexural (bending) properties of surgical mesh and determine if they correlate with mesh tensile properties. The flexural rigidity values of 11 different surgical mesh designs were determined along three textile directions (machine, cross-machine, and 45° to machine; n = 5 for each) using ASTM D1388-14 while tracking surface orientation. Tensile testing was also performed on the same specimens using ASTM D882-12. Linear regressions were performed to compare mesh flexural rigidity to mesh thickness, areal mass density, filament diameter, ultimate tensile strength, and maximum extension. Of 33 mesh specimen groups, 30 had significant differences in flexural rigidity values when comparing surface orientations (top and bottom). Flexural rigidity and mesh tensile properties also varied with textile direction (machine and cross-machine). There was no strong correlation between the flexural and tensile properties, with mesh thickness having the best overall correlation with flexural rigidity. Currently, surface orientation is not indicated on marketed surgical mesh, and a single mesh may behave differently depending on the direction of loading. The lack of correlation between flexural stiffness and tensile properties indicates the need to examine mesh bending stiffness to provide a more comprehensive understanding of surgical mesh mechanical behaviors. Further investigation is needed to determine if these flexural properties result in the surgical mesh behaving mechanically different depending on implantation direction. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 854-862, 2018. © 2017 Wiley Periodicals, Inc.

  7. Surgical Management of Pelvic floor Prolapse in women using Mesh

    African Journals Online (AJOL)

    RAH

    polytetrafluoroethylene) . This article reviews our experience with polypropylene mesh in pelvic floor repair at the. Southern General Hospital Glasgow. The objective was to determine the safety and effectiveness of the prolene mesh in the repair ...

  8. Mechanical behaviour of synthetic surgical meshes: finite element simulation of the herniated abdominal wall.

    Science.gov (United States)

    Hernández-Gascón, B; Peña, E; Melero, H; Pascual, G; Doblaré, M; Ginebra, M P; Bellón, J M; Calvo, B

    2011-11-01

    The material properties of meshes used in hernia surgery contribute to the overall mechanical behaviour of the repaired abdominal wall. The mechanical response of a surgical mesh has to be defined since the haphazard orientation of an anisotropic mesh can lead to inconsistent surgical outcomes. This study was designed to characterize the mechanical behaviour of three surgical meshes (Surgipro®, Optilene® and Infinit®) and to describe a mechanical constitutive law that accurately reproduces the experimental results. Finally, through finite element simulation, the behaviour of the abdominal wall was modelled before and after surgical mesh implant. Uniaxial loading of mesh samples in two perpendicular directions revealed the isotropic response of Surgipro® and the anisotropic behaviour of Optilene® and Infinit®. A phenomenological constitutive law was used to reproduce the measured experimental curves. To analyze the mechanical effect of the meshes once implanted in the abdomen, finite element simulation of the healthy and partially herniated repaired rabbit abdominal wall served to reproduce wall behaviour before and after mesh implant. In all cases, maximal displacements were lower and maximal principal stresses higher in the implanted abdomen than the intact wall model. Despite the fact that no mesh showed a behaviour that perfectly matched that of abdominal muscle, the Infinit® mesh was able to best comply with the biomechanics of the abdominal wall. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  9. Seeking new surgical predictors of mesh exposure after transvaginal mesh repair.

    Science.gov (United States)

    Wu, Pei-Ying; Chang, Chih-Hung; Shen, Meng-Ru; Chou, Cheng-Yang; Yang, Yi-Ching; Huang, Yu-Fang

    2016-10-01

    The purpose of this study was to explore new preventable risk factors for mesh exposure. A retrospective review of 92 consecutive patients treated with transvaginal mesh (TVM) in the urogynecological unit of our university hospital. An analysis of perioperative predictors was conducted in patients after vaginal repairs using a type 1 mesh. Mesh complications were recorded according to International Urogynecological Association (IUGA) definitions. Mesh-exposure-free durations were calculated by using the Kaplan-Meier method and compared between different closure techniques using log-rank test. Hazard ratios (HR) of predictors for mesh exposure were estimated by univariate and multivariate analyses using Cox proportional hazards regression models. The median surveillance interval was 24.1 months. Two late occurrences were found beyond 1 year post operation. No statistically significant correlation was observed between mesh exposure and concomitant hysterectomy. Exposure risks were significantly higher in patients with interrupted whole-layer closure in univariate analysis. In the multivariate analysis, hematoma [HR 5.42, 95 % confidence interval (CI) 1.26-23.35, P = 0.024), Prolift mesh (HR 5.52, 95 % CI 1.15-26.53, P = 0.033), and interrupted whole-layer closure (HR 7.02, 95 % CI 1.62-30.53, P = 0.009) were the strongest predictors of mesh exposure. Findings indicate the risks of mesh exposure and reoperation may be prevented by avoiding hematoma, large amount of mesh, or interrupted whole-layer closure in TVM surgeries. If these risk factors are prevented, hysterectomy may not be a relative contraindication for TVM use. We also provide evidence regarding mesh exposure and the necessity for more than 1 year of follow-up and preoperative counselling.

  10. In vivo characterization of Hyalonect, a novel biodegradable surgical mesh.

    Science.gov (United States)

    Rhodes, Nicholas P; Hunt, John A; Longinotti, Cristina; Pavesio, Alessandra

    2011-06-01

    Musculoskeletal reconstructive surgery often requires removal of significant quantities of bone tissue, such as the periosteum, causing critical problems following surgery like friction between different tissues and adhesion of soft tissues to the underlying bone. We studied the long-term host response and closure of large bone defects for periosteal reconstruction using Hyalonect, a novel membrane comprising knitted fibers of esterified hyaluronan, (HYAFF11). For biological characterization, 162 rats were used in a defect model in which a section of the dorsal muscular fascia was removed, and the membrane behavior observed over 540 d using conventional histology, with sham operated rats as controls. In addition, Hyalonect was used to cover defects made in the humeri of 7 dogs, filled with a variety of conventional bone filling compounds, and the regeneration process observed after 6 wks using histology. Low levels of inflammation were observed in the dorsal muscle fascia defect model, with cellular colonization of the mesh by 30 d, vascularization by 120 days, matrix fiber organization by 270 d, and the appearance of connective tissue identical to the surrounding tissue between 365 and 540 d, without the formation of fibrotic tissue. In addition, Hyalonect was shown to allow the regeneration of bone within the humeral defects whilst preventing fibrotic tissue in-growth, and allowing regeneration of tissue which, by 6 wk, had begun to resemble natural periosteal tissue. Hyalonect is suitable for improving the outcome of the final phases of orthopedic and trauma reconstructive surgical procedures, especially in the reconstruction of periosteal tissue. Copyright © 2011. Published by Elsevier Inc.

  11. The Effect of Cyclic Loading on the Mechanical Performance of Surgical Mesh

    Directory of Open Access Journals (Sweden)

    Ho Y.C.

    2010-06-01

    Full Text Available Polymeric meshes in the form of knitted nets are commonly used in the surgical repair of pelvic organ prolapses. Although a number of these prosthetic meshes are commercially available, there is little published data on their mechanical performance, in particular on the change in stiffness under the repeated loading experienced in vivo. In this in vitro study, cyclic tensile loading was applied to rectangular strips of four different commercially available meshes. The applied force and resultant displacement was monitored throughout the tests in order to evaluate the change in stiffness. In addition, each mesh was randomly marked using indelible ink in order to permit the use of threedimensional digital image correlation to evaluate local displacements during the tests. However, the scale and form of the deformation experienced by some of the meshes made correlation difficult so that confirmation of the values of stiffness were only obtained for two meshes. The results demonstrate that all the meshes experience an increase in stiffness during cyclic loading, that in most cases cyclic creep occurs and in some cases large-scale, irreversible reorganisation of the mesh structure occurs after as few as 200 cycles at loads of the order of 10N.

  12. Obstetrical and Gynecological Devices; Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair; Final order.

    Science.gov (United States)

    2016-01-05

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to reclassify surgical mesh for transvaginal pelvic organ prolapse (POP) repair from class II to class III. FDA is reclassifying these devices based on the determination that general controls and special controls together are not sufficient to provide reasonable assurance of safety and effectiveness for this device, and these devices present a potential unreasonable risk of illness or injury. The Agency is reclassifying surgical mesh for transvaginal POP repair on its own initiative based on new information.

  13. Surgical treatment of subcostal incisional hernia with polypropylene mesh - analysis of late results

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Oliveira Peres

    Full Text Available OBJECTIVE: To evaluate the results of subcostal incisional hernia repair using polypropylene mesh, the technical aspects of musculo-aponeurotic reconstruction, routine fixation of supra-aponeurotic mesh and follow-up for five years.METHODS: We conducted a retrospective study that assessed 24 patients undergoing subcostal incisional hernia repair with use of polypropylene mesh; 15 patients (62.5% were female; ages ranged from 33 to 82, and 79.1% had comorbidities.RESULTS: Early complications: three cases (12.5% of wound infection, three cases (12.5% of seroma, one case (4.1% of hematoma; and one case (4.1% of wound dehiscence. Late complications occurred in one case (4.1% of hernia recurrence attributed to technical failure in the fixation of the mesh and in one case (4.1% of chronic pain. There were no cases of exposure or rejection of the mesh.CONCLUSION: The subcostal incisional hernia, though not very relevant, requires adequate surgical treatment. Its surgical correction involves rebuilding the muscle-aponeurotic defect, supra-aponeurotic fixation of polypropylene mesh, with less complexity and lower rates of complications and recurrences.

  14. The Importance of Registries in the Postmarketing Surveillance of Surgical Meshes.

    Science.gov (United States)

    Köckerling, Ferdinand; Simon, Thomas; Hukauf, Martin; Hellinger, Achim; Fortelny, Rene; Reinpold, Wolfgang; Bittner, Reinhard

    2017-06-07

    To assess the role of registries in the postmarketing surveillance of surgical meshes. To date, surgical meshes are classified as group II medical devices. Class II devices do not require premarket clearance by clinical studies. Ethicon initiated a voluntary market withdrawal of Physiomesh for laparoscopic use after an analysis of unpublished data from the 2 large independent hernia registries-Herniamed German Registry and Danish Hernia Database. This paper now presents the relevant data from the Herniamed Registry. The present analysis compares the prospective perioperative and 1-year follow-up data collected for all patients with incisional hernia who had undergone elective laparoscopic intraperitoneal onlay mesh repair either with Physiomesh (n = 1380) or with other meshes recommended in the guidelines (n = 3834). Patients with Physiomesh repair had a markedly higher recurrence rate compared with the other recommended meshes (12.0% vs 5.0%; P manufacturing company must be taken into account.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

  15. Risk factors of surgical failure following transvaginal mesh repair for the treatment of pelvic organ prolapse.

    Science.gov (United States)

    Long, Cheng-Yu; Lo, Tsia-Shu; Wang, Chiu-Lin; Wu, Chin-Hu; Liu, Cheng-Min; Su, Juin-Huang

    2012-04-01

    To identify the factors associated with pelvic organ prolapse (POP) recurrence after transvaginal mesh (TVM) repair. One hundred and thirteen women with symptomatic POP stage II to IV were scheduled for TVM procedures. All subjects underwent urinalyses and pelvic examination using the POP quantification (POP-Q) staging system before and after surgery. Seven (6.2%) of 113 women reported POP recurrence after a mean follow-up time of 30 months. We performed a univariate analysis of patients' characteristics to identify the predictors of surgical failure after TVM. There was no difference between two groups as to body mass index, POP stage, mesh type, and preoperative urinary symptoms and urodynamic parameters (P>0.05). However, we found that uterine prolapse (P=0.016) and surgical experience (P=0.043) were two significant predictors of surgical failure. Multivariate logistic regression showed similar results. Advanced uterine prolapse and lack of surgical experience were two significant predictors of failure following TVM. POP recurrence after mesh repair appears to be unlikely beyond the learning curve. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  16. [TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

    Science.gov (United States)

    Adamík, Z

    2006-01-01

    Assessment of the effects of a new surgical method for complex resolution of pelvic floor defects. Case study. Department of Obstetrics and Gynaecology, Bata Hospital, Zlín. We evaluated the procedures and results of the new TVM (transvaginal mesh) surgical method which we used in a group of 12 patients. Ten patients had vaginal prolapse following vaginal hysterectomy and in two cases there was uterine prolapse and vaginal prolapse. Only in one case there was a small protrusion in the range of 0.5 cm which we resolved by removal of the penetrated section. The resulting anatomic effect was very good in all the cases.

  17. Hip Joint Replacement Using Monofilament Polypropylene Surgical Mesh: An Animal Model

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    Jacek Białecki

    2014-01-01

    Full Text Available Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS, triple pelvic osteotomy (TPO, total hip replacement (THR, and femoral head and neck resection (FHNE. The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform.

  18. Biodegradable rifampicin-releasing coating of surgical meshes for the prevention of bacterial infections

    Directory of Open Access Journals (Sweden)

    Reinbold J

    2017-09-01

    Full Text Available Jochen Reinbold,1 Teresa Hierlemann,1 Lukas Urich,1 Ann-Kristin Uhde,1 Ingrid Müller,2 Tobias Weindl,3 Ulrich Vogel,4 Christian Schlensak,1 Hans Peter Wendel,1 Stefanie Krajewski1 1Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Tübingen, 2Department of Pharmaceutical Engineering, Albstadt-Sigmaringen University of Applied Science, Albstadt, 3Aimecs® GmbH Medical Solutions, Pfarrkirchen, 4Institute of Pathology and Neuropathology, Tübingen, Germany Abstract: Polypropylene mesh implants are routinely used to repair abdominal wall defects or incisional hernia. However, complications associated with mesh implantation, such as mesh-related infections, can cause serious problems and may require complete surgical removal. Hence, the aim of the present study was the development of a safe and efficient coating to reduce postoperative mesh infections. Biodegradable poly(lactide-co-glycolide acid microspheres loaded with rifampicin as an antibacterial agent were prepared through single emulsion evaporation method. The particle size distribution (67.93±3.39 µm for rifampicin-loaded microspheres and 64.43±3.61 µm for unloaded microspheres was measured by laser diffraction. Furthermore, the encapsulation efficiency of rifampicin (61.5%±2.58% was detected via ultraviolet–visible (UV/Vis spectroscopy. The drug release of rifampicin-loaded microspheres was detected by UV/Vis spectroscopy over a period of 60 days. After 60 days, 92.40%±3.54% of the encapsulated rifampicin has been continuously released. The viability of BJ fibroblasts after incubation with unloaded and rifampicin-loaded microspheres was investigated using an MTT (3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide assay, which showed no adverse effects on the cells. Furthermore, the antibacterial impact of rifampicin-loaded microspheres and mesh implants, coated with the antibacterial microspheres, was investigated using an agar diffusion

  19. Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

    Science.gov (United States)

    2016-01-05

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to require the filing of a premarket approval application (PMA) or notice of completion of a product development protocol (PDP) for surgical mesh for transvaginal pelvic organ prolapse (POP) repair.

  20. Risk factors for surgical site infection after transvaginal mesh placement in a nationwide Japanese cohort.

    Science.gov (United States)

    Kamei, Jun; Yazawa, Satoshi; Yamamoto, Shingo; Kaburaki, Naoto; Takahashi, Satoru; Takeyama, Masami; Koyama, Masayasu; Homma, Yukio; Arakawa, Soichi; Kiyota, Hiroshi

    2018-03-01

    We conducted a nationwide survey on perioperative management and antimicrobial prophylaxis of transvaginal mesh surgeries for pelvic organ prolapse in Japan to understand the practice and risk factors for surgical site infection (SSI). Health records of women undergoing tension-free vaginal mesh (TVM) surgeries from 2010 to 2012 were obtained from 135 medical centers belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI. The hospital volume among institutions varied from 0 to 248 per year (median 16.7). Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 74 (55%), 66 (49%), and 24 (18%) hospitals, respectively. Prophylactic antimicrobials used were mostly first-generation (43%) or second-generation (42%) cephalosporin. SSI was reported in 86 of 9323 patients (0.92%). A multivariate analysis indicated lower hospital volume (odds ratio [OR], 0.995 [by 1-point increase]; P < 0.001), preoperative bowel preparation (OR, 2.08; P = 0.013), non-routine urine culture (OR, 3.00; P = 0.0006), and the use of antibiotics other than first-generation cephalosporin (OR, 5.29; P = 0.0011) as significant risk factors for SSI. In contrast, the cut-off points of hospital volume for preventing SSI was 116.7 cases (area under curve: 0.61). The prevalence of SSI in TVM surgeries was 0.92% in Japan. Lower hospital volume, bowel preparation, non-routine preoperative urine culture, and prophylactic antibiotics other than first-generation cephalosporin significantly elevated the incidence of SSI. © 2018 Wiley Periodicals, Inc.

  1. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    2012-01-01

    The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice.

  2. Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh.

    Science.gov (United States)

    Carracedo, D; López-Fando, L; Sánchez, M D; Jiménez, M Á; Gómez, J M; Laso, I; Rodríguez, M Á; Burgos, F J

    2017-03-01

    The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5,985.7 €±1,550.8 € vs. 6,534.3 €±1,015.5 €), although it did not achieve statistical signification. In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Long-term anisotropic mechanical response of surgical meshes used to repair abdominal wall defects.

    Science.gov (United States)

    Hernández-Gascón, B; Peña, E; Pascual, G; Rodríguez, M; Bellón, J M; Calvo, B

    2012-01-01

    Routine hernia repair surgery involves the implant of synthetic mesh. However, this type of procedure may give rise to pain and bowel incarceration and strangulation, causing considerable patient disability. The purpose of this study was to compare the long-term behaviour of three commercial meshes used to repair the partially herniated abdomen in New Zealand White rabbits: the heavyweight (HW) mesh, Surgipro(®) and lightweight (LW) mesh, Optilene(®), both made of polypropylene (PP), and a mediumweight (MW) mesh, Infinit(®), made of polytetrafluoroethylene (PTFE). The implanted meshes were mechanical and histological assessed at 14, 90 and 180 days post-implant. This behaviour was compared to the anisotropic mechanical behaviour of the unrepaired abdominal wall in control non-operated rabbits. Both uniaxial mechanical tests conducted in craneo-caudal and perpendicular directions and histological findings revealed substantial collagen growth over the repaired hernial defects causing stiffness in the repair zone, and thus a change in the original properties of the meshes. The mechanical behaviour of the healthy tissue in the craneo-caudal direction was not reproduced by any of the implanted meshes after 14 days or 90 days of implant, whereas in the perpendicular direction, SUR and OPT achieved similar behaviour. From a mechanical standpoint, the anisotropic PP-lightweight meshes may be considered a good choice in the long run, which correlates with the structure of the regenerated tissue. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    Directory of Open Access Journals (Sweden)

    Argirović Rajka

    2011-01-01

    Full Text Available Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA. Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. Results. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13% patients isolated anterior mesh in 52 (54% patients and isolated posterior mesh in 32 (33% patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3% patients, shrinkage of mesh in 6 (6.2% patients and de novo urinary incontinence in 5 (5.2% patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic. Conclusion. Our study suggests that transvaginal polypropylene mesh applied with a tensionfree technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.

  5. [Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure].

    Science.gov (United States)

    Argirović, Rajka; Berisavac, Milica; Likić-Ladević, Ivana; Kadija, Sasa; Bosković, Vladimir; Zizić, Vojislav

    2011-07-01

    Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA). A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who underwent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13%) patients isolated anterior mesh in 52 (54%) patients and isolated posterior mesh in 32 (33%) patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3%) patients, shrinkage of mesh in 6 (6.2%) patients and de novo urinary incontinence in 5 (5.2%) patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic). Our study suggests that transvaginal polypropylene mesh applied with a tension-free technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.

  6. Analysis of Surgical Outcomes and Determinants of Litigation Among Women With Transvaginal Mesh Complications.

    Science.gov (United States)

    Zoorob, Dani; Karram, Mickey; Stecher, Anna; Maxwell, Rose; Whiteside, James

    To identify litigation predictors among women with complications of transvaginal mesh. Chart review and patient survey were conducted among women who had undergone a complication-related explant of a transvaginal prolapse or incontinence sling mesh. Trained study personnel administered a 57-question survey addressing subjective complaints related to bowel, bladder, sexual dysfunction, and development of pain or recurrent prolapse. These data were analyzed with respect to the subject's reported pursuit of litigation related to the mesh complication. Categorical and continuous variables were analyzed using the χ test and the t test as indicated. Ninety-five (68%) of 139 women completed the surveys with 60% of the patients pursuing litigation at the time of the survey. Individual risk factors for pursuing litigation included development of vaginal pain after mesh placement (P = 0.01); dyspareunia after mesh placement (P = 0.01); persistence of dyspareunia, suprapubic pain, and groin pain after mesh excision (P = 0.04, P = 0.02, and P = 0.001, respectively); unsuccessful attempts at conservative management of pelvic pain using pelvic floor rehabilitation (P = 0.002). There is an association between a higher likelihood of pursuing litigation and new-onset or persistent pain symptoms attributable to transvaginal mesh.

  7. Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelvic Organ Prolapse

    Science.gov (United States)

    Ellington, David R.; Richter, Holly E.

    2013-01-01

    Women are seeking care for pelvic organ prolapse (POP) in increasing numbers and a significant proportion of them will undergo a second repair for recurrence. This has initiated interest by both surgeons and industry to utilize and design prosthetic mesh materials to help augment longevity of prolapse repairs. Unfortunately, the introduction of transvaginal synthetic mesh kits for use in women was done without the benefit of Level 1 data to determine its utility compared to native tissue repair. This report summarizes the potential benefit/risks of transvaginal synthetic mesh use for POP and recommendations regarding its continued use. PMID:23563869

  8. High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy

    NARCIS (Netherlands)

    van Iersel, J. J.; Formijne Jonkers, H. A.; Verheijen, P. M.; Draaisma, W. A.; Consten, E. C J; Broeders, I. A M J

    2016-01-01

    Purpose: To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. Methods: All consecutive patients receiving LVMR

  9. Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelvic Organ Prolapse

    OpenAIRE

    Ellington, David R.; Richter, Holly E.

    2013-01-01

    Women are seeking care for pelvic organ prolapse (POP) in increasing numbers and a significant proportion of them will undergo a second repair for recurrence. This has initiated interest by both surgeons and industry to utilize and design prosthetic mesh materials to help augment longevity of prolapse repairs. Unfortunately, the introduction of transvaginal synthetic mesh kits for use in women was done without the benefit of Level 1 data to determine its utility compared to native tissue repa...

  10. Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa.

    Science.gov (United States)

    Wang, Y T; Meheš, M M; Naseem, H-R; Ibrahim, M; Butt, M A; Ahmed, N; Wahab Bin Adam, M A; Issah, A-W; Mohammed, I; Goldstein, S D; Cartwright, K; Abdullah, F

    2014-08-01

    Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.

  11. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    OpenAIRE

    Argirović Rajka; Berisavac Milica; Likić-Lađević Ivana; Kadija Saša; Bošković Vladimir; Žižić Vojislav

    2011-01-01

    Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA). Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent...

  12. The Disability Impact and Associated Cost per Disability in Women Who Underwent Surgical Revision of Transvaginal Mesh Kits for Prolapse Repair.

    Science.gov (United States)

    Javadian, Pouya; Shobeiri, S Abbas

    2017-09-13

    The aim of this study was to investigate disability impact in patients and cost to the families of patients who have had complications of transvaginal prolapse mesh kits and underwent surgical revision. Patients who developed complications of transvaginal mesh kits for prolapse and who had undergone vaginal prolapse mesh surgical revision/removal in 2009 to 2014 at a single institution were identified by Current Procedural Terminology codes. The group was invited to complete a phone survey pertaining to the initial vaginal mesh used for prolapse surgery utilizing Sheehan Disability Scale (scale 0-10) and Years of life Lived with Disability (YLDs) questionnaires. The data collected were used to estimate the disability and cost analysis. We used our data to estimate the economic and quality-of-life impact of vaginal mesh complications on patients in the United States RESULTS: Sixty-two patients (62/198 [31.2%]) were consented to participate and completed the questionnaires by phone. Extremely disabled patients were 18 (29%) of 62 of whole cases, and 5 (8%) of 62 reported that they had no disability after vaginal mesh surgery. The median for overall disability score after vaginal mesh procedure was 8 (which reflects marked disability on a scale of 0-10). The majority of patients missed a median of 12 months of their school or work because of their mesh complications. Thirty-seven (59.6%) of 62 did not improve after mesh removal. Twenty-one (33.9%) of 62 stated that their family income dropped because of productivity loss related to mesh complications. The mean time between vaginal mesh surgery and mesh removal procedure was 4.7 years. Sheehan Disability Scale scores are significantly correlated with YLDs outcomes. Patients' overall disability score showed a significant correlation with YLDs scores (P mesh for prolapse reduction complications had a sustained disability impact that continued despite mesh removal. Likewise, the complications were associated with

  13. TOT versus TVT – mesh surgical treatment in stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Ovidiu Bratu

    2015-12-01

    Full Text Available Introduction: Stress urinary incontinence is a highly debilitating condition, with an important impact over the quality of life. When the conservative treatment fails, the surgical treatment is a viable solution. Minimally invasive sling procedures have become the gold standard of surgical management for stress urinary incontinence (SUI in women. Material and methods: The study was conducted on 68 patients with stress urinary incontinence, 52 have undergone the retropubic tension-free vaginal tape and 16 patients were operated using the transobturator tape procedure. All the patients were evaluated before the operation and the indication of the surgical treatment was established on the basis of physical examination (all the patients had positive cough test, abdominal ultrasound (to determine postvoid residual urine volume, urinalysis and urine culture (the majority of the patients have had before the operation recurrent urinary tract infections. Results: The satisfaction was similar in both groups of patients, with an average satisfaction rate of 91% for TVT and 86% for the patients who have undergone TOT procedure. The patients were in a proportion of 78,9% at menopause, with an average number of natural births of 1.9 and a mean BMI of 28.2. Regarding the surgical duration, this has varied between 20 and 40 minutes, being higher in the TVT cases (up to 5-7 minutes longer than TOT, because cystoscopy was performed during the operation to verify if the bladder was perforated or not. The urethral catheter was removed immediately after the operation in the case of the TOT procedure and in the day after the operation for the patients who have undergone TVT procedures (all of these patients associated genital prolapse. The hospitalization time was 3 days. We haven’t encountered significant intraoperative and postoperative complications. Conclusions: The TOT and TVT procedures have proven to be highly effective and safe methods in the treatment of

  14. High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy.

    Science.gov (United States)

    van Iersel, J J; Formijne Jonkers, H A; Verheijen, P M; Draaisma, W A; Consten, E C J; Broeders, I A M J

    2016-04-01

    To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. All consecutive patients receiving LVMR at the Meander Medical Centre, Amersfoort, the Netherlands, between 2004 and 2013 were analyzed. Kaplan-Meier estimates were calculated for recurrences. A total of 420 patients underwent LVMR. Sixty-five of these patients (actuarial 5-year incidence 24.3, 95 % confidence interval (CI) 18.6-30.0) developed symptomatic grade III/IV hemorrhoids requiring stapled or excisional hemorrhoidectomy. Re-do surgery for recurrent grade III/IV hemorrhoids was required for 15 of the 65 patients (actuarial 5-year recurrence rate 40.6, 95 % CI 23.2-58.0) after the primary hemorrhoidectomy. Three of the 65 patients developed an external rectal prolapse (ERP) recurrence and eight an internal rectal prolapse (IRP) recurrence. This generated a 5-year recurrence rate of 25.3 % (95 % CI 0-53.9) for ERP recurrence and 24.4 % (95 % CI 9.1-39.7) for IRP recurrence. The rest of the LVMR cohort not receiving additional surgery for hemorrhoids (n = 355) showed significantly lower actuarial 5-year ERP (0.8 %, p = 0.011) and IRP (11 %, p = 0.020) recurrence rates. High-grade hemorrhoids requiring surgery may be common after LVMR. The development of high-grade hemorrhoids after LVMR might be considered a predictor of rectal prolapse recurrence.

  15. A Comparison of the Incidence of Early Postoperative Infections between Patients Using Synthetic Mesh and Those Undergoing Traditional Pelvic Reconstructive Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Jaromír Mašata

    2013-01-01

    Full Text Available New mesh-related complications such as erosion, etc., can result from abnormal postoperative healing due to surgical site infection. The aim of our study was to compare systemic inflammatory responses and the incidence of early infectious complications after reconstructive surgery using synthetic mesh and after traditional vaginal wall repair. In this prospective observational study 99 women with symptomatic pelvic organ prolapse were included; 55 women underwent traditional repair and 44 repair using mesh. After the procedure infectious complications were monitored. The patients who underwent reconstructive surgery using mesh material were more likely to have febrile morbidity in the postoperative period than the patients who had been treated with traditional repair (p=0.031; there was a higher incidence of combination febrile morbidity with elevated C-reactive protein (CRP > 50 mg/l; p=0.046, and a higher incidence of CRP increase over 30 mg/l; p=0.005. Reconstructive procedures using synthetic mesh are accompanied by a higher incidence of early post-operative infectious complications.

  16. Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years' median follow-up.

    Science.gov (United States)

    de Landsheere, Laurent; Ismail, Sharif; Lucot, Jean-Philippe; Deken, Valérie; Foidart, Jean-Michel; Cosson, Michel

    2012-01-01

    The aim of this study was to explore the nature and rate of surgical intervention after transvaginal Prolift mesh repair for pelvic organ prolapse. This was a retrospective study of all patients who underwent Prolift mesh repair between January 2005 and January 2009. Patient data were obtained from medical records, and patients were telephoned to check if they had surgery in other hospitals. A total of 600 consecutive patients were identified. Of these, 524 patients (87.3%) were included in the study, with a median follow-up duration of 38 months (range, 15-63). Global reoperation rate was 11.6%. Indications of intervention were surgery for urinary incontinence (6.9%), mesh-related complications (3.6%), or prolapse recurrence (3%). The global reoperation rate after transvaginal Prolift mesh repair was 11.6%, with urinary incontinence surgery being the most common indication. Rates of mesh complications and prolapse recurrence are relatively low in an experienced team. Copyright © 2012 Mosby, Inc. All rights reserved.

  17. Surgical management of a De Garengeot’s hernia using a biologic mesh: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Amandine Klipfel

    2017-01-01

    Conclusion: The De Garengeot hernia is an uncommon differential diagnosis for patients presenting with clinical signs of strangled femoral hernia. Although hernia repairs with a synthetic mesh in the presence of appendicitis have been reported, we describe a case of femoral hernia repair using a biologic mesh, in a patient with a De Garengot hernia.

  18. Biaxial Mechanical Evaluation of Absorbable and Nonabsorbable Synthetic Surgical Meshes Used for Hernia Repair: Physiological Loads Modify Anisotropy Response.

    Science.gov (United States)

    Cordero, A; Hernández-Gascón, B; Pascual, G; Bellón, J M; Calvo, B; Peña, E

    2016-07-01

    The aim of this study was to obtain information about the mechanical properties of six meshes commonly used for hernia repair (Surgipro(®), Optilene(®), Infinit(®), DynaMesh(®), Ultrapro™ and TIGR(®)) by planar biaxial tests. Stress-stretch behavior and equibiaxial stiffness were evaluated, and the anisotropy was determined by testing. In particular, equibiaxial test (equal simultaneous loading in both directions) and biaxial test (half of the load in one direction following the Laplace law) were selected as a representation of physiologically relevant loads. The majority of the meshes displayed values in the range of 8 and 18 (N/mm) in each direction for equibiaxial stiffness (tangent modulus under equibiaxial load state in both directions), while a few achieved 28 and 50 (N/mm) (Infinit (®) and TIGR (®)). Only the Surgipro (®) mesh exhibited planar isotropy, with similar mechanical properties regardless of the direction of loading, and an anisotropy ratio of 1.18. Optilene (®), DynaMesh (®), Ultrapro (®) and TIGR (®) exhibited moderate anisotropy with ratios of 1.82, 1.84, 2.17 and 1.47, respectively. The Infinit (®) scaffold exhibited very high anisotropy with a ratio of 3.37. These trends in material anisotropic response changed during the physiological state in the human abdominal wall, i.e. T:0.5T test, which the meshes were loaded in one direction with half the load used in the other direction. The Surgipro (®) mesh increased its anisotropic response (Anis[Formula: see text] = 0.478) and the materials that demonstrated moderate and high anisotropic responses during multiaxial testing presented a quasi-isotropic response, especially the Infinit(®) mesh that decreased its anisotropic response from 3.369 to 1.292.

  19. Clinical observation of a modified surgical method: posterior vaginal mesh suspension of female rectocele with intractable constipation.

    Science.gov (United States)

    Hong, Ling; Li, Huai-Fang; Sun, Jing; Zhu, Jian-Long; Ai, Gui-hai; Li, Li; Zhang, Bo; Chi, Feng-li; Tong, Xiao-Wen

    2012-01-01

    To explore the feasibility and effectiveness of a modified posterior vaginal mesh suspension method in treating female rectocele with intractable constipation. Descriptive study (Canadian Task Force classification II-3). The study was performed in the Study Center for Female Pelvic Dysfunction Disease, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China. The Study Center includes 15 physicians, most of whom have received advanced training in pelvic floor dysfunctional disease and can skillfully perform many types of operations in patients with such disease. Almost 1500 operations to treat pelvic floor dysfunctional disease are performed every year at the center. Thirty-six women with rectocele with intractable constipation. Posterior vaginal mesh suspension. All patients were followed up for 15 to 36 months. In 29 patients, the condition was cured completely; in 5 patients it had improved; and in 2 patients, the intervention had no effect. Insofar as recovery and improved results, the overall effectiveness rate was 94.4%. Posterior vaginal mesh suspension is an effective, harmless, and convenient method for treatment of female rectocele with intractable constipation. It has positive short-term curative effects, with few complications and sequelae. However, the long-term effects of posterior vaginal mesh suspension should be evaluated. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

  20. Biomechanical and histologic evaluation of two application forms of surgical glue for mesh fixation to the abdominal wall.

    Science.gov (United States)

    Ortillés, Á; Pascual, G; Peña, E; Rodríguez, M; Pérez-Köhler, B; Mesa-Ciller, C; Calvo, B; Bellón, J M

    2017-11-01

    The use of an adhesive for mesh fixation in hernia repair reduces chronic pain and minimizes tissue damage in the patient. This study was designed to assess the adhesive properties of a medium-chain (n-butyl) cyanoacrylate glue applied as drops or as a spray in a biomechanical and histologic study. Both forms of glue application were compared to the use of simple-loose or continuous-running polypropylene sutures for mesh fixation. Eighteen adult New Zealand White rabbits were used. For mechanical tests in an ex vivo and in vivo study, patches of polypropylene mesh were fixed to an excised fragment of healthy abdominal tissue or used to repair a partial abdominal wall defect in the rabbit respectively. Depending on the fixation method used, four groups of 12 implants each or 10 implants each respectively for the ex vivo and in vivo studies were established: Glue-Drops, Glue-Spray, Suture-Simple and Suture-Continuous. Biomechanical resistance in the ex vivo implants was tested five minutes after mesh fixation. In vivo implants for biomechanical and histologic assessment were collected at 14 days postimplant. In the ex vivo study, the continuous suture implants showed the highest failure sample tension, while the implants fixed with glue showed lower failure sample tension values. However, the simple and continuous suture implants returned the highest stretch values. In the in vivo implants, failure sample tension values were similar among groups while the implants fixed with a continuous running suture had the higher stretch values, and the glue-fixed implants the lower stretch values. All meshes showed good tissue integration within the host tissue regardless of the fixation method used. Our histologic study revealed the generation of a denser, more mature repair tissue when the cyanoacrylate glue was applied as a spray rather than as drops. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Opfront: mesh

    DEFF Research Database (Denmark)

    2015-01-01

    Mesh generation and visualization software based on the CGAL library. Folder content: drawmesh Visualize slices of the mesh (surface/volumetric) as wireframe on top of an image (3D). drawsurf Visualize surfaces of the mesh (surface/volumetric). img2mesh Convert isosurface in image to volumetric m...... mesh (medit format). img2off Convert isosurface in image to surface mesh (off format). off2mesh Convert surface mesh (off format) to volumetric mesh (medit format). reduce Crop and resize 3D and stacks of images. data Example data to test the library on...

  2. Mesh Excision: Is Total Mesh Excision Necessary?

    Science.gov (United States)

    Wolff, Gillian F; Winters, J Christian; Krlin, Ryan M

    2016-04-01

    Nearly 29% of women will undergo a secondary, repeat operation for pelvic organ prolapse (POP) symptom recurrence following a primary repair, as reported by Abbott et al. (Am J Obstet Gynecol 210:163.e1-163.e1, 2014). In efforts to decrease the rates of failure, graft materials have been utilized to augment transvaginal repairs. Following the success of using polypropylene mesh (PPM) for stress urinary incontinence (SUI), the use of PPM in the transvaginal repair of POP increased. However, in recent years, significant concerns have been raised about the safety of PPM mesh. Complications, some specific to mesh, such as exposures, erosion, dyspareunia, and pelvic pain, have been reported with increased frequency. In the current literature, there is not substantive evidence to suggest that PPM has intrinsic properties that warrant total mesh removal in the absence of complications. There are a number of complications that can occur after transvaginal mesh placement that do warrant surgical intervention after failure of conservative therapy. In aggregate, there are no high-quality controlled studies that clearly demonstrate that total mesh removal is consistently more likely to achieve pain reduction. In the cases of obstruction and erosion, it seems clear that definitive removal of the offending mesh is associated with resolution of symptoms in the majority of cases and reasonable practice. There are a number of complications that can occur with removal of mesh, and patients should be informed of this as they formulate a choice of treatment. We will review these considerations as we examine the clinical question of whether total versus partial removal of mesh is necessary for the resolution of complications following transvaginal mesh placement.

  3. Trends in internet search activity, media coverage, and patient-centered health information after the FDA safety communications on surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    Stone, Benjamin V; Forde, James C; Levit, Valerie B; Lee, Richard K; Te, Alexis E; Chughtai, Bilal

    2016-11-01

    In July 2011, the US Food and Drug Administration (FDA) issued a safety communication regarding serious complications associated with surgical mesh for pelvic organ prolapse, prompting increased media and public attention. This study sought to analyze internet search activity and news article volume after this FDA warning and to evaluate the quality of websites providing patient-centered information. Google Trends™ was utilized to evaluate search engine trends for the term "pelvic organ prolapse" and associated terms between 1 January 2004 and 31 December 2014. Google News™ was utilized to quantify the number of news articles annually under the term "pelvic organ prolapse." The search results for the term "pelvic organ prolapse" were assessed for quality using the Health On the Net Foundation (HON) certification. There was a significant increase in search activity from 37.42 in 2010 to 57.75 in 2011, at the time of the FDA communication (p = 0.021). No other annual interval had a statistically significant increase in search activity. The single highest monthly search activity, given the value of 100, was August 2011, immediately following the July 2011 notification, with the next highest value being 98 in July 2011. Linear regression analysis of news articles per year since the FDA communication revealed r 2  = 0.88, with a coefficient of 186. Quality assessment demonstrated that 42 % of websites were HON-certified, with .gov sites providing the highest quality information. Although the 2011 FDA safety communication on surgical mesh was associated with increased public and media attention, the quality of relevant health information on the internet remains of poor quality. Future quality assurance measures may be critical in enabling patients to play active roles in their own healthcare.

  4. Time to rethink: an evidence-based response from pelvic surgeons to the FDA Safety Communication: "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse".

    Science.gov (United States)

    Murphy, Miles; Holzberg, Adam; van Raalte, Heather; Kohli, Neeraj; Goldman, Howard B; Lucente, Vincent

    2012-01-01

    In July of 2011 the U.S. Food and Drug Administration (FDA) released a safety communication entitled "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse." The stated purpose of this communication is to inform health care providers and patients that serious complications with placement of this mesh are not rare and that it is not clear that these repairs are more effective than nonmesh repair. The comments regarding efficacy are based on a systematic review of the scientific literature from 1996-2011 conducted by the FDA. Our review of the literature during this time yields some different conclusions regarding the safety and efficacy of mesh use in prolapse repair. It may be useful to consider this information prior to making recommendations regarding mesh use in prolapse surgery according to the recent UPDATE.

  5. Management of complications of mesh surgery.

    Science.gov (United States)

    Lee, Dominic; Zimmern, Philippe E

    2015-07-01

    Transvaginal placements of synthetic mid-urethral slings and vaginal meshes have largely superseded traditional tissue repairs in the current era because of presumed efficacy and ease of implant with device 'kits'. The use of synthetic material has generated novel complications including mesh extrusion, pelvic and vaginal pain and mesh contraction. In this review, our aim is to discuss the management, surgical techniques and outcomes associated with mesh removal. Recent publications have seen an increase in presentation of these mesh-related complications, and reports from multiple tertiary centers have suggested that not all patients benefit from surgical intervention. Although the true incidence of mesh complications is unknown, recent publications can serve to guide physicians and inform patients of the surgical outcomes from mesh-related complications. In addition, the literature highlights the growing need for a registry to account for a more accurate reporting of these events and to counsel patients on the risk and benefits before proceeding with mesh surgeries.

  6. Mesh erosion after abdominal sacrocolpopexy.

    Science.gov (United States)

    Kohli, N; Walsh, P M; Roat, T W; Karram, M M

    1998-12-01

    To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.

  7. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

    -month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated......A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh...

  8. Current situation of transvaginal mesh repair for pelvic organ prolapse.

    Science.gov (United States)

    Zhu, Lan; Zhang, Lei

    2014-09-01

    Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Surgical mesh has been used since the 1950s to repair abdominal hernias. In the 1970s, gynecologists began using surgical mesh products to indicate the repair of pelvic organ prolapse (POP), and in the 1990s, gynecologists began using surgical mesh for POP. Then the U.S. Food and Drug Administration (FDA) approved the first surgical mesh product specifically for use in POP. Surgical mesh materials can be divided into several categories. Most surgical mesh devices cleared for POP procedures are composed of non-absorbable synthetic polypropylene. Mesh can be placed in the anterior vaginal wall to aid in the correction of cystocele (anterior repair), in the posterior vaginal wall to aid in correction of rectocele (posterior repair), or attached to the top of the vagina to correct uterine prolapse or vaginal apical prolapse (apical repair). Over the past decades, surgical mesh products for transvaginal POP repair became incorporated into "kits" that included tools to aid in the delivery and insertion of the mesh. Surgical mesh kits continue to evolve, adding new insertion tools, tissue fixation anchors, surgical techniques, and ab- sorbable and biological materials. This procedure has been performed popularly. It was also performed increased in China. But this new technique met some trouble recently and let shake in urogynecology.

  9. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Stina Öberg

    2016-01-01

    Full Text Available A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated in a video.

  10. Multicenter, Prospective, Longitudinal Study of the Recurrence, Surgical Site Infection, and Quality of Life After Contaminated Ventral Hernia Repair Using Biosynthetic Absorbable Mesh: The COBRA Study

    NARCIS (Netherlands)

    Rosen, M.J.; Bauer, J.J.; Harmaty, M.; Carbonell, A.M.; Cobb, W.S.; Matthews, B.; Goldblatt, M.I.; Selzer, D.J.; Poulose, B.K.; Hansson, B.M.E.; Rosman, C.; Chao, J.J.; Jacobsen, G.R.

    2017-01-01

    OBJECTIVE: The aim of the study was to evaluate biosynthetic absorbable mesh in single-staged contaminated (Centers for Disease Control class II and III) ventral hernia (CVH) repair over 24 months. BACKGROUND: CVH has an increased risk of postoperative infection. CVH repair with synthetic or

  11. One-Year Surgical Outcomes and Quality of Life after Minimally Invasive Sling Procedures for the Treatment of Female Stress Urinary Incontinence: TVT SECUR® vs. CureMesh®

    Science.gov (United States)

    Joo, Young Min; Choe, Jin Ho

    2010-01-01

    Purpose We compared the efficacy and safety of two minimally invasive sling procedures used to treat female stress urinary incontinence (SUI), tension-free vaginal tape (TVT) SECUR® and CureMesh®, and assessed the 1-year surgical outcomes. Materials and Methods Sixty women with SUI were assigned to undergo either the TVT SECUR (n=38) or CureMesh (n=22) procedures between April 2007 and June 2008. Patients were monitored via outpatient visits at 1 month, 3 months, and 1 year after surgery. The efficacy of these procedures was evaluated by the cough test or by a urodynamic study. At these postoperative visits, the patients also completed several questionnaires, including incontinence quality of life, patient's perception of urgency severity, the scored form of the Bristol Female Lower Urinary Tract Symptoms, visual analog scale, and questions about perceived benefit, satisfaction, and willingness to undergo the same operation again. The objective cure rate was defined as no leakage during the cough test with a full bladder. The subjective cure rate was evaluated by self-assessment of goal achievement performed 1 year postoperatively. Results The two groups were similar in preoperative characteristics and urodynamic parameters. The objective cure rates were similar between TVT SECUR and CureMesh (68.4% vs. 77.3%). All respondents reported improvement after surgery. There were no intra-operative complications. Conclusions Our results showed that the TVT SECUR and CureMesh procedures are both safe and simple to perform and have no significant differences in efficacy. Comparative studies with long-term follow-up are warranted to determine the true efficacy of these procedures. PMID:20495697

  12. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh.

    Science.gov (United States)

    Roth, Ted M; Reight, Ian

    2012-07-01

    Sacral colpopexy may be complicated by mesh exposure, and the surgical treatment of mesh exposure typically results in minor postoperative morbidity and few delayed complications. A 75-year-old woman presented 7 years after a laparoscopic sacral colpopexy, with Mersilene mesh, with an apical mesh exposure. She underwent an uncomplicated transvaginal excision and was asymptomatic until 8 months later when she presented with vaginal drainage and a sacral abscess. This was successfully treated with laparoscopic enterolysis, drainage of the abscess, and explantation of the remaining mesh. Incomplete excision of exposed colpopexy mesh can lead to ascending infection and sacral abscess. Laparoscopic drainage and mesh removal may be considered in these patients.

  13. Assessment of the psychometric properties of the Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) following surgical placement of Prolift+M: a transvaginal partially absorbable mesh system for the treatment of pelvic organ prolapse.

    Science.gov (United States)

    Roy, Sanjoy; Mohandas, Anita; Coyne, Karin; Gelhorn, Heather; Gauld, Judi; Sikirica, Vanja; Milani, Alfredo L

    2012-04-01

    Impairment of sexual function is a significant problem among women suffering from pelvic organ prolapse (POP). Because anatomical measures of POP do not always correspond with patients' subjective reports of their condition, patient-reported outcome measures may provide additional valuable information regarding the experiences of women who have undergone surgery. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) is a validated, widely used condition-specific questionnaire focused on sexual function among patients with POP or urinary incontinence. This study aims to report sexual function outcomes as measured by PISQ-12 and to evaluate the psychometric characteristics of the questionnaire following surgical mesh implant for the treatment of POP. The PISQ-12 was used to measure sexual function, while a set of other measures, namely, Pelvic Organ Prolapse Quantification, Patient Global Impression of Change, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Surgical Satisfaction Questionnaire, was used for validation. Data for the study were collected from a prospective multicenter, single-arm study of surgical POP repair via the transvaginal placement of a partially absorbable mesh system. For baseline, month 3, and month 12 following POP surgery, several psychometric properties of the PISQ-12 were evaluated, including internal consistency (Cronbach's alpha), concurrent validity, discriminant validity, and responsiveness. As measured by the PISQ-12 questionnaire, statistically significant improvements were observed in the composite summary score as well as all three subscale scores at 1 year. The PISQ-12 generally demonstrated good psychometric properties including internal consistency reliability, validity, and responsiveness. The PISQ-12 items had good distributional properties at baseline, with substantial ceiling effects at follow-up visits reflecting improvements experienced by the patients. The PISQ-12 is a valid

  14. Pure transvaginal excision of mesh erosion involving the bladder.

    Science.gov (United States)

    Firoozi, Farzeen; Goldman, Howard B

    2013-06-01

    We present a pure transvaginal approach to the removal of eroded mesh involving the bladder secondary to placement of transvaginal mesh for management of pelvic organ prolapse (POP) using a mesh kit. Although technically challenging, we demonstrate the feasibility of a purely transvaginal approach, avoiding a potentially more morbid transabdominal approach. The video presents the surgical technique of pure transvaginal excision of mesh erosion involving the bladder after mesh placement using a prolapse kit was performed. This video shows that purely transvaginal removal of mesh erosion involving the bladder can be done safely and is feasible.

  15. Laparoscopic removal of mesh used in pelvic floor surgery.

    Science.gov (United States)

    Khong, Su-Yen; Lam, Alan

    2009-01-01

    Various meshes are being used widely in clinical practice for pelvic reconstructive surgery despite the lack of evidence of their long-term safety and efficacy. Management of complications such as mesh erosion and dyspareunia can be challenging. Most mesh-related complications can probably be managed successfully via the transvaginal route; however, this may be impossible if surgical access is poor. This case report demonstrates the successful laparoscopic removal of mesh after several failed attempts via the vaginal route.

  16. Postoperative pain outcomes after transvaginal mesh revision.

    Science.gov (United States)

    Danford, Jill M; Osborn, David J; Reynolds, W Stuart; Biller, Daniel H; Dmochowski, Roger R

    2015-01-01

    Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patient's subjective complaints of pelvic pain associated with original placement of mesh. After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients' postoperative pain complaints were assessed. Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.12-0.64, p = 0.003). Excision or revision of vaginal mesh appears to be effective in improving patients' pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain.

  17. Transrectal Mesh Erosion Requiring Bowel Resection.

    Science.gov (United States)

    Kemp, Marta Maria; Slim, Karem; Rabischong, Benoît; Bourdel, Nicolas; Canis, Michel; Botchorishvili, Revaz

    To report a case of a transrectal mesh erosion as complication of laparoscopic promontofixation with mesh repair, necessitating bowel resection and subsequent surgical interventions. Sacrocolpopexy has become a standard procedure for vaginal vault prolapse [1], and the laparoscopic approach has gained popularity owing to more rapid recovery and less morbidity [2,3]. Mesh erosion is a well-known complication of surgical treatment for prolapse as reported in several negative evaluations, including a report from the US Food and Drug Administration in 2011 [4]. Mesh complications are more common after surgeries via the vaginal approach [5]; nonetheless, the incidence of vaginal mesh erosion after laparoscopic procedures is as high as 9% [6]. The incidence of transrectal mesh exposure after laparoscopic ventral rectopexy is roughly 1% [7]. The diagnosis may be delayed because of its rarity and variable presentation. In addition, polyester meshes, such as the mesh used in this case, carry a higher risk of exposure [8]. A 57-year-old woman experiencing genital prolapse, with the cervix classified as +3 according to the Pelvic Organ Prolapse Quantification system, underwent laparoscopic standard sacrocolpopexy using polyester mesh. Subtotal hysterectomy and bilateral adnexectomy were performed concomitantly. A 3-year follow-up consultation demonstrated no signs or symptoms of erosion of any type. At 7 years after the surgery, however, the patient presented with rectal discharge, diagnosed as infectious rectocolitis with the isolation of Clostridium difficile. She underwent a total of 5 repair surgeries in a period of 4 months, including transrectal resection of exposed mesh, laparoscopic ablation of mesh with digestive resection, exploratory laparoscopy with abscess drainage, and exploratory laparoscopy with ablation of residual mesh and transverse colostomy. She recovered well after the last intervention, exhibiting no signs of vaginal or rectal fistula and no recurrence

  18. Transvaginal mesh procedures for pelvic organ prolapse.

    Science.gov (United States)

    Walter, Jens-Erik

    2011-02-01

    To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available

  19. Efficacy of anchoring the four-arm transvaginal mesh to the mid-urethra vs original surgery as a surgical correction for stress urine incontinence in coexisting anterior vaginal prolapse grades II and III: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Fekete, Zoltán; Surányi, Andrea; Rénes, Lórand; Németh, Gábor; Kozinszky, Zoltan

    2017-12-28

    The prevalence of obesity with aging is escalating alarmingly; and pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh has been employed with increasing popularity in the treatment of POP and is usually highly effective in controlling the principal symptoms of prolapse. However, studies have reported that mesh operations provide fairly unfavorable SUI cure rates. Therefore, additional anti-incontinence surgical strategies are increasingly being scrutinized to achieve better postoperative continence without any significant side-effects for patients with both POP and SUI. We hypothesize that the modification with the fixing of the mesh to the mid-urethra is superior to the original transvaginal mesh operation (TVM) with regard to anti-incontinence. One hundred and thirty patients diagnosed with POP-Q II-III and concomitant SUI requiring surgical treatment will be included in this prospective, randomized, double-blind, controlled clinical trial. Patients will be randomly allocated to receive either original TVM (TVM group, n = 65) or modified TVM surgery (mTVM group, n = 65). As the primary outcome parameter, we will evaluate the objective SUI and POP cure rates. Secondary endpoints include postoperative morbidity as assessed with the International Urogynaecological Association classification and subjective prolapse and incontinence cure rates reported by questionnaires. Recognizing the importance of an additional surgical procedure for anti-incontinence management, we aim to investigate whether a stabilizing suturing of the mesh to the mid-urethra delivers superior SUI correction compared to the original prosthesis surgery. ClinicalTrials.gov, NCT02935803. Registered on 20 May 2016.

  20. The Role of Chronic Mesh Infection in Delayed-Onset Vaginal Mesh Complications or Recurrent Urinary Tract Infections: Results From Explanted Mesh Cultures.

    Science.gov (United States)

    Mellano, Erin M; Nakamura, Leah Y; Choi, Judy M; Kang, Diana C; Grisales, Tamara; Raz, Shlomo; Rodriguez, Larissa V

    2016-01-01

    Vaginal mesh complications necessitating excision are increasingly prevalent. We aim to study whether subclinical chronically infected mesh contributes to the development of delayed-onset mesh complications or recurrent urinary tract infections (UTIs). Women undergoing mesh removal from August 2013 through May 2014 were identified by surgical code for vaginal mesh removal. Only women undergoing removal of anti-incontinence mesh were included. Exclusion criteria included any women undergoing simultaneous prolapse mesh removal. We abstracted preoperative and postoperative information from the medical record and compared mesh culture results from patients with and without mesh extrusion, de novo recurrent UTIs, and delayed-onset pain. One hundred seven women with only anti-incontinence mesh removed were included in the analysis. Onset of complications after mesh placement was within the first 6 months in 70 (65%) of 107 and delayed (≥6 months) in 37 (35%) of 107. A positive culture from the explanted mesh was obtained from 82 (77%) of 107 patients, and 40 (37%) of 107 were positive with potential pathogens. There were no significant differences in culture results when comparing patients with delayed-onset versus immediate pain, extrusion with no extrusion, and de novo recurrent UTIs with no infections. In this large cohort of patients with mesh removed for a diverse array of complications, cultures of the explanted vaginal mesh demonstrate frequent low-density bacterial colonization. We found no differences in culture results from women with delayed-onset pain versus acute pain, vaginal mesh extrusions versus no extrusions, or recurrent UTIs using standard culture methods. Chronic prosthetic infections in other areas of medicine are associated with bacterial biofilms, which are resistant to typical culture techniques. Further studies using culture-independent methods are needed to investigate the potential role of chronic bacterial infections in delayed vaginal mesh

  1. Robotic removal of eroded vaginal mesh into the bladder.

    Science.gov (United States)

    Macedo, Francisco Igor B; O'Connor, Jeffrey; Mittal, Vijay K; Hurley, Patrick

    2013-11-01

    Vaginal mesh erosion into the bladder after midurethral sling procedure or cystocele repair is uncommon, with only a few cases having been reported in the literature. The ideal surgical management is still controversial. Current options for removal of eroded mesh include: endoscopic, transvaginal or abdominal (either open or laparoscopic) approaches. We, herein, present the first case of robotic removal of a large eroded vaginal mesh into the bladder and discuss potential benefits and limitations of the technique. © 2013 The Japanese Urological Association.

  2. Role of biological mesh in surgical treatment of paracolostomy hernias Uso de prótese biológica no tratamento cirúrgico de hérnias paracolostômicas

    Directory of Open Access Journals (Sweden)

    Sergio Eduardo Alonso Araujo

    2005-08-01

    Full Text Available BACKGROUND: Paracolostomy hernia is a frequent complication of intestinal stoma. Its correction can be made through relocation of the colostomy or by keeping it in place and performing abdominal wall reinforcement through direct suturing with or without a prosthesis. METHOD: Results of surgical treatment of paracolostomy hernias were analyzed in 22 patients who underwent surgery in our hospital during the past 15 years, with or without biological mesh (bovine pericardium. All patients had terminal colostomies after abdominoperineal excision of the rectum. RESULTS: In 15 (68.2% patients, hernia correction was made by maintaining the colostomy in place, in 2 of them (9.1% without reinforcement, and in the other 13 (59.1% through reinforcement of the aponeurosis with biological mesh. In the 7 (31.8% other patients, hernia correction was accomplished by relocation of the colostomy. The mean follow-up period was 50.2 months. Recurrence was observed in 3 (13.6% patients after a median of 16 months post-correction. CONCLUSION: Paracolostomy hernia remains a surgical challenge due to its high recurrence rate. Primary repair using a prosthesis of biological material may be preferable since muscle-aponeurotic weakness is frequently observed.Hérnias paracolostômicas são complicações freqüentes de estomas intestinais. A correção pode ser realizada através do seu reposicionamento ou mantendo a mesma localização, associada ao reforço da parede abdominal com ou sem o emprego de prótese. MÉTODOS: Os resultados do tratamento cirúrgico de hérnias paracolostômicas são analisados em 22 pacientes em nosso serviço nos últimos 15 anos. Todos os pacientes eram portadores de colostomias terminais após ressecção abdominoperineal do reto. RESULTADOS: Em 15 (68,2% pacientes, a correção da hérnia foi realizada mantendo-se a colostomia no local original, em 2 (9,1% deles através de herniorrafia simples e em 13 (59,1% com reforço da aponeurose com

  3. [CLINICAL EVALUATION OF THE NEW ANTISEPTIC MESHES].

    Science.gov (United States)

    Gogoladze, M; Kiladze, M; Chkhikvadze, T; Jiqia, D

    2016-12-01

    Improving the results of hernia treatment and prevention of complications became a goal of our research which included two parts - experimental and clinical. Histomorphological and bacteriological researches showed that the best result out of the 3 control groups was received in case of covering implant "Coladerm"+ with chlorhexidine. Based on the experiment results working process continued in clinics in order to test and introduce new "coladerm"+ chlorhexidine covered poliprophilene meshes into practice. For clinical illustration there were 60 patients introduced to the research who had hernioplasty procedures by different nets: I group - standard meshes+"coladerm"+chlorhexidine, 35 patients; II group - standard meshes +"coladerm", 15 patients; III group - standard meshes, 10 patients. Assessment of the wound and echo-control was done post-surgery on the 8th, 30th and 90th days. This clinical research based on the experimental results once again showed the best anti-microbe features of new antiseptic polymeric biocomposite meshes (standard meshes+"coladerm"+chlorhexidine); timely termination of regeneration and reparation processes without any post-surgery suppurative complications. We hope that new antiseptic polymeric biocomposite meshes presented by us will be successfully used in surgical practice of hernia treatment based on and supported by expermental-clinical research.

  4. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    Background For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. Data sources...... A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  5. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. DATA SOURCES......: A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  6. Oral, intestinal, and skin bacteria in ventral hernia mesh implants

    Directory of Open Access Journals (Sweden)

    Odd Langbach

    2016-07-01

    Full Text Available Background: In ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6–10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level. Objective: The purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket. Methods: Thirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques. Results: A great variety of taxa were detected in 20 (66.7% mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98–100% suggesting, but not proving, a transfer of oral bacteria to the mesh. Conclusion: The results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also

  7. The use of mesh implants in vaginal prolapse surgery: Position ...

    African Journals Online (AJOL)

    Abstract. This is the 2014 updated guideline and position statement from the South African Urogynaecology Association on the use of transvaginal mesh for the surgical correction of pelvic organ prolapse.

  8. Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits.

    Science.gov (United States)

    Ridgeway, Beri; Walters, Mark D; Paraiso, Marie Fidela R; Barber, Matthew D; McAchran, Sarah E; Goldman, Howard B; Jelovsek, J Eric

    2008-12-01

    The purpose of this study was to determine the complications, treatments, and outcomes in patients choosing to undergo removal of mesh previously placed with a mesh procedural kit. This was a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 3-year period at Cleveland Clinic. At last follow-up, patients reported degree of pain, level of improvement, sexual activity, and continued symptoms. Nineteen patients underwent removal of mesh during the study period. Indications for removal included chronic pain (6/19), dyspareunia (6/19), recurrent pelvic organ prolapse (8/19), mesh erosion (12/19), and vesicovaginal fistula (3/19), with most patients (16/19) citing more than 1 reason. There were few complications related to the mesh removal. Most patients reported significant relief of symptoms. Mesh removal can be technically difficult but appears to be safe with few complications and high relief of symptoms, although some symptoms can persist.

  9. Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

    Science.gov (United States)

    Iglesia, Cheryl B; Hale, Douglass S; Lucente, Vincent R

    2013-03-01

    Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.

  10. Current role of mesh in vaginal prolapse surgery.

    Science.gov (United States)

    Richter, Lee A; Carter, Charelle; Gutman, Robert E

    2014-10-01

    This report summarizes the latest literature on transvaginal mesh (TVM) for the treatment of pelvic organ prolapse, with a focus on indications for use and management of complications. We describe trends in TVM by reviewing the recent literature and summarizing national meeting presentations. Vaginal mesh complications are most often managed surgically, and the majority of patients experiencing mesh-related pain have symptom improvement after intervention. New efforts will focus on identifying variables associated with success after intervention for mesh-related complications, to aid reconstructive pelvic surgeons in outcome prediction and patient counselling. Although the use of TVM has plateaued in recent years, we are seeing an exponential rise in synthetic mesh implant removal. Reconstructive pelvic surgeons advising patients with TVM complications should report that surgical intervention is often necessary, improvement rates of pain-related symptoms after surgery are high, and up to a third may require multiple interventions.

  11. Symptom resolution after operative management of complications from transvaginal mesh.

    Science.gov (United States)

    Crosby, Erin C; Abernethy, Melinda; Berger, Mitchell B; DeLancey, John O; Fenner, Dee E; Morgan, Daniel M

    2014-01-01

    Complications from transvaginal mesh placed for prolapse often require operative management. The aim of this study is to describe the outcomes of vaginal mesh removal. A retrospective review of all patients having surgery by the urogynecology group in the department of obstetrics and gynecology at our institution for a complication of transvaginal mesh placed for prolapse was performed. Demographics, presenting symptoms, surgical procedures, and postoperative symptoms were abstracted. Comparative statistics were performed using the χ or Fisher's exact test with significance at Pmesh and 84 had follow-up data. The most common presenting signs and symptoms were: mesh exposure, 62% (n=56); pain, 64% (n=58); and dyspareunia, 48% (n=43). During operative management, mesh erosion was encountered unexpectedly in a second area of the vagina in 5% (n=4), in the bladder in 1% (n=1), and in the bowel in 2% (n=2). After vaginal mesh removal, 51% (n=43) had resolution of all presenting symptoms. Mesh exposure was treated successfully in 95% of patients, whereas pain was only successfully treated in 51% of patients. Removal of vaginal mesh is helpful in relieving symptoms of presentation. Patients can be reassured that exposed mesh can almost always be successfully managed surgically, but pain and dyspareunia are only resolved completely in half of patients. III.

  12. The mesh controversy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Joshua A. Cohn

    2016-09-01

    Full Text Available Pelvic organ prolapse and stress urinary incontinence are common conditions for which approximately 11% of women will undergo surgical intervention in their lifetime. The use of vaginal mesh for pelvic organ prolapse and stress urinary incontinence rose rapidly in the early 2000s as over 100 mesh products were introduced into the clinical armamentarium with little regulatory oversight for their use. US Food and Drug Administration Public Health Notifications in 2008 and 2011, as well as reclassification of transvaginal mesh for prolapse to class III in early 2016, were a response to debilitating complications associated with transvaginal mesh placement in many women. The midurethral sling has not been subject to the same reclassification and continues to be endorsed as the “gold standard” for surgical management of stress urinary incontinence by subspecialty societies. However, litigators have not differentiated between mesh for prolapse and mesh for incontinence. As such, all mesh, including that placed for stress urinary incontinence, faces continued controversy amidst an uncertain future. In this article, we review the background of the mesh controversy, recent developments, and the anticipated role of mesh in surgery for prolapse and stress urinary incontinence going forward.

  13. [Implants for genital prolapse : Contra mesh surgery].

    Science.gov (United States)

    Hampel, C

    2017-12-01

    Alloplastic transvaginal meshes have become very popular in the surgery of pelvic organ prolapse (POP) as did alloplastic suburethral slings in female stress incontinence surgery, but without adequate supporting data. The simplicity of the mesh procedure facilitates its propagation with acceptance of higher revision and complication rates. Since attending physicians do more and more prolapse surgeries without practicing or teaching alternative techniques, expertise in these alternatives, which might be very useful in cases of recurrence, persistence or complications, is permanently lost. It is doubtful that proper and detailed information about alternatives, risks, and benefits of transvaginal alloplastic meshes is provided to every single prolapse patient according to the recommendations of the German POP guidelines, since the number of implanted meshes exceeds the number of properly indicated mesh candidates by far. Although there is no dissent internationally about the available mesh data, thousands of lawsuits in the USA, insolvency of companies due to claims for compensation and unambiguous warnings from foreign urological societies leave German urogynecologists still unimpressed. The existing literature in pelvic organ prolapse exclusively focusses on POP stage and improvement of that stage with surgical therapy. Instead, typical prolapse symptoms should trigger therapy and improvement of these symptoms should be the utmost treatment goal. It is strongly recommended for liability reasons to obtain specific written informed consent.

  14. Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse

    OpenAIRE

    Naoko Takazawa; Akiko Fujisaki; Yasukuni Yoshimura; Akira Tsujimura; Shigeo Horie

    2018-01-01

    Purpose: This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). Materials and Methods: This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each righ...

  15. Mesh removal following transvaginal mesh placement: a case series of 104 operations.

    Science.gov (United States)

    Marcus-Braun, Naama; von Theobald, Peter

    2010-04-01

    The objective of the study was to reveal the way we treat vaginal mesh complications in a trained referral center. This is a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 5-year period. Eighty-three patients underwent 104 operations including 61 complete mesh removal, 14 partial excision, 15 section of sub-urethral sling, and five laparoscopies. Main indications were erosion, infection, granuloma, incomplete voiding, and pain. Fifty-eight removals occurred more than 2 years after the primary mesh placement. Mean operation time was 21 min, and there were two intraoperative and ten minor postoperative complications. Stress urinary incontinence (SUI) recurred in 38% and cystocele in 19% of patients. In a trained center, mesh removal was found to be a quick and safe procedure. Mesh-related complications may frequently occur more than 2 years after the primary operation. Recurrence was mostly associated with SUI and less with genital prolapse.

  16. Gastroenterology-Urology Devices; Manual Gastroenterology-Urology Surgical Instruments and Accessories. Final rule; technical amendment.

    Science.gov (United States)

    2017-03-01

    The Food and Drug Administration (FDA) is amending the identification of manual gastroenterology-urology surgical instruments and accessories to reflect that the device does not include specialized surgical instrumentation for use with urogyencologic surgical mesh specifically intended for use as an aid in the insertion, placement, fixation, or anchoring of surgical mesh during urogynecologic procedures ("specialized surgical instrumentation for use with urogynecologic surgical mesh"). These amendments are being made to reflect changes made in the recently issued final reclassification order for specialized surgical instrumentation for use with urogynecologic surgical mesh.

  17. Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

    Science.gov (United States)

    Hurtado, Eric A; Appell, Rodney A

    2009-01-01

    This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair. The mean follow-up time after surgery was 3.4 months. Eight of 12 patients had mesh that had formed a fibrotic band. Six of 12 patients had complete resolution of pain. Of the nine patients with mesh exposure, all required significant resection of the vaginal wall. No further mesh exposure occurred. The use of transvaginal mesh kits may cause previously undescribed complications such as pelvic/vaginal pain or large extrusions requiring complete removal. Removal of all mesh except the arms may cure or significantly improve these problems.

  18. Prolapse Recurrence after Transvaginal Mesh Removal.

    Science.gov (United States)

    Rawlings, Tanner; Lavelle, Rebecca S; Coskun, Burhan; Alhalabi, Feras; Zimmern, Philippe E

    2015-11-01

    We determined the rate of pelvic organ prolapse recurrence after transvaginal mesh removal. Following institutional review board approval a longitudinally collected database of women undergoing transvaginal mesh removal for complications after transvaginal mesh placement with at least 1 year minimum followup was queried for pelvic organ prolapse recurrence. Recurrent prolapse was defined as greater than stage 1 on examination or the need for reoperation at the site of transvaginal mesh removal. Outcome measures were based on POP-Q (Pelvic Organ Prolapse Quantification System) at the last visit. Patients were grouped into 3 groups, including group 1--recurrent prolapse in the same compartment as transvaginal mesh removal, 2--persistent prolapse and 3--prolapse in a compartment different than transvaginal mesh removal. Of 73 women 52 met study inclusion criteria from 2007 to 2013, including 73% who presented with multiple indications for transvaginal mesh removal. The mean interval between insertion and removal was 45 months (range 10 to 165). Overall mean followup after transvaginal mesh removal was 30 months (range 12 to 84). In group 1 (recurrent prolapse) the rate was 15% (6 of 40 patients). Four women underwent surgery for recurrent prolapse at a mean 7 of months (range 5 to 10). Two patients elected observation. The rate of persistent prolapse (group 2) was 23% (12 of 52 patients). Three women underwent prolapse reoperation at a mean of 10 months (range 8 to 12). In group 3 (de novo/different compartment prolapse) the rate was 6% (3 of 52 patients). One woman underwent surgical repair at 52 months. At a mean 2.5-year followup 62% of patients (32 of 52) did not have recurrent or persistent prolapse after transvaginal mesh removal and 85% (44 of 52) did not undergo any further procedure for prolapse. Specifically for pelvic organ prolapse in the same compartment as transvaginal mesh removal 12% of patients had recurrence, of whom 8% underwent prolapse repair

  19. Geometrically Consistent Mesh Modification

    KAUST Repository

    Bonito, A.

    2010-01-01

    A new paradigm of adaptivity is to execute refinement, coarsening, and smoothing of meshes on manifolds with incomplete information about their geometry and yet preserve position and curvature accuracy. We refer to this collectively as geometrically consistent (GC) mesh modification. We discuss the concept of discrete GC, show the failure of naive approaches, and propose and analyze a simple algorithm that is GC and accuracy preserving. © 2010 Society for Industrial and Applied Mathematics.

  20. The mesh controversy [version 1; referees: 2 approved

    OpenAIRE

    Joshua A. Cohn; Elizabeth Timbrook Brown; Casey G. Kowalik; Melissa R. Kaufmann; Roger R. Dmochowski; W. Stuart Reynolds

    2016-01-01

    Pelvic organ prolapse and stress urinary incontinence are common conditions for which approximately 11% of women will undergo surgical intervention in their lifetime. The use of vaginal mesh for pelvic organ prolapse and stress urinary incontinence rose rapidly in the early 2000s as over 100 mesh products were introduced into the clinical armamentarium with little regulatory oversight for their use. US Food and Drug Administration Public Health Notifications in 2008 and 2011, as well as recla...

  1. To mesh or not to mesh: a review of pelvic organ reconstructive surgery

    Science.gov (United States)

    Dällenbach, Patrick

    2015-01-01

    Pelvic organ prolapse (POP) is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to clarify the risks, benefits, and the recognized indications for its use. PMID:25848324

  2. Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal.

    Science.gov (United States)

    McCoy, Olugbemisola; Vaughan, Taylor; Nickles, S Walker; Ashley, Matt; MacLachlan, Lara S; Ginsberg, David; Rovner, Eric

    2016-08-01

    We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence. In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion. This cohort of patients was evaluated for outcomes, including subjective and objective success, change in quality of life and complications between those who underwent staged vs concomitant synthetic mesh removal with autologous fascial pubovaginal sling placement. All 46 patients had received at least 1 prior mesh sling for incontinence and 8 (17%) had received prior transvaginal polypropylene mesh for pelvic organ prolapse repair. A total of 30 patients underwent concomitant mesh incision with or without partial excision and autologous sling placement while 16 underwent staged autologous sling placement. Mean followup was 16 months. Of the patients 22% required a mean of 1.8 subsequent interventions an average of 6.5 months after autologous sling placement with no difference in median quality of life at final followup. At last followup 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively. There was no difference in subjective success between patients treated with a staged vs a concomitant approach (69% vs 80%, p = 0.48). Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Persistent pelvic pain following transvaginal mesh surgery: a cause for mesh removal.

    Science.gov (United States)

    Marcus-Braun, Naama; Bourret, Antoine; von Theobald, Peter

    2012-06-01

    Persistent pelvic pain after vaginal mesh surgery is an uncommon but serious complication that greatly affects women's quality of life. Our aim was to evaluate various procedures for mesh removal performed at a tertiary referral center in cases of persistent pelvic pain, and to evaluate the ensuing complications and outcomes. A retrospective study was conducted at the University Hospital of Caen, France, including all patients treated for removal or section of vaginal mesh due to pelvic pain as a primary cause, between January 2004 and September 2009. Ten patients met the inclusion criteria. Patients were diagnosed between 10 months and 3 years after their primary operation. Eight cases followed suburethral sling procedures and two followed mesh surgery for pelvic organ prolapse. Patients presented with obturator neuralgia (6), pudendal neuralgia (2), dyspareunia (1), and non-specific pain (1). The surgical treatment to release the mesh included: three cases of extra-peritoneal laparoscopy, four cases of complete vaginal mesh removal, one case of partial mesh removal and two cases of section of the suburethral sling. In all patients with obturator neuralgia, symptoms were resolved or improved, whereas in both cases of pudendal neuralgia the symptoms continued. There were no intra-operative complications. Post-operative Retzius hematoma was observed in one patient after laparoscopy. Mesh removal in a tertiary center is a safe procedure, necessary in some cases of persistent pelvic pain. Obturator neuralgia seems to be easier to treat than pudendal neuralgia. Early diagnosis is the key to success in prevention of chronic disease. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Coarse mesh code development

    Energy Technology Data Exchange (ETDEWEB)

    Lieberoth, J.

    1975-06-15

    The numerical solution of the neutron diffusion equation plays a very important role in the analysis of nuclear reactors. A wide variety of numerical procedures has been proposed, at which most of the frequently used numerical methods are fundamentally based on the finite- difference approximation where the partial derivatives are approximated by the finite difference. For complex geometries, typical of the practical reactor problems, the computational accuracy of the finite-difference method is seriously affected by the size of the mesh width relative to the neutron diffusion length and by the heterogeneity of the medium. Thus, a very large number of mesh points are generally required to obtain a reasonably accurate approximate solution of the multi-dimensional diffusion equation. Since the computation time is approximately proportional to the number of mesh points, a detailed multidimensional analysis, based on the conventional finite-difference method, is still expensive even with modern large-scale computers. Accordingly, there is a strong incentive to develop alternatives that can reduce the number of mesh-points and still retain accuracy. One of the promising alternatives is the finite element method, which consists of the expansion of the neutron flux by piecewise polynomials. One of the advantages of this procedure is its flexibility in selecting the locations of the mesh points and the degree of the expansion polynomial. The small number of mesh points of the coarse grid enables to store the results of several of the least outer iterations and to calculate well extrapolated values of them by comfortable formalisms. This holds especially if only one energy distribution of fission neutrons is assumed for all fission processes in the reactor, because the whole information of an outer iteration is contained in a field of fission rates which has the size of all mesh points of the coarse grid.

  5. Obturator foramen dissection for excision of symptomatic transobturator mesh.

    Science.gov (United States)

    Reynolds, W Stuart; Kit, Laura Chang; Kaufman, Melissa R; Karram, Mickey; Bales, Gregory T; Dmochowski, Roger R

    2012-05-01

    Groin pain after transobturator synthetic mesh placement can be recalcitrant to conservative therapy and ultimately requires surgical excision. We describe our experiences with and technique of obturator foramen dissection for mesh excision. The records of 8 patients treated from 2005 to 2010, were reviewed. Obturator dissection was performed via a lateral groin incision over the inferior pubic ramus at the level of the obturator foramen, typically in conjunction with orthopedic surgery. Five patients had transobturator mid urethral sling surgery for stress urinary incontinence, 2 had mid urethral sling and trocar based anterior vaginal wall mesh kits with transobturator passage of mesh arms for stress urinary incontinence and pelvic organ prolapse, and 1 had an anterior vaginal wall mesh kit for pelvic organ prolapse. Patients had 0 to 2 prior transvaginal mesh excisions before obturator surgery. All patients presented with intractable pain in the area of the obturator foramen and/or medial groin for which conservative treatment measures had failed. Six patients underwent concurrent vaginal and obturator dissection and 2 underwent obturator dissection alone. In all cases residual mesh (3 to 11 cm) was identified and excised from the obturator foramen. Mesh was closely associated to or traversing the adductor longus muscle and tendon with significant fibrous reaction in all cases. Postoperatively 5 patients were cured of pain and/or infection, and 3 reported no or some improvement at a mean followup of 6 months (range 1 to 12). Our experience suggests that surgical excision of residual mesh can alleviate many of the symptoms in many patients. In all cases mesh remnants were identified and removed, and typically involved neuromuscular structures adjacent to the obturator foramen. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. Selective laser vaporization of polypropylene sutures and mesh

    Science.gov (United States)

    Burks, David; Rosenbury, Sarah B.; Kennelly, Michael J.; Fried, Nathaniel M.

    2012-02-01

    Complications from polypropylene mesh after surgery for female stress urinary incontinence (SUI) may require tedious surgical revision and removal of mesh materials with risk of damage to healthy adjacent tissue. This study explores selective laser vaporization of polypropylene suture/mesh materials commonly used in SUI. A compact, 7 Watt, 647-nm, red diode laser was operated with a radiant exposure of 81 J/cm2, pulse duration of 100 ms, and 1.0-mm-diameter laser spot. The 647-nm wavelength was selected because its absorption by water, hemoglobin, and other major tissue chromophores is low, while polypropylene absorption is high. Laser vaporization of ~200-μm-diameter polypropylene suture/mesh strands, in contact with fresh urinary tissue samples, ex vivo, was performed. Non-contact temperature mapping of the suture/mesh samples with a thermal camera was also conducted. Photoselective vaporization of polypropylene suture and mesh using a single laser pulse was achieved with peak temperatures of 180 and 232 °C, respectively. In control (safety) studies, direct laser irradiation of tissue alone resulted in only a 1 °C temperature increase. Selective laser vaporization of polypropylene suture/mesh materials is feasible without significant thermal damage to tissue. This technique may be useful for SUI procedures requiring surgical revision.

  7. Estudo das telas cirúrgicas de polipropileno/poliglecaprone e de polipropileno/polidioxanona/celulose oxidada regenerada na cicatrização de defeito produzido na parede abdominal de ratos Study of surgical meshes of polypropylene/polyglecaprone and polypropylene/polydioxanone/oxidized regenerated cellulose on the healing of defects produced in abdominal wall of rats

    Directory of Open Access Journals (Sweden)

    Marcia Regina Zanello Pundek

    2010-06-01

    Full Text Available RACIONAL: O uso de telas cirúrgicas para a correção de defeitos da parede abdominal vem ocupando cada vez mais espaço nas operações no mundo todo. OBJETIVO: Estudar duas telas cirúrgicas distintas (Proceed® e Ultrapro® na cicatrização de defeito produzido em parede abdominal de ratos avaliando-se macroscopia, tensiometria e microscopia. MÉTODO: A amostra foi constituída por 32 ratos Wistar, divididos em dois grupos de 16 animais e quatro subgrupos de oito, submetidos à eutanásia com 15 dias e 30 dias para avaliação. As variáveis macroscópicas foram: presença de hematoma nos bordos da sutura da tela cirúrgica na parede abdominal, união entre a tela e a borda da ferida, presença de infecção no sítio cirúrgico, presença de fístulas de vísceras com a tela cirúrgica, presença de aderências dentro da cavidade abdominal e presença de hérnia incisional. Na microscopia avaliaram-se as fases do processo inflamatório da cicatrização, e na tensiometria a força tênsil necessária para ruptura do material. RESULTADOS: A união entre a tela cirúrgica e a borda da ferida foi melhor no subgrupo Ultrapro 15 dias que no Proceed 15 dias; com 30 dias foi igual nos dois subgrupos. Não houve diferença significativa quanto às demais variáveis da macroscopia. Os dois grupos nos dois momentos tiveram a mesma proporção de casos com processo inflamatório crônico, mas houve maior escore de inflamação do Ultrapro 15 dias que do Ultrapro 30 dias. O subgrupo Ultrapro 15 dias mostrou força de ruptura maior que o subgrupo Proceed 15 dias, mas em 30 dias não houve diferença. Ultrapro mostrou força de ruptura igual para os dois momentos, mas Proceed 30 dias mostrou força de ruptura maior que Proceed 15 dias. CONCLUSÃO: As telas são semelhantes nas variáveis analisadas.BACKGROUND: The use of surgical meshes for the repair of abdominal wall defects has been increasing its share in surgeries worldwide. AIM: To study two

  8. Documentation for MeshKit - Reactor Geometry (&mesh) Generator

    Energy Technology Data Exchange (ETDEWEB)

    Jain, Rajeev [Argonne National Lab. (ANL), Argonne, IL (United States); Mahadevan, Vijay [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-09-30

    This report gives documentation for using MeshKit’s Reactor Geometry (and mesh) Generator (RGG) GUI and also briefly documents other algorithms and tools available in MeshKit. RGG is a program designed to aid in modeling and meshing of complex/large hexagonal and rectilinear reactor cores. RGG uses Argonne’s SIGMA interfaces, Qt and VTK to produce an intuitive user interface. By integrating a 3D view of the reactor with the meshing tools and combining them into one user interface, RGG streamlines the task of preparing a simulation mesh and enables real-time feedback that reduces accidental scripting mistakes that could waste hours of meshing. RGG interfaces with MeshKit tools to consolidate the meshing process, meaning that going from model to mesh is as easy as a button click. This report is designed to explain RGG v 2.0 interface and provide users with the knowledge and skills to pilot RGG successfully. Brief documentation of MeshKit source code, tools and other algorithms available are also presented for developers to extend and add new algorithms to MeshKit. RGG tools work in serial and parallel and have been used to model complex reactor core models consisting of conical pins, load pads, several thousands of axially varying material properties of instrumentation pins and other interstices meshes.

  9. In vitro extracellular matrix model to evaluate stroma cell response to transvaginal mesh.

    Science.gov (United States)

    Wu, Ming-Ping; Huang, Kuan-Hui; Long, Cheng-Yu; Yang, Chau-Chen; Tong, Yat-Ching

    2014-04-01

    The use of surgical mesh for female pelvic floor reconstruction has increased in recent years. However, there is paucity of information about the biological responses of host stroma cells to different meshes. This study was aimed to establish an in vitro experimental model to study the micro-environment of extracellular matrix (ECM) with embedded mesh and the stroma cell behaviors to different synthetic meshes. Matrigel multi-cellular co-culture system with embedded mesh was used to evaluate the interaction of stroma cells and synthetic mesh in a simulated ECM environment. Human umbilical vein endothelial cells (HUVEC) and NIH3T3 fibroblasts were inoculated in the system. The established multi-cellular Matrigel co-culture system was used to detect stroma cell recruitment and tube formation ability for different synthetic meshes. HUVEC and NIH3T3 cells were recruited into the mesh interstices and organized into tube-like structures in type I mesh material from Perigee, Marlex and Prolift 24 hr after cell inoculation. On the contrary, there was little recruitment of HUVEC and NIH3T3 cells into the type III mesh of intra-vaginal sling (IVS). The Matrigel multi-cellular co-culture system with embedded mesh offers a useful in vitro model to study the biological behaviors of stroma cells in response to different types of synthetic meshes. The system can help to select ideal mesh candidates before actual implantation into the human body. © 2013 Wiley Periodicals, Inc.

  10. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Cihad Tatar

    2016-08-01

    Full Text Available Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of noncomplicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3, and the other consisting of patients not undergoing bowel resection (Group 4. Results: In Group 1, it was observed that eight (7.14% of the patients had wound infections, while two (1.78% had hematomas, four (3.57% had seromas, and one (0.89% had relapse. In Group 2, one (2.56% of the patients had a wound infection, while three (7.69% had hematomas, one (2.56% had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection

  11. To mesh or not to mesh: a review of pelvic organ reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Dällenbach P

    2015-04-01

    Full Text Available Patrick Dällenbach Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, Geneva, Switzerland Abstract: Pelvic organ prolapse (POP is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to

  12. Toward An Unstructured Mesh Database

    Science.gov (United States)

    Rezaei Mahdiraji, Alireza; Baumann, Peter Peter

    2014-05-01

    Unstructured meshes are used in several application domains such as earth sciences (e.g., seismology), medicine, oceanography, cli- mate modeling, GIS as approximate representations of physical objects. Meshes subdivide a domain into smaller geometric elements (called cells) which are glued together by incidence relationships. The subdivision of a domain allows computational manipulation of complicated physical structures. For instance, seismologists model earthquakes using elastic wave propagation solvers on hexahedral meshes. The hexahedral con- tains several hundred millions of grid points and millions of hexahedral cells. Each vertex node in the hexahedrals stores a multitude of data fields. To run simulation on such meshes, one needs to iterate over all the cells, iterate over incident cells to a given cell, retrieve coordinates of cells, assign data values to cells, etc. Although meshes are used in many application domains, to the best of our knowledge there is no database vendor that support unstructured mesh features. Currently, the main tool for querying and manipulating unstructured meshes are mesh libraries, e.g., CGAL and GRAL. Mesh li- braries are dedicated libraries which includes mesh algorithms and can be run on mesh representations. The libraries do not scale with dataset size, do not have declarative query language, and need deep C++ knowledge for query implementations. Furthermore, due to high coupling between the implementations and input file structure, the implementations are less reusable and costly to maintain. A dedicated mesh database offers the following advantages: 1) declarative querying, 2) ease of maintenance, 3) hiding mesh storage structure from applications, and 4) transparent query optimization. To design a mesh database, the first challenge is to define a suitable generic data model for unstructured meshes. We proposed ImG-Complexes data model as a generic topological mesh data model which extends incidence graph model to multi

  13. Sonographic diagnosis of abscess following breast-conserving surgery with insertion of nonabsorbable mesh.

    Science.gov (United States)

    Song, Sung Eun; Seo, Bo Kyoung; Son, Gil-Soo; Kim, Young-Sik

    2014-09-01

    Immediate mesh insertion has been recently used for breast reconstruction after breast-conserving surgery. We report a case of abscess formation following immediate nonabsorbable mesh insertion with breast-conserving surgery. In this article, we demonstrate multimodal breast imaging features and pathologic correlations of the case. In addition, we illustrate characteristic sonographic findings of nonabsorbable mesh fibers to differentiate them from a gossypiboma caused by a retained surgical sponge or tumor recurrence. © 2014 Wiley Periodicals, Inc.

  14. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males

    DEFF Research Database (Denmark)

    Bay-Nielsen, M; Nilsson, E; Nordin, P

    2004-01-01

    BACKGROUND: Chronic pain is common after herniorrhaphy, but the effect of surgical technique (mesh versus non-mesh repair) and the social consequences of the pain have not been established. The aim of this study was to analyse chronic postherniorrhaphy pain and its social consequences in young...

  15. SUPERIMPOSED MESH PLOTTING IN MCNP

    Energy Technology Data Exchange (ETDEWEB)

    J. HENDRICKS

    2001-02-01

    The capability to plot superimposed meshes has been added to MCNP{trademark}. MCNP4C featured a superimposed mesh weight window generator which enabled users to set up geometries without having to subdivide geometric cells for variance reduction. The variance reduction was performed with weight windows on a rectangular or cylindrical mesh superimposed over the physical geometry. Experience with the new capability was favorable but also indicated that a number of enhancements would be very beneficial, particularly a means of visualizing the mesh and its values. The mathematics for plotting the mesh and its values is described here along with a description of other upgrades.

  16. Wireless mesh networks.

    Science.gov (United States)

    Wang, Xinheng

    2008-01-01

    Wireless telemedicine using GSM and GPRS technologies can only provide low bandwidth connections, which makes it difficult to transmit images and video. Satellite or 3G wireless transmission provides greater bandwidth, but the running costs are high. Wireless networks (WLANs) appear promising, since they can supply high bandwidth at low cost. However, the WLAN technology has limitations, such as coverage. A new wireless networking technology named the wireless mesh network (WMN) overcomes some of the limitations of the WLAN. A WMN combines the characteristics of both a WLAN and ad hoc networks, thus forming an intelligent, large scale and broadband wireless network. These features are attractive for telemedicine and telecare because of the ability to provide data, voice and video communications over a large area. One successful wireless telemedicine project which uses wireless mesh technology is the Emergency Room Link (ER-LINK) in Tucson, Arizona, USA. There are three key characteristics of a WMN: self-organization, including self-management and self-healing; dynamic changes in network topology; and scalability. What we may now see is a shift from mobile communication and satellite systems for wireless telemedicine to the use of wireless networks based on mesh technology, since the latter are very attractive in terms of cost, reliability and speed.

  17. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse.

    Science.gov (United States)

    Altman, Daniel; Väyrynen, Tapio; Engh, Marie Ellström; Axelsen, Susanne; Falconer, Christian

    2011-05-12

    The use of standardized mesh kits for repair of pelvic-organ prolapse has spread rapidly in recent years, but it is unclear whether this approach results in better outcomes than traditional colporrhaphy. In this multicenter, parallel-group, randomized, controlled trial, we compared the use of a trocar-guided, transvaginal polypropylene-mesh repair kit with traditional colporrhaphy in women with prolapse of the anterior vaginal wall (cystocele). The primary outcome was a composite of the objective anatomical designation of stage 0 (no prolapse) or 1 (position of the anterior vaginal wall more than 1 cm above the hymen), according to the Pelvic Organ Prolapse Quantification system, and the subjective absence of symptoms of vaginal bulging 12 months after the surgery. Of 389 women who were randomly assigned to a study treatment, 200 underwent prolapse repair with the transvaginal mesh kit and 189 underwent traditional colporrhaphy. At 1 year, the primary outcome was significantly more common in the women treated with transvaginal mesh repair (60.8%) than in those who underwent colporrhaphy (34.5%) (absolute difference, 26.3 percentage points; 95% confidence interval, 15.6 to 37.0). The surgery lasted longer and the rates of intraoperative hemorrhage were higher in the mesh-repair group than in the colporrhaphy group (Pmesh-repair group and 0.5% in the colporrhaphy group (P=0.07), and the respective rates of new stress urinary incontinence after surgery were 12.3% and 6.3% (P=0.05). Surgical reintervention to correct mesh exposure during follow-up occurred in 3.2% of 186 patients in the mesh-repair group. As compared with anterior colporrhaphy, use of a standardized, trocar-guided mesh kit for cystocele repair resulted in higher short-term rates of successful treatment but also in higher rates of surgical complications and postoperative adverse events. (Funded by the Karolinska Institutet and Ethicon; ClinicalTrials.gov number, NCT00566917.).

  18. A THREE-YEAR EXPERIENCE WITH ANTERIOR TRANSOBTURATOR MESH (ATOM AND POSTERIOR ISCHIORECTAL MESH (PIRM

    Directory of Open Access Journals (Sweden)

    Marijan Lužnik

    2018-02-01

    Full Text Available Background. Use of alloplastic mesh implantates allow a new urogynecologycal surgical techniques achieve a marked improvement in pelvic organ static and pelvic floor function with minimally invasive needle transvaginal intervention like an anterior transobturator mesh (ATOM and a posterior ischiorectal mesh (PIRM procedures. Methods. In three years, between April 2006 and May 2009, we performed one hundred and eightyfour operative corrections of female pelvic organ prolapse (POP and pelvic floor dysfunction (PFD with mesh implantates. The eighty-three patients with surgical procedure TVT-O or Monarc as solo intervention indicated by stress urinary incontinence without POP, are not included in this number. In 97 % of mesh operations, Gynemesh 10 × 15 cm was used. For correction of anterior vaginal prolapse with ATOM procedure, Gynemesh was individually trimmed in mesh with 6 free arms for tension-free transobturator application and tension-free apical collar. IVS (Intravaginal sling 04 Tunneller (Tyco needle system was used for transobturator application of 6 arms through 4 dermal incisions (2 on right and 2 on left. Minimal anterior median colpotomy was made in two separate parts. For correction of posterior vaginal prolapse with PIRM procedure Gynemesh was trimmed in mesh with 4 free arms and tension-free collar. Two ischiorectal long arms for tension-free application through fossa ischiorectale – right and left, and two short arms for perineal body also on both sides. IVS 02 Tunneller (Tyco needle system was used for tension-free application of 4 arms through 4 dermal incisions (2 on right and 2 on left in PIRM. Results. All 184 procedures were performed relatively safely. In 9 cases of ATOM we had perforation of bladder, in 5 by application of anterior needle, in 3 by application of posterior needle and in one case with pincette when collar was inserted in lateral vesico – vaginal space. In 2 cases of PIRM we had perforation of rectum

  19. Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

    Science.gov (United States)

    Kelly, Erin C; Winick-Ng, Jennifer; Welk, Blayne

    2016-07-01

    To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume. We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5-6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11-14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model. A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0-8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58-2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40-0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation. Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.

  20. Notes on the Mesh Handler and Mesh Data Conversion

    International Nuclear Information System (INIS)

    Lee, Sang Yong; Park, Chan Eok

    2009-01-01

    At the outset of the development of the thermal-hydraulic code (THC), efforts have been made to utilize the recent technology of the computational fluid dynamics. Among many of them, the unstructured mesh approach was adopted to alleviate the restriction of the grid handling system. As a natural consequence, a mesh handler (MH) has been developed to manipulate the complex mesh data from the mesh generator. The mesh generator, Gambit, was chosen at the beginning of the development of the code. But a new mesh generator, Pointwise, was introduced to get more flexible mesh generation capability. An open source code, Paraview, was chosen as a post processor, which can handle unstructured as well as structured mesh data. Overall data processing system for THC is shown in Figure-1. There are various file formats to save the mesh data in the permanent storage media. A couple of dozen of file formats are found even in the above mentioned programs. A competent mesh handler should have the capability to import or export mesh data as many as possible formats. But, in reality, there are two aspects that make it difficult to achieve the competence. The first aspect to consider is the time and efforts to program the interface code. And the second aspect, which is even more difficult one, is the fact that many mesh data file formats are proprietary information. In this paper, some experience of the development of the format conversion programs will be presented. File formats involved are Gambit neutral format, Ansys-CFX grid file format, VTK legacy file format, Nastran format and CGNS

  1. What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

    Science.gov (United States)

    Köckerling, F; Alam, N N; Antoniou, S A; Daniels, I R; Famiglietti, F; Fortelny, R H; Heiss, M M; Kallinowski, F; Kyle-Leinhase, I; Mayer, F; Miserez, M; Montgomery, A; Morales-Conde, S; Muysoms, F; Narang, S K; Petter-Puchner, A; Reinpold, W; Scheuerlein, H; Smietanski, M; Stechemesser, B; Strey, C; Woeste, G; Smart, N J

    2018-04-01

    Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. A European working group, "BioMesh Study Group", composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used. The cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes. The routine use of biologic and biosynthetic meshes cannot be recommended.

  2. Evidence for replacement of an infected synthetic by a biological mesh in abdominal wall hernia repair

    Directory of Open Access Journals (Sweden)

    Agneta eMontgomery

    2016-01-01

    Full Text Available The incidence of deep infection using a synthetic mesh in inguinal hernia repair is low and reported to be well below 1%. This is in contrast to incisional hernia surgery where the reported incidence is 3% respective 13% comparing laparoscopic to open mesh repair reported in a Cochrane review. Main risk factors were long operation time, surgical site contamination and early wound complications. An infected mesh can be preserved using conservative treatment were negative pressure wound therapy (VAC® could play an important role. If strategy fails, the mesh needs to be removed. This review aims to look at evidence for situations were a biological mesh would work as a replacement of a removed infected synthetic mesh. Material and MethodsA literature search of the Medline database was performed using the PubMed search engine. Twenty publications were found relevant for this review.ResultsFor studies reviewed three options are presented: removal of the infected synthetic mesh alone, replacement with either a new synthetic or a new biological mesh. Operations were all performed at specialist centers. Removal of the mesh alone was an option limited to inguinal hernias. In ventral/incisional hernias the use of a biological mesh for replacement resulted in a very high recurrence rate, if bridging was required. Either a synthetic or a biological mesh seems to work as a replacement when fascial closure can be achieved. Evidence is though very low. ConclusionWhen required, either a synthetic or a biological meshes seems to work as a replacement for an infected synthetic mesh if the defect can be closed. It is however not recommended to use a biological mesh for bridging. Mesh replacement surgery is demanding and is recommended to be performed in a specialist center.

  3. A comparative study of onlay and retrorectus mesh placement in incisional hernia repair

    Directory of Open Access Journals (Sweden)

    Kundan Kharde

    2013-01-01

    Full Text Available Introduction: Incisional hernia after abdominal surgery is a well-known complication and the incidence of incisional hernias continues to be 2-11% after laparotomy. The repair of incisional hernia has always been a challenge to the surgeon. Various operative techniques for the repair of incisional hernia are in practice; however, the management is not standardized. The retro-rectus mesh placement or the sub-lay technique, popularized by Rives and Stoppa in Europe, has been reported to be quite effective, with low recurrence rates (0-23% and minimal complications. Aims and Objective: The purpose of this study was to compare the traditional on-lay mesh and retro-rectus mesh placement in incisional hernia repairs in terms of time taken for surgery, early complications (wound infections, Mesh extrusion, and Delayed complications (Recurrence. Materials and Methods: This is a prospective study which was conducted in the surgical department of our hospital. A total of 50 cases were included in this study. Of these cases, 25 cases were operated by the on-lay mesh method and 25 by retro-rectus mesh placement. Only the patients with midline hernias up to 10 cm in diameter were included in the study. Result: The operative time for retro-rectus mesh placement was insignificantly higher than that of on-lay mesh repair, whereas, complications like superficial Surgical site infection SSI were identical in both the study groups, but deep SSI leading to infection of mesh was higher in on-lay mesh repair. The recurrence rate was found to be 4% in on-lay mesh repair and 0% in retro-rectus mesh repair. Conclusion: The follow-up period in this study was 6months; hence, late recurrences were not taken into account. However, the low rate of local complications and the low recurrence rate indicate that retro-rectus mesh repair has an advantage over traditional on-lay repair.

  4. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.

    2013-01-01

    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  5. Streaming simplification of tetrahedral meshes.

    Science.gov (United States)

    Vo, Huy T; Callahan, Steven P; Lindstrom, Peter; Pascucci, Valerio; Silva, Cláudio T

    2007-01-01

    Unstructured tetrahedral meshes are commonly used in scientific computing to represent scalar, vector, and tensor fields in three dimensions. Visualization of these meshes can be difficult to perform interactively due to their size and complexity. By reducing the size of the data, we can accomplish real-time visualization necessary for scientific analysis. We propose a two-step approach for streaming simplification of large tetrahedral meshes. Our algorithm arranges the data on disk in a streaming, I/O-efficient format that allows coherent access to the tetrahedral cells. A quadric-based simplification is sequentially performed on small portions of the mesh in-core. Our output is a coherent streaming mesh which facilitates future processing. Our technique is fast, produces high quality approximations, and operates out-of-core to process meshes too large for main memory.

  6. Sacral colpopexy versus transvaginal mesh colpopexy in obese patients.

    Science.gov (United States)

    McDermott, Colleen D; Park, Jean; Terry, Colin L; Woodman, Patrick J; Hale, Douglass S

    2013-05-01

    Obesity can predispose women to pelvic organ prolapse and can also affect the success of pelvic organ prolapse surgery. The purpose of this study was to compare the postoperative anatomical outcomes following sacral colpopexy (SC) and transvaginal mesh colpopexy in a group of obese women with pelvic organ prolapse. We conducted a retrospective cohort study of obese women who underwent SC (n = 56) or transvaginal mesh colpopexy (n = 35). Follow-up ranged from 6 to 12 months. Preoperative, perioperative, and postoperative variables were compared using Student t, Mann-Whitney U, and Fisher exact tests, and by analysis of covariance. The women in the SC group had significantly higher mean apical vaginal measurements (P transvaginal mesh colpopexy group. There were no significant differences between the groups for other postoperative outcomes, including mesh erosion, recurrent prolapse symptoms, dyspareunia, and surgical satisfaction (P > 0.05). In these 91 obese patients with pelvic organ prolapse, SC resulted in better anatomical outcomes than transvaginal mesh colpopexy. However, the two procedures had similar outcomes with regard to recurrent symptoms and surgical satisfaction.

  7. Surface meshing with curvature convergence

    KAUST Repository

    Li, Huibin; Zeng, Wei; Morvan, Jean-Marie; Chen, Liming; Gu, Xianfengdavid

    2014-01-01

    Surface meshing plays a fundamental role in graphics and visualization. Many geometric processing tasks involve solving geometric PDEs on meshes. The numerical stability, convergence rates and approximation errors are largely determined by the mesh qualities. In practice, Delaunay refinement algorithms offer satisfactory solutions to high quality mesh generations. The theoretical proofs for volume based and surface based Delaunay refinement algorithms have been established, but those for conformal parameterization based ones remain wide open. This work focuses on the curvature measure convergence for the conformal parameterization based Delaunay refinement algorithms. Given a metric surface, the proposed approach triangulates its conformal uniformization domain by the planar Delaunay refinement algorithms, and produces a high quality mesh. We give explicit estimates for the Hausdorff distance, the normal deviation, and the differences in curvature measures between the surface and the mesh. In contrast to the conventional results based on volumetric Delaunay refinement, our stronger estimates are independent of the mesh structure and directly guarantee the convergence of curvature measures. Meanwhile, our result on Gaussian curvature measure is intrinsic to the Riemannian metric and independent of the embedding. In practice, our meshing algorithm is much easier to implement and much more efficient. The experimental results verified our theoretical results and demonstrated the efficiency of the meshing algorithm. © 2014 IEEE.

  8. Surface meshing with curvature convergence

    KAUST Repository

    Li, Huibin

    2014-06-01

    Surface meshing plays a fundamental role in graphics and visualization. Many geometric processing tasks involve solving geometric PDEs on meshes. The numerical stability, convergence rates and approximation errors are largely determined by the mesh qualities. In practice, Delaunay refinement algorithms offer satisfactory solutions to high quality mesh generations. The theoretical proofs for volume based and surface based Delaunay refinement algorithms have been established, but those for conformal parameterization based ones remain wide open. This work focuses on the curvature measure convergence for the conformal parameterization based Delaunay refinement algorithms. Given a metric surface, the proposed approach triangulates its conformal uniformization domain by the planar Delaunay refinement algorithms, and produces a high quality mesh. We give explicit estimates for the Hausdorff distance, the normal deviation, and the differences in curvature measures between the surface and the mesh. In contrast to the conventional results based on volumetric Delaunay refinement, our stronger estimates are independent of the mesh structure and directly guarantee the convergence of curvature measures. Meanwhile, our result on Gaussian curvature measure is intrinsic to the Riemannian metric and independent of the embedding. In practice, our meshing algorithm is much easier to implement and much more efficient. The experimental results verified our theoretical results and demonstrated the efficiency of the meshing algorithm. © 2014 IEEE.

  9. Outcomes of trocar-guided Gynemesh PS™ versus single-incision trocarless Polyform™ transvaginal mesh procedures.

    Science.gov (United States)

    Larouche, Maryse; Merovitz, Lisa; Correa, José A; Walter, Jens-Erik

    2015-01-01

    The aim of the study was to compare rates of success, mesh exposure, and surgical re-intervention after trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh procedures. We conducted a retrospective cohort study of all transvaginal mesh procedures performed at our centers between January 2008 and May 2012. Multiple logistic regression models were used to explore the binary outcomes of objective and subjective success rates, as well as mesh exposure and re-intervention rates, between the two procedures after adjustment for patient's age, parity, body mass index, smoking status, previous hysterectomy, previous prolapse surgery, and follow-up time. We included 103 transvaginal mesh procedures (47 trocar-guided Gynemesh PS™ and 56 trocarless Polyform™). In both groups, Pelvic Organ Prolapse Quantification (POP-Q) scores were significantly improved after the procedure. Median follow-up was 340 days and interquartile range (IQR) 152-644. Objective success rates were 55.3 % (26/47) in the trocar group and 60.7 % (34/56) in the trocarless group (p = 0.9), whereas subjective success was 83.0 % (39/47) and 94.6 % (53/56), respectively (p = 0.1). The adjusted odds of developing mesh exposure were significantly less after trocarless transvaginal mesh procedures compared to trocar-guided ones [odds ratio (OR) 0.16, 95 % confidence interval (CI) 0.03-0.97]. Surgical re-interventions, aimed mostly at treating recurrent prolapse, mesh exposure, and latent stress urinary incontinence, were also significantly less frequent after trocarless procedures [5 patients (8.9 %) requiring re-intervention versus 15 (31.9 %), respectively, adjusted OR 0.15, 95 % CI 0.04-0.60]. Trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh systems result in similar objective and subjective success rates. The newer Polyform™ mesh results in significantly fewer mesh exposures and surgical re-interventions.

  10. [Current state of transvaginal meshes by resolution of pelvic organ prolapse].

    Science.gov (United States)

    Jírová, J; Pán, M

    Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans-vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials). Review. Department of Obstetrics and Gynecology, Regional hospital Mladá Boleslav a.s., Mladá Boleslav. Overview of the results of recent studies published in the Czech and English language in recent years. Pelvic organ prolapse repair with vaginal mesh has generally lower count of relapse especially in patients with wide genital hiatal area and with major levator ani avulsion. The spectrum of complications differs from classical techniques because of the presence of synthetic nonabsorbable material. Some of the specific complications we did not encounter during classical operations include vaginal mesh erosion, infection of mesh associated with chronic pelvic pain, dyspareunia, protrusion of the mesh into the closest organs or the rejection and progressive extrusion of the mesh. Primary enthusiasm has now been replaced with worries of major complications. Future tasks should therefore be aimed at minimizing the rate of complications associated with transvaginal meshes. Except using well-known and safe materials and providing specialized training of physicians for each mesh implantation technique, other precautions outlined in this article should help, such as a closer specification of indication for the application of transvaginal mesh.

  11. Reconstructive laparoscopic prolapse surgery to avoid mesh erosions

    Directory of Open Access Journals (Sweden)

    Devassy, Rajesh

    2013-09-01

    Full Text Available Introduction: The objective of the study is to examine the efficacy of the purely laparoscopic reconstructive management of cystocele and rectocele with mesh, to avoid the risk of erosion by the graft material, a well known complication in vaginal mesh surgery. Material and methods: We performed a prospective, single-case, non-randomized study in 325 patients who received laparoscopic reconstructive management of pelvic organe prolaps with mesh. The study was conducted between January 2004 and December 2012 in a private clinic in India. The most common prolapse symptoms were reducible vaginal lump, urinary stress incontinence, constipation and flatus incontinence, sexual dysfunction and dypareunia. The degree e of the prolaps was staged according to POPQ system. The approach was purely laparoscopic and involved the use of polypropylene (Prolene or polyurethane with activated regenerated cellulose coating (Parietex mesh. Results: The mean age was 55 (30–80 years and the most of the patients were multiparous (272/325. The patients received a plastic correction of the rectocele only (138 cases, a cystocele and rectocele (187 cases with mesh. 132 patients had a concomitant total hysterectomy; in 2 cases a laparoscopic supracervical hysterectomy was performed and 190 patients had a laparoscopic colposuspension. The mean operation time was 82.2 (60–210 minutes. The mean follow up was 3.4 (3–5 years. Urinary retention developed in 1 case, which required a new laparoscopical intervention. Bladder injury, observed in the same case was in one session closed with absorbable suture. There were four recurrences of the rectocele, receiving a posterior vaginal colporrhaphy. Erosions of the mesh were not reported or documented. Conclusion: The pure laparoscopic reconstructive management of the cystocele and rectocele with mesh seems to be a safe and effective surgical procedure potentially avoiding the risk of mesh erosions.

  12. Ventral hernia repair with poly-4-hydroxybutyrate mesh.

    Science.gov (United States)

    Plymale, Margaret A; Davenport, Daniel L; Dugan, Adam; Zachem, Amanda; Roth, John Scott

    2018-04-01

    Biomaterial research has made available a biologically derived fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for use in ventral and incisional hernia repair (VIHR). This study evaluates outcomes of patients undergoing VIHR with P4HB mesh. An IRB-approved prospective pilot study was conducted to assess clinical and quality of life (QOL) outcomes for patients undergoing VIHR with P4HB mesh. Perioperative characteristics were defined. Clinical outcomes, employment status, QOL using 12-item short form survey (SF-12), and pain assessments were followed for 24 months postoperatively. 31 patients underwent VIHR with bioresorbable mesh via a Rives-Stoppa approach with retrorectus mesh placement. The median patient age was 52 years, median body mass index was 33 kg/m 2 , and just over half of the patients were female. Surgical site occurrences occurred in 19% of patients, most of which were seroma. Hernia recurrence rate was 0% (median follow-up = 414 days). Patients had significantly improved QOL at 24 months compared to baseline for SF-12 physical component summary and role emotional (p < 0.05). Ventral hernia repair with P4HB bioresorbable mesh results in favorable outcomes. Early hernia recurrence was not identified among the patient cohort. Quality of life improvements were noted at 24 months versus baseline for this cohort of patients with bioresorbable mesh. Use of P4HB mesh for ventral hernia repair was found to be feasible in this patient population. (ClinicalTrials.gov Identifier: NCT01863030).

  13. Outcome of transvaginal mesh and tape removed for pain only.

    Science.gov (United States)

    Hou, Jack C; Alhalabi, Feras; Lemack, Gary E; Zimmern, Philippe E

    2014-09-01

    Because there is reluctance to operate for pain, we evaluated midterm outcomes of vaginal mesh and synthetic suburethral tape removed for pain as the only indication. After receiving institutional review board approval we reviewed a prospective database of women without a neurogenic condition who underwent surgery for vaginal mesh or suburethral tape removal with a focus on pain as the single reason for removal and a minimum 6-month followup. The primary outcome was pain level assessed by a visual analog scale (range 0 to 10) at baseline and at each subsequent visit with the score at the last visit used for analysis. Parameters evaluated included demographics, mean time to presentation and type of mesh or tape inserted. From 2005 to 2013, 123 patients underwent surgical removal of mesh (69) and suburethral tape (54) with pain as the only indication. Mean followup was 35 months (range 6 to 59) in the tape group and 22 months (range 6 to 47) in the mesh group. The visual analog scale score decreased from a mean preoperative level of 7.9 to 0.9 postoperatively (p = 0.0014) in the mesh group and from 5.3 to 1.5 (p = 0.00074) in the tape group. Pain-free status, considered a score of 0, was achieved in 81% of tape and 67% of mesh cases, respectively. No statistically significant difference was found between the groups. When pain is the only indication for suburethral tape or vaginal mesh removal, a significant decrease in the pain score can be durably expected after removal in most patients at midterm followup. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Trans-Vaginal Mesh Revision: A Comprehensive Review on Etiologies and Management Strategies with Emphasis on Postoperative Pain Outcomes.

    Science.gov (United States)

    Mock, Stephen; Reynolds, William S; Dmochowski, Roger R

    2014-05-01

    The use of polypropylene mesh to augment surgery aimed to correct pelvic organ prolapse and stress urinary incontinence stems largely from the high recurrence rates of native tissue repairs. While objective outcomes were improved, mesh related complications began to emerge that included mesh exposures, extrusions, dyspareunia and other pain issues. However, the indication for and benefit of surgical intervention(s) to address these complications are lacking. We aim to review to current literature regarding postoperative pain outcomes following vaginal mesh revision. Evidence based literature indicates that mesh complications are not rare and surgery that aims to address them generally have an overall benefit. However, studies available are generally small case series of a retrospective nature with short follow up. Some themes are evident: there is a long lag period from mesh insertion to removal; there is a lack of a true denominator of total mesh insertions making it hard to gauge the real scope of the problem; mesh material found not along the expected trocar path or coursing close to neurovascular structures thus raises the possibility of technical errors during insertion. Transvaginal mesh revision(s) for mesh complications generally have a positive effect on pain outcomes, but better controlled studies are needed. Additionally, since technical issues may be a factor in the development of mesh complications, rigorous training and sufficient surgical case volume should be emphasized. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Leveraging the power of mesh

    Energy Technology Data Exchange (ETDEWEB)

    Glass, H. [Cellnet, Alpharetta, GA (United States)

    2006-07-01

    Mesh network applications are used by utilities for metering, demand response, and mobile workforce management. This presentation provided an overview of a multi-dimensional mesh application designed to offer improved scalability and higher throughput in advanced metering infrastructure (AMI) systems. Mesh applications can be used in AMI for load balancing and forecasting, as well as for distribution and transmission planning. New revenue opportunities can be realized through the application's ability to improve notification and monitoring services, and customer service communications. Mesh network security features include data encryption, data fragmentation and the automatic re-routing of data. In order to use mesh network applications, networks must have sufficient bandwidth and provide flexibility at the endpoint layer to support multiple devices from multiple vendors, as well as support multiple protocols. It was concluded that smart meters will not enable energy response solutions without an underlying AMI that is reliable, scalable and self-healing. .refs., tabs., figs.

  16. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  17. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  18. Streaming Compression of Hexahedral Meshes

    Energy Technology Data Exchange (ETDEWEB)

    Isenburg, M; Courbet, C

    2010-02-03

    We describe a method for streaming compression of hexahedral meshes. Given an interleaved stream of vertices and hexahedral our coder incrementally compresses the mesh in the presented order. Our coder is extremely memory efficient when the input stream documents when vertices are referenced for the last time (i.e. when it contains topological finalization tags). Our coder then continuously releases and reuses data structures that no longer contribute to compressing the remainder of the stream. This means in practice that our coder has only a small fraction of the whole mesh in memory at any time. We can therefore compress very large meshes - even meshes that do not file in memory. Compared to traditional, non-streaming approaches that load the entire mesh and globally reorder it during compression, our algorithm trades a less compact compressed representation for significant gains in speed, memory, and I/O efficiency. For example, on the 456k hexahedra 'blade' mesh, our coder is twice as fast and uses 88 times less memory (only 3.1 MB) with the compressed file increasing about 3% in size. We also present the first scheme for predictive compression of properties associated with hexahedral cells.

  19. Mesh Adaptation and Shape Optimization on Unstructured Meshes, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — In this SBIR CRM proposes to implement the entropy adjoint method for solution adaptive mesh refinement into the Loci/CHEM unstructured flow solver. The scheme will...

  20. Computational mesh generation for vascular structures with deformable surfaces

    International Nuclear Information System (INIS)

    Putter, S. de; Laffargue, F.; Breeuwer, M.; Vosse, F.N. van de; Gerritsen, F.A.; Philips Medical Systems, Best

    2006-01-01

    Computational blood flow and vessel wall mechanics simulations for vascular structures are becoming an important research tool for patient-specific surgical planning and intervention. An important step in the modelling process for patient-specific simulations is the creation of the computational mesh based on the segmented geometry. Most known solutions either require a large amount of manual processing or lead to a substantial difference between the segmented object and the actual computational domain. We have developed a chain of algorithms that lead to a closely related implementation of image segmentation with deformable models and 3D mesh generation. The resulting processing chain is very robust and leads both to an accurate geometrical representation of the vascular structure as well as high quality computational meshes. The chain of algorithms has been tested on a wide variety of shapes. A benchmark comparison of our mesh generation application with five other available meshing applications clearly indicates that the new approach outperforms the existing methods in the majority of cases. (orig.)

  1. Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment

    NARCIS (Netherlands)

    Notten, K. J. B.; Essers, B. A.; Weemhoff, M.; Rutten, A. G. H.; Donners, J. J. A. E.; van Gestel, I.; Kruitwagen, R. F. M. P.; Roovers, J. P. W. R.; Dirksen, C. D.

    2015-01-01

    We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or

  2. Mersiline mesh in premaxillary augmentation.

    Science.gov (United States)

    Foda, Hossam M T

    2005-01-01

    Premaxillary retrusion may distort the aesthetic appearance of the columella, lip, and nasal tip. This defect is characteristically seen in, but not limited to, patients with cleft lip nasal deformity. This study investigated 60 patients presenting with premaxillary deficiencies in which Mersiline mesh was used to augment the premaxilla. All the cases had surgery using the external rhinoplasty technique. Two methods of augmentation with Mersiline mesh were used: the Mersiline roll technique, for the cases with central symmetric deficiencies, and the Mersiline packing technique, for the cases with asymmetric deficiencies. Premaxillary augmentation with Mersiline mesh proved to be simple technically, easy to perform, and not associated with any complications. Periodic follow-up evaluation for a mean period of 32 months (range, 12-98 months) showed that an adequate degree of premaxillary augmentation was maintained with no clinically detectable resorption of the mesh implant.

  3. GENERATION OF IRREGULAR HEXAGONAL MESHES

    Directory of Open Access Journals (Sweden)

    Vlasov Aleksandr Nikolaevich

    2012-07-01

    Decomposition is performed in a constructive way and, as option, it involves meshless representation. Further, this mapping method is used to generate the calculation mesh. In this paper, the authors analyze different cases of mapping onto simply connected and bi-connected canonical domains. They represent forward and backward mapping techniques. Their potential application for generation of nonuniform meshes within the framework of the asymptotic homogenization theory is also performed to assess and project effective characteristics of heterogeneous materials (composites.

  4. Field-aligned mesh joinery

    OpenAIRE

    Cignoni, Paolo; Pietroni, Nico; Malomo, Luigi

    2014-01-01

    Mesh joinery is an innovative method to produce illustrative shape approximations suitable for fabrication. Mesh joinery is capable of producing complex fabricable structures in an efficient and visually pleasing manner. We represent an input geometry as a set of planar pieces arranged to compose a rigid structure, by exploiting an efficient slit mechanism. Since slices are planar, to fabricate them a standard 2D cutting system is enough. We automatically arrange slices according to a smooth ...

  5. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  6. Method and system for mesh network embedded devices

    Science.gov (United States)

    Wang, Ray (Inventor)

    2009-01-01

    A method and system for managing mesh network devices. A mesh network device with integrated features creates an N-way mesh network with a full mesh network topology or a partial mesh network topology.

  7. Mesh versus non-mesh repair of ventral abdominal hernias

    International Nuclear Information System (INIS)

    Jawaid, M.A.; Talpur, A.H.

    2008-01-01

    To investigate the relative effectiveness of mesh and suture repair of ventral abdominal hernias in terms of clinical outcome, quality of life and rate of recurrence in both the techniques. This is a retrospective descriptive analysis of 236 patients with mesh and non-mesh repair of primary ventral hernias performed between January 2000 to December 2004 at Surgery Department, Liaquat University of Medical and Health Sciences, Jamshoro. The record sheets of the patients were analyzed and data retrieved to compare the results of both techniques for short-term and long-term results. The data retrieved is statistically analyzed on SPSS version 11. There were 43 (18.22%) males and 193 (81.77%) females with a mean age of 51.79 years and a range of 59 (81-22). Para-umbilical hernia was the commonest of ventral hernia and accounted for 49.8% (n=118) of the total study population followed by incisional hernia comprising 24% (n=57) of the total number. There was a significant difference in the recurrent rate at 3 years interval with 23/101 (22.77%) recurrences in suture-repaired subjects compared to 10/135 (7.40%) in mesh repair group. Chronic pain lasting up to 1-2 years was noted in 14 patients with suture repair. Wound infection is comparatively more common (8.14%) in mesh group. The other variables such as operative and postoperative complications, total hospital stay and quality of life is also discussed. Mesh repair of ventral hernia is much superior to non-mesh suture repair in terms of recurrence and overall outcome. (author)

  8. Effects of mesenchymal stem cell and fibroblast coating on immunogenic potential of prosthetic meshes in vitro.

    Science.gov (United States)

    Gao, Yue; Krpata, David M; Criss, Cory N; Liu, Lijia; Posielski, Natasza; Rosen, Michael J; Novitsky, Yuri W

    2014-08-01

    The aim of this study was to reveal the effect of fibroblast or mesenchymal stem cell (MSC) coating on the mesh-induced production of IL-1β, IL-6, and VEGF by macrophages. Four commonly used surgical meshes were tested in this study, including Parietex, SoftMesh, TIGR, and Strattice. One-square-centimeter pieces of each mesh were placed on top of a monolayer of human fibroblasts or rat MSCs. The coating status was monitored with a light microscope. The human promonocytic cell line U937 was induced to differentiate into macrophages (MΦ). Three weeks later, meshes were transferred to new 24-well plates and cocultured with the MΦs for 72 h. Culture medium was collected and analyzed for IL-1β, IL-6, and VEGF production using standard ELISA essays. Parallel mesh samples were fixed with paraformaldehyde or glutaraldehyde for histology or transmission electronic microscopy (TEM) analyses, respectively. Uncoated meshes induced increased production of all three cytokines compared with macrophages cultured alone. HF coating further increased the production of both IL-6 and VEGF but reduced IL-1β production. Except for the SoftMesh group, MSC coating significantly blunted release of all cytokines to levels even lower than with MΦs cultured alone. MΦs tended to deteriorate in the presence of MSCs. Both histology and TEM revealed intimate interactions between cell-coated meshes and MΦs. Cytokine response to fibroblast coating varied, while MSC coating blunted the immunogenic effect of both synthetic and biologic meshes in vitro. Cell coating appears to affect mesh biocompatibility and may become a key process in mesh evolution.

  9. User Manual for the PROTEUS Mesh Tools

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Micheal A. [Argonne National Lab. (ANL), Argonne, IL (United States); Shemon, Emily R. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-06-01

    This report describes the various mesh tools that are provided with the PROTEUS code giving both descriptions of the input and output. In many cases the examples are provided with a regression test of the mesh tools. The most important mesh tools for any user to consider using are the MT_MeshToMesh.x and the MT_RadialLattice.x codes. The former allows the conversion between most mesh types handled by PROTEUS while the second allows the merging of multiple (assembly) meshes into a radial structured grid. Note that the mesh generation process is recursive in nature and that each input specific for a given mesh tool (such as .axial or .merge) can be used as “mesh” input for any of the mesh tools discussed in this manual.

  10. User Manual for the PROTEUS Mesh Tools

    International Nuclear Information System (INIS)

    Smith, Micheal A.; Shemon, Emily R.

    2015-01-01

    This report describes the various mesh tools that are provided with the PROTEUS code giving both descriptions of the input and output. In many cases the examples are provided with a regression test of the mesh tools. The most important mesh tools for any user to consider using are the MT M eshToMesh.x and the MT R adialLattice.x codes. The former allows the conversion between most mesh types handled by PROTEUS while the second allows the merging of multiple (assembly) meshes into a radial structured grid. Note that the mesh generation process is recursive in nature and that each input specific for a given mesh tool (such as .axial or .merge) can be used as ''mesh'' input for any of the mesh tools discussed in this manual.

  11. Preparation and Characterization of Antibacterial Polypropylene Meshes with Covalently Incorporated β-Cyclodextrins and Captured Antimicrobial Agent for Hernia Repair

    Directory of Open Access Journals (Sweden)

    Noor Sanbhal

    2018-01-01

    Full Text Available Polypropylene (PP light weight meshes are commonly used as hernioplasty implants. Nevertheless, the growth of bacteria within textile knitted mesh intersections can occur after surgical mesh implantation, causing infections. Thus, bacterial reproduction has to be stopped in the very early stage of mesh implantation. Herein, novel antimicrobial PP meshes grafted with β-CD and complexes with triclosan were prepared for mesh infection prevention. Initially, PP mesh surfaces were functionalized with suitable cold oxygen plasma. Then, hexamethylene diisocyanate (HDI was successfully grafted on the plasma-activated PP surfaces. Afterwards, β-CD was connected with the already HDI reacted PP meshes and triclosan, serving as a model antimicrobial agent, was loaded into the cyclodextrin (CD cavity for desired antibacterial functions. The hydrophobic interior and hydrophilic exterior of β-CD are well suited to form complexes with hydrophobic host guest molecules. Thus, the prepared PP mesh samples, CD-TCL-2 and CD-TCL-6 demonstrated excellent antibacterial properties against Staphylococcus aureus and Escherichia coli that were sustained up to 11 and 13 days, respectively. The surfaces of chemically modified PP meshes showed dramatically reduced water contact angles. Moreover, X-ray diffractometer (XRD, differential scanning calorimeter (DSC, and Thermogravimetric (TGA evidenced that there was no significant effect of grafted hexamethylene diisocyanate (HDI and CD on the structural and thermal properties of the PP meshes.

  12. No. 351-Transvaginal Mesh Procedures for Pelvic Organ Prolapse.

    Science.gov (United States)

    Larouche, Maryse; Geoffrion, Roxana; Walter, Jens-Erik

    2017-11-01

    This guideline reviews the evidence related to the risks and benefits of using transvaginal mesh in pelvic organ prolapse repairs in order to update recommendations initially made in 2011. Gynaecologists, residents, urologists, urogynaecologists, and other health care providers who assess, counsel, and care for women with pelvic organ prolapse. Adult women with symptomatic pelvic organ prolapse considering surgery and those who have previously undergone transvaginal mesh procedures for the treatment of pelvic organ prolapse. The discussion relates to transvaginal mesh procedures compared with other surgical options for pelvic organ prolapse (mainly about vaginal native tissue repairs and minimally about other alternatives such as biological and absorbable vaginal mesh and abdominally placed surgical mesh). The outcomes of interest are objective and subjective success rates and intraoperative and postoperative complications, such as adjacent organ injury (urinary, gastrointestinal), infection, hematoma/bleeding, vaginal mesh exposure, persistent pain, dyspareunia, de novo stress urinary incontinence, and reoperation. PubMed, Medline, the Cochrane Database, and EMBASE were searched using the key words pelvic organ prolapse/surgery*, prolapse/surgery*, surgical mesh, surgical mesh*/adverse effects, transvaginal mesh, and pelvic organ prolapse. were restricted to English or French language and human research. Articles obtained through this search strategy were included until the end of June 2016. Pertinent new studies were added up to September 2016. Grey literature was not searched. Clinical practice guidelines and guidelines of specialty societies were reviewed. Systematic reviews were included when available. Randomized controlled trials and observational studies were included when evidence for the outcome of interest or in the target population was not available from systematic reviews. New studies not yet included in systematic reviews were also included. Only

  13. Textile properties of synthetic prolapse mesh in response to uniaxial loading

    Science.gov (United States)

    Barone, William R.; Moalli, Pamela A.; Abramowitch, Steven D.

    2016-01-01

    , with values decreasing by as much as 87% (P mesh products that were tested were found to have porosities that approached 0% and 0 pores with diameters >1 mm. CONCLUSION In this study, it was shown that the pore size of current prolapse meshes dramatically decreases in response to mechanical loading. These findings suggest that prolapse meshes, which are more likely to experience tensile forces in vivo relative to hernia repair meshes, have pores that are unfavorable for tissue integration after surgical tensioning and/or loading in urogynecologic surgeries. Such decreases in pore geometry support the hypothesis that regional increases in the concentration of mesh leads to an enhanced local foreign body response. Although pore deformation in transvaginal meshes requires further characterization, the findings presented here provide a mechanical understanding that can be used to recognize potential areas of concern for complex mesh geometries. Understanding mesh mechanics in response to surgical and in vivo loading conditions may provide improved design criteria for mesh and a refinement of surgical techniques, ultimately leading to better patient outcomes. PMID:27001219

  14. Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

    OpenAIRE

    Powell, Ben; Whang, Susan H.; Bachman, Sharon L.; Andres Astudillo, J.; Sporn, Emanuel; Miedema, Brent W.; Thaler, Klaus

    2010-01-01

    Background: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Methods: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel...

  15. Cache-Oblivious Mesh Layouts

    International Nuclear Information System (INIS)

    Yoon, S; Lindstrom, P; Pascucci, V; Manocha, D

    2005-01-01

    We present a novel method for computing cache-oblivious layouts of large meshes that improve the performance of interactive visualization and geometric processing algorithms. Given that the mesh is accessed in a reasonably coherent manner, we assume no particular data access patterns or cache parameters of the memory hierarchy involved in the computation. Furthermore, our formulation extends directly to computing layouts of multi-resolution and bounding volume hierarchies of large meshes. We develop a simple and practical cache-oblivious metric for estimating cache misses. Computing a coherent mesh layout is reduced to a combinatorial optimization problem. We designed and implemented an out-of-core multilevel minimization algorithm and tested its performance on unstructured meshes composed of tens to hundreds of millions of triangles. Our layouts can significantly reduce the number of cache misses. We have observed 2-20 times speedups in view-dependent rendering, collision detection, and isocontour extraction without any modification of the algorithms or runtime applications

  16. Connectivity editing for quadrilateral meshes

    KAUST Repository

    Peng, Chihan; Zhang, Eugene; Kobayashi, Yoshihiro; Wonka, Peter

    2011-01-01

    We propose new connectivity editing operations for quadrilateral meshes with the unique ability to explicitly control the location, orientation, type, and number of the irregular vertices (valence not equal to four) in the mesh while preserving sharp edges. We provide theoretical analysis on what editing operations are possible and impossible and introduce three fundamental operations to move and re-orient a pair of irregular vertices. We argue that our editing operations are fundamental, because they only change the quad mesh in the smallest possible region and involve the fewest irregular vertices (i.e., two). The irregular vertex movement operations are supplemented by operations for the splitting, merging, canceling, and aligning of irregular vertices. We explain how the proposed highlevel operations are realized through graph-level editing operations such as quad collapses, edge flips, and edge splits. The utility of these mesh editing operations are demonstrated by improving the connectivity of quad meshes generated from state-of-art quadrangulation techniques. © 2011 ACM.

  17. Connectivity editing for quadrilateral meshes

    KAUST Repository

    Peng, Chihan

    2011-12-12

    We propose new connectivity editing operations for quadrilateral meshes with the unique ability to explicitly control the location, orientation, type, and number of the irregular vertices (valence not equal to four) in the mesh while preserving sharp edges. We provide theoretical analysis on what editing operations are possible and impossible and introduce three fundamental operations to move and re-orient a pair of irregular vertices. We argue that our editing operations are fundamental, because they only change the quad mesh in the smallest possible region and involve the fewest irregular vertices (i.e., two). The irregular vertex movement operations are supplemented by operations for the splitting, merging, canceling, and aligning of irregular vertices. We explain how the proposed highlevel operations are realized through graph-level editing operations such as quad collapses, edge flips, and edge splits. The utility of these mesh editing operations are demonstrated by improving the connectivity of quad meshes generated from state-of-art quadrangulation techniques. © 2011 ACM.

  18. Laparoscopy-like operative vaginoscopy: a new approach to manage mesh erosions.

    Science.gov (United States)

    Billone, Valentina; Amorim-Costa, Célia; Campos, Sara; Rabischong, Benoĭt; Bourdel, Nicolas; Canis, Michel; Botchorishvili, Revaz

    2015-01-01

    Mesh erosion through the vagina is the most common complication of synthetic mesh used for pelvic organ prolapse repair. However, conventional transvaginal mesh excision has many technical limitations. We aimed at creating and describing a new surgical technique for transvaginal removal of exposed mesh that would enable better exposition and access, thus facilitating optimal treatment. A step-by-step video showing the technique. A university tertiary care hospital. Five patients previously submitted to pelvic organ prolapse repair using synthetic mesh, presenting mesh erosion through the vagina. Mesh excision using a laparoscopy-like operative vaginoscopy in which standard laparoscopic instruments are used through a single-incision laparoscopic surgery port device placed in the vagina. In all cases, a very good exposure of the mesh was achieved, a minimal tissue traction was required, and the procedures were performed in a very ergonomic way. All the patients were discharged on the same day of the surgery and had a painless postoperative course. So far, there have been no cases of relapse. This seems to be a simple, cheap, and valuable minimally invasive technique with many advantages in comparison with the conventional approach. More cases and time are necessary to access its long-term efficacy. It may possibly be used for the management of other conditions. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  19. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review

    Directory of Open Access Journals (Sweden)

    Hemendra N Shah

    2012-01-01

    Full Text Available We reviewed the incidence, predisposing factors, presentation and management of complications related to the use of synthetic mesh in the management of stress urinary incontinence and pelvic organ prolapse repair. Immediate complications, such as bleeding, hematoma, injury to adjacent organs during placement of mesh and complication of voiding dysfunction are not discussed in this review, since they are primarily related to technique. A PubMed search of related articles published in English was done from April 2008 to March 2011. Key words used were urinary incontinence, mesh, complications, midurethral sling, anterior prolapse, anterior vaginal repair, pelvic organ prolapse, transvaginal mesh, vault prolapse, midurethral slings, female stress urinary incontinence, mesh erosion, vaginal mesh complications, and posterior vaginal wall prolapse. Since there were very few articles dealing with the management of mesh-related complications in the period covered in the search we extended the search from January 2005 onwards. Articles were selected to fit the scope of the topic. In addition, landmark publications and Manufacturer and User Facility Device Experience (MAUDE data (FDA website were included on the present topic. A total of 170 articles were identified. The use of synthetic mesh in sub-urethral sling procedures is now considered the standard for the surgical management of stress urinary incontinence. Synthetic mesh is being increasingly used in the management of pelvic organ prolapse. While the incidence of extrusion and erosion with mid-urethral sling is low, the extrusion rate in prolapse repair is somewhat higher and the use in posterior compartment remains controversial. When used through the abdominal approach the extrusion and erosion rates are lower. The management of mesh complication is an individualized approach. The choice of the technique should be based on the type of mesh complication, location of the extrusion and/or erosion

  20. Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    FILIP ETIENNE MUYSOMS

    2016-09-01

    Full Text Available Background: Prophylactic mesh augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IH. As part of the BioMesh consensus project, a systematic literature review has been performed to detect those studies where MAR was performed with a non-permanent absorbable mesh (biological or biosynthetic. Methods: A computerized search was performed within 12 databases (Embase, Medline, Web-of-Science, Scopus, Cochrane, CINAHL, Pubmed publisher, Lilacs, Scielo, ScienceDirect, ProQuest, Google scholar with appropriate search terms. Qualitative evaluation was performed using the MINORS score for cohort studies and the Jadad score for RCTs. Results: For midline laparotomy incisions and stoma reversal wounds, 2 RCTs, 2 case control studies and 2 case series were identified. The studies were very heterogeneous in terms of mesh configuration (cross linked versus non cross linked, mesh position (intraperitoneal versus retromuscular versus onlay, surgical indication (gastric bypass versus aortic aneurysm, outcome results (effective versus non effective. After qualitative assessment we have to conclude that the level of evidence on the efficacy and safety of biological meshes for prevention of incisional hernias is very low. No comparative studies were found comparing biological mesh with synthetic non-absorbable meshes for the prevention of incisional hernias. Conclusion: There is no evidence supporting the use of non-permanent absorbable mesh (biological or biosynthetic for prevention of incisional hernias when closing a laparotomy in high-risk patients or in stoma reversal wounds. There is no evidence that a non-permanent absorbable mesh should be preferred to synthetic non-absorbable mesh both in clean or clean-contaminated surgery.

  1. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review

    Science.gov (United States)

    Shah, Hemendra N.; Badlani, Gopal H.

    2012-01-01

    We reviewed the incidence, predisposing factors, presentation and management of complications related to the use of synthetic mesh in the management of stress urinary incontinence and pelvic organ prolapse repair. Immediate complications, such as bleeding, hematoma, injury to adjacent organs during placement of mesh and complication of voiding dysfunction are not discussed in this review, since they are primarily related to technique. A PubMed search of related articles published in English was done from April 2008 to March 2011. Key words used were urinary incontinence, mesh, complications, midurethral sling, anterior prolapse, anterior vaginal repair, pelvic organ prolapse, transvaginal mesh, vault prolapse, midurethral slings, female stress urinary incontinence, mesh erosion, vaginal mesh complications, and posterior vaginal wall prolapse. Since there were very few articles dealing with the management of mesh-related complications in the period covered in the search we extended the search from January 2005 onwards. Articles were selected to fit the scope of the topic. In addition, landmark publications and Manufacturer and User Facility Device Experience (MAUDE) data (FDA website) were included on the present topic. A total of 170 articles were identified. The use of synthetic mesh in sub-urethral sling procedures is now considered the standard for the surgical management of stress urinary incontinence. Synthetic mesh is being increasingly used in the management of pelvic organ prolapse. While the incidence of extrusion and erosion with mid-urethral sling is low, the extrusion rate in prolapse repair is somewhat higher and the use in posterior compartment remains controversial. When used through the abdominal approach the extrusion and erosion rates are lower. The management of mesh complication is an individualized approach. The choice of the technique should be based on the type of mesh complication, location of the extrusion and/or erosion, its magnitude

  2. Effects of the polypropylene mesh implanted through inguinotomy in the spermatic funiculus, epididium and testis of dogs

    Directory of Open Access Journals (Sweden)

    Goldenberg Alberto

    2005-01-01

    Full Text Available PURPOSE: To investigate the effects of polypropylene mesh, implanted by inguinotomy, in the spermatic funiculus, epididium and testis of dogs. METHODS: Eighteen dogs were considered (12-23 Kg, separated in three groups. Group A (n=7: left side (with mesh versus right side (without mesh; Group B (n=7: left side (without mesh versus right side (with mesh and Group C (n=4: without any surgical manipulation (control group. After being observed for 60 days, the animals were subjected to bilateral removal of the spermatic funiculus, epididium and testis that were submitted to histological analysis. During the re-operation, a macroscopic evaluation was performed. RESULTS: On the mesh side, we noted 100% of mesh adherence to the posterior wall of the inguinal canal, as well as the adherence of the spermatic funiculus to the mesh. A congestion of the pampiniform plexus was noted in three animals. Chronic inflammation reaction and foreign body reaction in the spermatic funiculus was observed in 100% of the animals. On the side that did not carry a mesh, chronic inflammatory reaction was observed in 71% of the animals. All the animals presented chronic inflammatory reaction in the deferent duct in the mesh side and in eleven animals in the side without the mesh. These alterations were not found in Group C. There was a considerable statistical reduction in the average difference of the diameter of the lumen of the deferent duct in the mesh side. In the epididium and testis, macro and microscopic alterations were not significant, although one animal presented a marked reduction of spermatogenesis on the mesh side. CONCLUSION: The polypropylene mesh, when in contact with the spermatic funiculus of dogs, causes a more intense chronic inflammatory reaction and a significant reduction in the diameter of the lumen of the deferent duct.

  3. Comparative efficacy of Prolene and Prolene-Vicryl composite mesh for experimental ventral hernia repair in dogs.

    Science.gov (United States)

    Anjum, H; Bokhari, S G; Khan, M A; Awais, M; Mughal, Z U; Shahzad, H K; Ijaz, F; Siddiqui, M I; Khan, I U; Chaudhry, A S; Akhtar, R; Aslam, S; Akbar, H; Asif, M; Maan, M K; Khan, M A; Noor, A; Khan, W A; Ullah, A; Hayat, M A

    2016-01-01

    In this study, efficacy of two hernia mesh implants viz. conventional Prolene and a novel Prolene-Vicryl composite mesh was assessed for experimental ventral hernia repair in dogs. Twelve healthy mongrel dogs were selected and randomly divided into three groups, A, Band C (n=4). In all groups, an experimental laparotomy was performed; thereafter, the posterior rectus sheath and peritoneum were sutured together, while, a 5 × 5 cm defect was created in the rectus muscle belly and anterior rectus sheath. For sublay hernioplasty, the hernia mesh (Prolene: group A; Prolene-Vicryl composite mesh: group B), was implanted over the posterior rectus sheath. In group C (control), mesh was not implanted; instead the laparotomy incision was closed after a herniorrhaphy. Post-operative pain, mesh shrinkage and adhesion formation were assessed as short term complications. Post-operatively, pain at surgical site was significantly less (P<0.001) in group B (composite mesh); mesh shrinkage was also significantly less in group B (21.42%, P<0.05) than in group A (Prolene mesh shrinkage: 58.18%). Group B (composite mesh) also depicted less than 25% adhesions (Mean ± SE: 0.75 ± 0.50 scores, P≤0.013) when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions (n=2), or, only flimsy adhesions (n=2) in group B (composite mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. Conclusively, the Prolene-Vicryl composite mesh proved superior to the Prolene mesh regarding lesser mesh contraction, fewer adhesions and no short-term follow-up complications.

  4. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  5. Complications of transvaginal silicone-coated polyester synthetic mesh sling.

    Science.gov (United States)

    Govier, F E; Kobashi, K C; Kuznetsov, D D; Comiter, C; Jones, P; Dakil, S E; James, R

    2005-10-01

    To report a premarket multicenter trial to test the feasibility of a transvaginal silicone-coated polyester synthetic mesh sling in women with anatomic incontinence. Fifty-one patients in four centers underwent transvaginal placement of a silicone-coated polyester synthetic mesh sling (American Medical Systems) during an 8-month period. Of the 51 patients, 31 were part of a prospective institutional review board-approved feasibility trial in three centers funded by American Medical Systems (group 1) and 20 underwent implantation by a single surgeon and their data were retrospectively reviewed (group 2). The studies were done concomitantly, and all slings were fixed transvaginally with bone anchors. All patients in group 1 were followed up at 4 weeks, 6 months, and 1 year (as applicable) with repeat questionnaires, physical examinations, and pad tests. In group 1, 20 patients completed 6 months of follow-up. Ten patients (32%) required a second surgical procedure at an average of 183 days (range 68 to 343) postoperatively. Eight patients (26%) had vaginal extrusion of the mesh, one (3%) required sling lysis, and one (3%) required sling removal because of infection. In group 2, 8 patients (40%) underwent sling removal for vaginal extrusion at a mean of 160 days (range 83 to 214). Transvaginally placed silicone-coated mesh slings used for the treatment of urinary incontinence demonstrated an unacceptably high vaginal extrusion rate in this study. Once identified, this study was immediately terminated, and this product was not marketed for this application in the United States.

  6. Transvaginal mesh kits--how "serious" are the complications and are they reversible?

    Science.gov (United States)

    Lee, Dominic; Dillon, Benjamin; Lemack, Gary; Gomelsky, Alex; Zimmern, Philippe

    2013-01-01

    To review the merit of the U.S. Food and Drug Administration-issued warnings on the use of transvaginal mesh in women with pelvic organ prolapse because of escalating complications. On institutional review board approval, we reviewed the data from 2 tertiary institutions managing complications of transvaginal mesh. The data recorded included mesh type, details of surgical removal, and patient-reported clinical outcomes. From 2006 to March 2011, 58 women were evaluated. Their mean age was 54.6 years (range 32-80), with a mean follow-up of 13 months (range 6-67). The mean interval to mesh excision surgery from the original prolapse surgery was 21 months (range 2-60). Of the 58 women, 35 (60%) had undergone concurrent midurethral sling surgery with the transvaginal mesh surgery. Also, 21 of the 58 patients (36%) had undergone initial mesh removal attempts before their referral to either tertiary institution. Most women presented with multiple complaints, with mesh extrusion the most frequently reported (n=43 [74%]). Of the 58 women, 17 (29%) required re-excision of residual mesh, 13 once and 4 twice. Five women developed recurrent symptomatic pelvic organ prolapse (7%). The residual rate of dyspareunia and pelvic pain was 14% and 22%, respectively. Fourteen women (24%) were treated successfully, with complete resolution of all presenting symptoms. As outlined in the Food and Drug Administration notifications, patients should be forewarned that some transvaginal mesh complications are life altering and might not always be surgically correctable. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Clinical and ultrasonographic study of patients presenting with transvaginal mesh complications.

    Science.gov (United States)

    Manonai, Jittima; Rostaminia, Ghazaleh; Denson, Lindsay; Shobeiri, S Abbas

    2016-03-01

    The objective of this study was to investigate the clinical and ultrasonographic findings of women who had three-dimensional endovaginal ultrasound (EVUS) for the management of vaginal mesh complications. This was a retrospective study of patients that had EVUS due to mesh complications at a tertiary care center. The clinical charts were reviewed. The stored 3D volumes were reviewed regarding mesh information by two examiners independently. The predictive value of physical examination for detection of vaginal mesh was calculated. Patient outcomes were reviewed. Seventy-nine patients presented to our center because of their, or their physicians' concern regarding mesh complications. Forty-one (51.9%) had vaginal/pelvic pain, and 51/62 (82.2%) of sexually active women experienced dyspareunia. According to ultrasonographic findings, mesh or sling was not demonstrated in six patients who believed they have had mesh/sling implantation. The positive predictive value for vaginal examination was 94.5% (95% CI: 84.9%-98.8%), negative predictive value was 12.5% (95% CI: 2.8%-32.4%), sensitivity was 72.2% (95% CI: 59.4%-81.2%), and specificity was 50.0% (95% CI: 12.4%-87.6%). Fifty-four patients were indicated for surgical treatment. Median postoperative review was 12 (range, 3-18) months and 38/53 (71.7%) patients were satisfied. The most common complaints of vaginal mesh complications were pain and dyspareunia. EVUS appeared to be helpful for assessing mesh presence, location, and extent including planning for surgical intervention. © 2015 Wiley Periodicals, Inc.

  8. Multigrid for refined triangle meshes

    Energy Technology Data Exchange (ETDEWEB)

    Shapira, Yair

    1997-02-01

    A two-level preconditioning method for the solution of (locally) refined finite element schemes using triangle meshes is introduced. In the isotropic SPD case, it is shown that the condition number of the preconditioned stiffness matrix is bounded uniformly for all sufficiently regular triangulations. This is also verified numerically for an isotropic diffusion problem with highly discontinuous coefficients.

  9. Resterilized Polypropylene Mesh for Inguinal Hernia Repair

    African Journals Online (AJOL)

    2018-04-19

    Apr 19, 2018 ... Conclusion: The use of sterilized polypropylene mesh for the repair of inguinal ... and nonabsorbable materials to reduce the tissue–mesh. INTRODUCTION ... which we have been practicing in our center since we introduced ...

  10. 6th International Meshing Roundtable '97

    Energy Technology Data Exchange (ETDEWEB)

    White, D.

    1997-09-01

    The goal of the 6th International Meshing Roundtable is to bring together researchers and developers from industry, academia, and government labs in a stimulating, open environment for the exchange of technical information related to the meshing process. In the pas~ the Roundtable has enjoyed significant participation born each of these groups from a wide variety of countries. The Roundtable will consist of technical presentations from contributed papers and abstracts, two invited speakers, and two invited panels of experts discussing topics related to the development and use of automatic mesh generation tools. In addition, this year we will feature a "Bring Your Best Mesh" competition and poster session to encourage discussion and participation from a wide variety of mesh generation tool users. The schedule and evening social events are designed to provide numerous opportunities for informal dialog. A proceedings will be published by Sandia National Laboratories and distributed at the Roundtable. In addition, papers of exceptionally high quaIity will be submitted to a special issue of the International Journal of Computational Geometry and Applications. Papers and one page abstracts were sought that present original results on the meshing process. Potential topics include but are got limited to: Unstructured triangular and tetrahedral mesh generation Unstructured quadrilateral and hexahedral mesh generation Automated blocking and structured mesh generation Mixed element meshing Surface mesh generation Geometry decomposition and clean-up techniques Geometry modification techniques related to meshing Adaptive mesh refinement and mesh quality control Mesh visualization Special purpose meshing algorithms for particular applications Theoretical or novel ideas with practical potential Technical presentations from industrial researchers.

  11. Surgical treatment for giant incisional hernia

    DEFF Research Database (Denmark)

    Eriksson, A; Rosenberg, J; Bisgaard, T

    2014-01-01

    INTRODUCTION: Repair for giant incisional hernias is a challenge due to unacceptable high morbidity and recurrence rates. Several surgical techniques are available, but all are poorly documented. This systematic review was undertaken to evaluate the existing literature on repair for giant...... % with a wide range between studies of 4-100 %. The mortality ranged from 0 to 5 % (median 0 %) and recurrence rate ranged from 0 to 53 % (median 5 %). Study follow-up ranged from 15 to 97 months (median 36 months). Mesh repair should always be used for patients undergoing repair for a giant hernia......, and the sublay position may have advantages over onlay positioning. To avoid tension, it may be advisable to use a mesh in combination with a component separation technique. Inlay positioning of the mesh and repair without a mesh should be avoided. CONCLUSIONS: Evidence to optimise repair for giant hernias...

  12. Long-term follow-up of treatment for synthetic mesh complications.

    Science.gov (United States)

    Hansen, Brooke L; Dunn, Guinn Ellen; Norton, Peggy; Hsu, Yvonne; Nygaard, Ingrid

    2014-01-01

    The objectives of this study are (1) to describe the presenting symptoms, findings, and treatment and (2) to describe the self-reported improvement and function at least 6 months after presentation in women presenting to 1 urogynecology division for complications associated with synthetic vaginal mesh. Women evaluated between 2006 and 2011 were identified by diagnostic codes. We abstracted information from the medical record and attempted to contact all women to complete a follow-up telephone survey questionnaire consisting of several validated instruments. A total of 111 women were evaluated for complications associated with synthetic vaginal mesh. The mean interval from index surgery was 2.4 years. Of these, 84% were referred from outside hospitals. Index surgeries included vaginal mesh kits/vaginally placed mesh (47%), midurethral mesh slings (37%), abdominally placed vaginal mesh (11%), and vaginal mesh kit with concomitantly placed mesh sling (5%). The most common complications were extrusion (65%), contraction (17%), and chronic pelvic pain (16%). A total of 98 women underwent some type of treatment (85 surgical) by urogynecologists, pelvic pain specialists, or physical therapists. Eighty-four (76%) provided follow-up information at mean interval since presentation of 2.3 years. At follow-up, the mean (SD) Pelvic Floor Distress Inventory score was 98 (67), the mean (SD) EQ-5D index score was 0.69 (0.23), and 22% reported vaginal discharge, 15% vaginal bleeding or spotting, and 45% sexual abstinence due to problems related to mesh. A total of 71% reported being overall better, whereas 29% were the same or worse. Two years after tertiary care level multidisciplinary treatment of vaginal mesh complications, many women still report symptoms that negatively impact their quality of life.

  13. User Manual for the PROTEUS Mesh Tools

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Micheal A. [Argonne National Lab. (ANL), Argonne, IL (United States); Shemon, Emily R [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-09-19

    PROTEUS is built around a finite element representation of the geometry for visualization. In addition, the PROTEUS-SN solver was built to solve the even-parity transport equation on a finite element mesh provided as input. Similarly, PROTEUS-MOC and PROTEUS-NEMO were built to apply the method of characteristics on unstructured finite element meshes. Given the complexity of real world problems, experience has shown that using commercial mesh generator to create rather simple input geometries is overly complex and slow. As a consequence, significant effort has been put into place to create multiple codes that help assist in the mesh generation and manipulation. There are three input means to create a mesh in PROTEUS: UFMESH, GRID, and NEMESH. At present, the UFMESH is a simple way to generate two-dimensional Cartesian and hexagonal fuel assembly geometries. The UFmesh input allows for simple assembly mesh generation while the GRID input allows the generation of Cartesian, hexagonal, and regular triangular structured grid geometry options. The NEMESH is a way for the user to create their own mesh or convert another mesh file format into a PROTEUS input format. Given that one has an input mesh format acceptable for PROTEUS, we have constructed several tools which allow further mesh and geometry construction (i.e. mesh extrusion and merging). This report describes the various mesh tools that are provided with the PROTEUS code giving both descriptions of the input and output. In many cases the examples are provided with a regression test of the mesh tools. The most important mesh tools for any user to consider using are the MT_MeshToMesh.x and the MT_RadialLattice.x codes. The former allows the conversion between most mesh types handled by PROTEUS while the second allows the merging of multiple (assembly) meshes into a radial structured grid. Note that the mesh generation process is recursive in nature and that each input specific for a given mesh tool (such as .axial

  14. Prevention of parastomal hernia with a preperitoneal polypropelene mesh.

    Science.gov (United States)

    Valdés-Hernández, Javier; Díaz Milanés, Juan Antonio; Capitán Morales, Luis Cristóbal; Del Río la Fuente, Francisco Javier; Torres Arcos, Cristina; Cañete Gómez, Jesús; Oliva Mompeán, Fernando; Padillo Ruiz, Javier

    2015-01-01

    To show our results with the use of a polypropylene mesh at the stoma site, as prophylaxis of parastomal hernias in patients with rectal cancer when a terminal colostomy is performed. From January 2010 until March 2014, 45 consecutive patients with rectal cancer, underwent surgical treatment with the need of a terminal colostomy. A prophylactic mesh was placed in a sublay position at the stoma site in all cases. We analyze Demographics, technical issues and effectiveness of the procedure, as well as subsequent complications. A prophylactic mesh was placed in 45 patients, 35 male and 10 females, mean age of 66.2 (47-88) and Body Mass Index 29.19 (20.4-40.6). A total of 7 middle rectal carcinoma, 36 low rectal carcinoma, one rectal melanoma and one squamous cell anal carcinoma were electively treated with identical protocol. Abdominoperineal resection was performed in 38 patients, and low anterior resection with terminal colostomy in 7. An open approach was elected in 39 patients and laparoscopy in 6, with 2 conversions to open surgery. Medium follow up was 22 months (2.1-53). Overall, 3 parastomal hernias (6.66%) were found, one of which was a radiological finding with no clinical significance. No complications related to the mesh or the colostomy were found. The use of a prophylactic polypropylene mesh placed in a sublay position at the stoma site is a safe and feasible technique. It lowers the incidence of parastomal hernias with no increased morbidity. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Medpor plus titanic mesh implant in the repair of orbital blowout fractures].

    Science.gov (United States)

    Han, Xiao-hui; Zhang, Jia-yu; Cai, Jian-qiu; Shi, Ming-guang

    2011-05-10

    To study the efficacy of porous polyethylene (Medpor) plus titanic mesh sheets in the repair of orbital blowout fractures. A total of 20 patients underwent open surgical reduction with the combined usage of Medpor and titanic mesh. And they were followed up for average period of 14.5 months (range: 9 - 18). There is no infection or extrusion of medpor and titanic mesh in follow-up periods. There was no instance of decreased visual acuity at post-operation. And all cases of enophthalmos were corrected. The post-operative protrusion degree of both eyes was almost identical at less than 2 mm. The movement of eye balls was satisfactory in all directions. Diplopia disappeared in 18 cases with a cure rate of 90%, 1 case improved and 1 case persisted. Medpor plus titanic mesh implant is a safe and effective treatment in the repair of orbital blow out fractures.

  16. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  17. Voltammetry at micro-mesh electrodes

    Directory of Open Access Journals (Sweden)

    Wadhawan Jay D.

    2003-01-01

    Full Text Available The voltammetry at three micro-mesh electrodes is explored. It is found that at sufficiently short experimental durations, the micro-mesh working electrode first behaves as an ensemble of microband electrodes, then follows the behaviour anticipated for an array of diffusion-independent micro-ring electrodes of the same perimeter as individual grid-squares within the mesh. During prolonged electrolysis, the micro-mesh electrode follows that behaviour anticipated theoretically for a cubically-packed partially-blocked electrode. Application of the micro-mesh electrode for the electrochemical determination of carbon dioxide in DMSO electrolyte solutions is further illustrated.

  18. Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

    Science.gov (United States)

    Powell, Ben; Whang, Susan H.; Bachman, Sharon L.; Andres Astudillo, J.; Sporn, Emanuel; Miedema, Brent W.

    2010-01-01

    Background: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Methods: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel gastroscope with an endoscopic atraumatic grasper was used for grasping sutures. Further fascial sutures were placed every 5cm. Results: Mesh repair was feasible in all 7 animals. Mean operative time was 133 minutes. Technical difficulties were encountered. No gross contamination was seen at the time of necropsy. However, 5 animals had positive mesh cultures; 7 had positive cultures in the rectouterine space in enrichment broth or on direct culture. Conclusion: Transvaginal placement of synthetic mesh to repair a large porcine hernia using NOTES is challenging but feasible. Future studies need to be conducted to develop better techniques and determine the significance of mesh contamination. PMID:20932375

  19. 22nd International Meshing Roundtable

    CERN Document Server

    Staten, Matthew

    2014-01-01

    This volume contains the articles presented at the 22nd International Meshing Roundtable (IMR) organized, in part, by Sandia National Laboratories and was held on Oct 13-16, 2013 in Orlando, Florida, USA.  The first IMR was held in 1992, and the conference series has been held annually since.  Each year the IMR brings together researchers, developers, and application experts in a variety of disciplines, from all over the world, to present and discuss ideas on mesh generation and related topics.  The technical papers in this volume present theoretical and novel ideas and algorithms with practical potential, as well as technical applications in science and engineering, geometric modeling, computer graphics and visualization.

  20. 21st International Meshing Roundtable

    CERN Document Server

    Weill, Jean-Christophe

    2013-01-01

    This volume contains the articles presented at the 21st International Meshing Roundtable (IMR) organized, in part, by Sandia National Laboratories and was held on October 7–10, 2012 in San Jose, CA, USA. The first IMR was held in 1992, and the conference series has been held annually since. Each year the IMR brings together researchers, developers, and application experts in a variety of disciplines, from all over the world, to present and discuss ideas on mesh generation and related topics. The technical papers in this volume present theoretical and novel ideas and algorithms with practical potential, as well as technical applications in science and engineering, geometric modeling, computer graphics, and visualization.

  1. Adaptive Mesh Refinement in CTH

    International Nuclear Information System (INIS)

    Crawford, David

    1999-01-01

    This paper reports progress on implementing a new capability of adaptive mesh refinement into the Eulerian multimaterial shock- physics code CTH. The adaptivity is block-based with refinement and unrefinement occurring in an isotropic 2:1 manner. The code is designed to run on serial, multiprocessor and massive parallel platforms. An approximate factor of three in memory and performance improvements over comparable resolution non-adaptive calculations has-been demonstrated for a number of problems

  2. Cesarean section after abdominal mesh repair for pregnancy-related desmoid tumor: a case report

    Directory of Open Access Journals (Sweden)

    Ooi S

    2017-07-01

    Full Text Available Sara Ooi, Harry Ngo Obstetrics and Gynaecology Department, Liverpool Hospital, Liverpool, NSW, Australia Abstract: We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT arising from the previous cesarean section (CS scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair. It provides evidence that CS can be safely accomplished following abdominal wall reconstructions and further arguments against elective lower segment CS. Keywords: abdominal wall, cesarean section, complications, desmoid tumor, surgical mesh

  3. Abdominal closure reinforcement by using polypropylene mesh functionalized with poly-epsilon-caprolactone nanofibers and growth factors for prevention of incisional hernia formation

    Czech Academy of Sciences Publication Activity Database

    Plencner, M.; East, B.; Tonar, Z.; Otáhal, M.; Prosecká, E.; Rampichová, M.; Krejčí, T.; Litvinec, Andrej; Buzgo, M.; Míčková, A.; Nečas, A.; Hoch, J.; Amler, E.

    2014-01-01

    Roč. 9, č. 2014 (2014), s. 3263-3227 E-ISSN 1178-2013 Institutional support: RVO:67985823 Keywords : nanofibers * growth factors * surgical mesh Subject RIV: FP - Other Medical Disciplines Impact factor: 4.383, year: 2014

  4. Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Yi-Hung Sun

    2017-05-01

    Conclusion: Patients with POP at an advanced stage during peritoneal dialysis who failed to be treated conservatively may require a surgical intervention. Uterus-sparing transvaginal mesh was a feasible minimal invasive option.

  5. In vivo characterisation of the inflammatory reaction following mesh implantation in transgenic mice models.

    Science.gov (United States)

    Fet, N; Alizai, P H; Fragoulis, A; Wruck, C; Pufe, T; Tolba, R H; Neumann, U P; Klinge, U

    2014-06-01

    Hernia repair with prosthetic meshes represents one of the most common surgical procedures in the field of surgery. This intervention is always associated with an ensuing inflammatory response, angiogenesis and fibrotic encapsulation forming a foreign body granuloma (FBG) around the mesh fibres. Several studies have described this inflammatory reaction by characterising inflammatory cell infiltrate around the FBG after mesh explantation. However, very little is known about the real-time progression of such an inflammatory response. The aim of this study was to investigate the feasibility of monitoring the ongoing inflammatory response to mesh implantation using bioluminescence in vivo. Three luciferase transgenic mice strains (FVB/N-Tg(Vegfr2-luc)-Xen, BALB/C-Tg(NFκB-RE-luc)-Xen and Tg(INS/EpRE-Luc)T20Rbl) were used. Mice were anaesthetized with 2 % isoflurane, and two incisions were made on the left and right sides of the abdomen of the mice. A 1-cm(2) propylene mesh was implanted subcutaneously in the right incision wound of each mouse, and the left wound served as control. Two hundred microliters of D-luciferin was injected into the mice, and bioluminescence measurements were done prior to the surgical intervention and subsequently every 3 days. After mesh explantation, histological analysis was done. Statistical analysis was done using prism GraphPad software. Bioluminescence results revealed different time points of maximum signal for the different mice strains. VEGFR2 gene expression peaked on day 6, NFkB on day 12 and ARE on day 3 post mesh implantation. We also observed much higher bioluminescent signal around the FBG surrounding the mesh as compared to the control wound, with p response over a given period of time.

  6. Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications.

    Science.gov (United States)

    Punjani, Nahid; Winick-Ng, Jennifer; Welk, Blayne

    2017-01-01

    To determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). Administrative data in Ontario, Canada, between 2002 and 2013 were used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh removal/erosion/fistula, or urethrolysis). Two potential risk factors were analyzed: postoperative retention (within 30 days of procedure) and number of postoperative emergency room visits or hospital admissions for UTI symptoms. A total of 59,556 women had a MUS, of which 1598 (2.7%) required revision surgery. Of the 2025 women who presented to the emergency room or were admitted to hospital for postoperative retention, 212 (10.5%) required operative mesh revision. Of the 11,747 patients who had at least one postoperative UTI, 366 (3.1%) patients required operative mesh revision. In adjusted analysis, postoperative retention was significantly predictive of future reoperation (hazard ratio [HR] 3.46, 95% confidence interval [CI] 2.97-4.02), and this difference persisted when urethrolysis was excluded as a reason for sling revision (HR 3.08, 95% CI 2.62-3.63). Similarly, in adjusted analysis, each additional postoperative hospital visit for UTI symptoms increased the risk for surgical intervention for mesh complications (HR 1.74, 95% CI 1.61-1.87). Postoperative urinary retention and hospital presentation for UTI symptoms are associated with an increased risk of reoperation for MUS complications. These patients should be followed and investigated for mesh complications when appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Histological assessment of titanium and polypropylene fiber mesh implantation with and without fibrin tissue glue.

    NARCIS (Netherlands)

    Hallers, E.J.O. ten; Jansen, J.A.; Marres, H.A.M.; Rakhorst, G.; Verkerke, G.J.

    2007-01-01

    Polypropylene (PP) and titanium (Ti) meshes are well-known surgical implants that provoke a relative low foreign body reaction. Firm stabilization of the implant is important to prevent migration and subsequent failure of the operation. Fibrin tissue glues are commercially available adhesives and

  8. Histological assessment of titanium and polypropylene fiber mesh implantation with and without fibrin tissue glue

    NARCIS (Netherlands)

    ten Hallers, E.J. Olivier; Jansen, John A.; Marres, Henri A.M.; Rakhorst, Gerhard; Verkerke, Gijsbertus Jacob

    2007-01-01

    Polypropylene (PP) and titanium (Ti) meshes are well-known surgical implants that provoke a relative low foreign body reaction. Firm stabilization of the implant is important to prevent migration and subsequent failure of the operation. Fibrin tissue glues are commercially available adhesives and

  9. Histological assessment of titanium and polypropylene fiber mesh implantation with and without fibrin tissue glue

    NARCIS (Netherlands)

    ten Hallers, E. J. Olivier; Jansen, John A.; Marres, Henri A. M.; Rakhorst, Gerhard; Verkerke, Gijsbertus J.

    Polypropylene (PP) and titanium (Ti) meshes are well-known surgical implants that provoke a relative low foreign body reaction. Firm stabilization of the implant is important to prevent migration and subsequent failure of the operation. Fibrin tissue glues are commercially available adhesives and

  10. The Use of Nontreated Mosquito‑Net Mesh Cloth for a Tension Free ...

    African Journals Online (AJOL)

    Wideochir Inne Tech Malo. Inwazyjne 2013;8:36‑42. 15. Taylor EW, Duffy K, Lee K, Hill R, Noone A, Macintyre I, et al. Surgical site infection after groin hernia repair. Br J Surg. 2004;91:105‑11. 16. Tongaonkar RR, Sandra DL, Kingsnorth AN. Ten year personal experience of using Low Density Polyethylene (LDPE) mesh for.

  11. Glue versus suture for mesh fixation in inguinal hernia repair.

    Science.gov (United States)

    Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun

    2018-03-22

    Inguinal hernia is one of the most common surgical problem presenting to the surgical OPD. Surgery is the mainstay of treatment for inguinal hernia today. Surgery for inguinal hernia has undergone a great evolution over a period of several centuries. Lichenstein's tension free hernioplasty is the one of the first surgeries taught to a surgical resident. The main aim of surgeries in this era is to give the best possible results with the least possible pain, scar and time. This has given rise to so many modifications to the classical Lichenstein's procedure and also to laparoscopic hernioplasty. Pain after inguinal hernia surgery is found to be debilitating and altering the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. This has paved way to the development of various atraumatic methods of fixation, tissue glue is one such development. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Primary objective was to compare the immediate and chronic post-operative pain. Secondary objective was to compare the time taken for the procedure by the two methods in use and also to compare the presence of any complications. and methodology: This study was done in the General Surgery department of XXX hospital, medical college and research centre, kattangulathur after Ethics committee clearance. It is a single blinded study. The study was done on 51 patients consenting for the study and meeting the inclusion criterias from the period of March 2016 to August 2017 out of which 26 were selected for glue mesh fixation and 25 for suture mesh fixation according to simple randomization. The suture group patients underwent classical Lichenstein's tension free hernioplasty and the glue group underwent Lichenstein's hernioplasty with glue where dots of

  12. Assessment of Pain and Quality of Life in Lichtenstein Hernia Repair Using a New Monofilament PTFE Mesh: Comparison of Suture vs. Fibrin-Sealant Mesh Fixation.

    Science.gov (United States)

    Fortelny, René H; Petter-Puchner, Alexander H; Redl, Heinz; May, Christopher; Pospischil, Wolfgang; Glaser, Karl

    2014-01-01

    Inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become the gold standard in open inguinal hernia repair. Despite the low recurrence rates, pain and discomfort remain a problem for a large number of patients. The aim of this study was to compare suture fixation vs. fibrin sealing by using a new monofilament PTFE mesh, i.e., the Infinit(®) mesh by W. L. Gore & Associates. This study was designed as a controlled prospective single-center two-cohort study. A total of 38 patients were enrolled and operated in Lichtenstein technique either standard suture mesh fixation or fibrin-sealant mesh fixation were used as described in the TIMELI trial. Primary outcome parameters were postoperative complications with the new mesh (i.e., seroma, infection), pain, and quality of life evaluated by the VAS and the SF-36 questionnaire. Secondary outcome was recurrence assessed by ultrasound and physical examination. Follow-up time was 1 year. Significantly, less postoperative pain was reported in the fibrin-sealant group compared to the suture group at 6 weeks (P = 0.035), 6 months (P = 0.023), and 1 year (P = 0.011) postoperatively. Additionally, trends toward a higher postoperative quality of life, a faster surgical procedure, and a shorter hospital stay were seen in the fibrin-sealant group. Fibrin-sealant mesh fixation in Lichtenstein hernioplasty effectively reduces acute and chronic postoperative pain. Monofilament, macro-porous, knitted PTFE meshes seem to be a practicable alternative to commonly used polypropylene meshes in open inguinal hernia repair.

  13. Assessment of pain and quality of life in Lichtenstein hernia repair using a new monofilament PTFE mesh: comparison of suture vs. fibrin sealant mesh fixation

    Directory of Open Access Journals (Sweden)

    René H Fortelny

    2014-11-01

    Full Text Available Background: Inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become the gold standard in open inguinal hernia repair. Despite the low recurrence rates, pain and discomfort remain a problem for a large number of patients. The aim of this study was to compare suture fixation vs. fibrin sealing by using a new monofilament PTFE mesh, i.e. the Infinit® mesh by W. L. Gore & Associates. Methods: This study was designed as a controlled prospective single-centre two cohort study. A total of 38 patients were enrolled and operated in Lichtenstein technique either standard suture mesh fixation or fibrin sealant mesh fixation were used as described in the TIMELI trial. Primary outcome parameters were postoperative complications with the new mesh (i.e. seroma, infection, pain and quality of life evaluated by the VAS and the SF-36 questionnaire. Secondary outcome was recurrence assessed by ultrasound and physical examination. Follow-up time was 1 year.Results: Significantly less postoperative pain was reported in the fibrin sealant group compared to the suture group at 6 weeks (P=0.035, 6 months (P=0.023 and 1 year (P=0.011 postoperatively. Additionally trends towards a higher postoperative quality of life, a faster surgical procedure and a shorter hospital stay were seen in the fibrin sealant group.Conclusion: Fibrin sealant mesh fixation in Lichtenstein hernioplasty effectively reduces acute and chronic postoperative pain. Monofilament, macro-porous, knitted PTFE meshes seem to be a practicable alternative to commonly used polypropylene meshes in open inguinal hernia repair.

  14. A prospective randomised trial comparing mesh types and fixation in totally extraperitoneal inguinal hernia repairs.

    Science.gov (United States)

    Cristaudo, Adam; Nayak, Arun; Martin, Sarah; Adib, Reza; Martin, Ian

    2015-05-01

    The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique. Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 × 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 × 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 × 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 × 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores. At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12. In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  15. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

    OpenAIRE

    Kdous, Moez; Zhioua, Fethi

    2014-01-01

    Objectives To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. Patients and methods In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ?2 according to the Baden?Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh?, Aspide Medical, France). All surgical procedures were carried out by the same experien...

  16. Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy

    Directory of Open Access Journals (Sweden)

    Jennings Jason

    2010-01-01

    Full Text Available Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP approach using Polypropylene Mesh (Mesh and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.

  17. Sierra toolkit computational mesh conceptual model

    International Nuclear Information System (INIS)

    Baur, David G.; Edwards, Harold Carter; Cochran, William K.; Williams, Alan B.; Sjaardema, Gregory D.

    2010-01-01

    The Sierra Toolkit computational mesh is a software library intended to support massively parallel multi-physics computations on dynamically changing unstructured meshes. This domain of intended use is inherently complex due to distributed memory parallelism, parallel scalability, heterogeneity of physics, heterogeneous discretization of an unstructured mesh, and runtime adaptation of the mesh. Management of this inherent complexity begins with a conceptual analysis and modeling of this domain of intended use; i.e., development of a domain model. The Sierra Toolkit computational mesh software library is designed and implemented based upon this domain model. Software developers using, maintaining, or extending the Sierra Toolkit computational mesh library must be familiar with the concepts/domain model presented in this report.

  18. Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery.

    Science.gov (United States)

    Schmid, Corina; O'Rourke, Peter; Maher, Christopher

    2013-05-01

    A prospective case series to assess the safety and efficacy of laparoscopic sacrocolpopexy for the surgical management of recurrent pelvic organ prolapse (POP) after transvaginal polypropylene mesh prolapse surgery. Between January and December 2010, women with post-hysterectomy recurrent prolapse (≥ stage 2 POP-Q) after transvaginal polypropylene mesh prolapse surgery were included. Perioperative morbidity and short-term complications were recorded and evaluated. Surgical outcomes were objectively assessed utilising the Pelvic Organ Prolapse Quantification system (POP-Q), the validated, condition-specific Australian Pelvic Floor Questionnaire (APFQ) and the Patient Global Impression of Improvement (PGI-I) at 12 months. All 16 women in this study had undergone surgery with trocar-guided transvaginal polypropylene mesh kits. In 75% the recurrent prolapse affected the compartment of prior mesh surgery with the anterior (81%) and apical (75%) compartment prolapse predominating. At a mean follow-up of 12 months, all women had resolution of awareness of prolapse, had transvaginal mesh surgery is feasible and safe. Further widespread evaluation is required.

  19. Use of polypropylene mesh in hernioplasty by Lichtenstein's technique

    International Nuclear Information System (INIS)

    Montejo Sainz, Jesus Enrique; Pisonero Socias, Juan Jose

    2011-01-01

    INTRODUCTION. The aim of present study was to assess the benefit using the prosthesis (polypropylene mesh) in the hernioplasty using the Lichtenstein's technique in the 'Joaquin Albarran' Clinical Surgical Hospital. METHODS. A prospective study (with an interval of 14 months) was conducted in 140 surgical interventions carried out using the Lichtenstein's technique in patients presenting with inguinal hernia. One hundred and ten patients were excluded due to interventions were of ambulatory method. The following data were studied: type of hernia found in the physical examination, age, sex, and race, type of job, intervention's date, and technique used as well as the complications during the immediate postoperative time. Also, the hernia's relapse after operation, surgical complications and tolerance to polypropylene mesh were taking into account. RESULTS. There was predominance of male sex confirming a direct influence among types of jobs requiring a strong physical effort and the appearance of inguinal hernias (63,3 %). There were only three complications: a hematoma and two seromas. There were not relapses and any case of infection, both local and systemic. The use of prophylactic antibiotics showed an appropriate cost-benefit relationship. CONCLUSIONS. The old age, the male sex and a sustained physical effort have a directly proportional relation to appearance of inguinal hernias. The feasibility of Lichtenstein's hernioplasty, the null incidence of hernia relapses and no appearance of complications including the rejection to prosthetic material, favoured the use of polypropylene in this plasty. Authors recommended the use of perioperative prophylactic antibiotic therapy to avoid wound's infection and thus to secure the result of surgical intervention and its durability. (author)

  20. Unstructured mesh adaptivity for urban flooding modelling

    Science.gov (United States)

    Hu, R.; Fang, F.; Salinas, P.; Pain, C. C.

    2018-05-01

    Over the past few decades, urban floods have been gaining more attention due to their increase in frequency. To provide reliable flooding predictions in urban areas, various numerical models have been developed to perform high-resolution flood simulations. However, the use of high-resolution meshes across the whole computational domain causes a high computational burden. In this paper, a 2D control-volume and finite-element flood model using adaptive unstructured mesh technology has been developed. This adaptive unstructured mesh technique enables meshes to be adapted optimally in time and space in response to the evolving flow features, thus providing sufficient mesh resolution where and when it is required. It has the advantage of capturing the details of local flows and wetting and drying front while reducing the computational cost. Complex topographic features are represented accurately during the flooding process. For example, the high-resolution meshes around the buildings and steep regions are placed when the flooding water reaches these regions. In this work a flooding event that happened in 2002 in Glasgow, Scotland, United Kingdom has been simulated to demonstrate the capability of the adaptive unstructured mesh flooding model. The simulations have been performed using both fixed and adaptive unstructured meshes, and then results have been compared with those published 2D and 3D results. The presented method shows that the 2D adaptive mesh model provides accurate results while having a low computational cost.

  1. Adaptive hybrid mesh refinement for multiphysics applications

    International Nuclear Information System (INIS)

    Khamayseh, Ahmed; Almeida, Valmor de

    2007-01-01

    The accuracy and convergence of computational solutions of mesh-based methods is strongly dependent on the quality of the mesh used. We have developed methods for optimizing meshes that are comprised of elements of arbitrary polygonal and polyhedral type. We present in this research the development of r-h hybrid adaptive meshing technology tailored to application areas relevant to multi-physics modeling and simulation. Solution-based adaptation methods are used to reposition mesh nodes (r-adaptation) or to refine the mesh cells (h-adaptation) to minimize solution error. The numerical methods perform either the r-adaptive mesh optimization or the h-adaptive mesh refinement method on the initial isotropic or anisotropic meshes to equidistribute weighted geometric and/or solution error function. We have successfully introduced r-h adaptivity to a least-squares method with spherical harmonics basis functions for the solution of the spherical shallow atmosphere model used in climate modeling. In addition, application of this technology also covers a wide range of disciplines in computational sciences, most notably, time-dependent multi-physics, multi-scale modeling and simulation

  2. Meshes optimized for discrete exterior calculus (DEC).

    Energy Technology Data Exchange (ETDEWEB)

    Mousley, Sarah C. [Univ. of Illinois, Urbana-Champaign, IL (United States); Deakin, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Knupp, Patrick [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Scott A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-12-01

    We study the optimization of an energy function used by the meshing community to measure and improve mesh quality. This energy is non-traditional because it is dependent on both the primal triangulation and its dual Voronoi (power) diagram. The energy is a measure of the mesh's quality for usage in Discrete Exterior Calculus (DEC), a method for numerically solving PDEs. In DEC, the PDE domain is triangulated and this mesh is used to obtain discrete approximations of the continuous operators in the PDE. The energy of a mesh gives an upper bound on the error of the discrete diagonal approximation of the Hodge star operator. In practice, one begins with an initial mesh and then makes adjustments to produce a mesh of lower energy. However, we have discovered several shortcomings in directly optimizing this energy, e.g. its non-convexity, and we show that the search for an optimized mesh may lead to mesh inversion (malformed triangles). We propose a new energy function to address some of these issues.

  3. RGG: Reactor geometry (and mesh) generator

    International Nuclear Information System (INIS)

    Jain, R.; Tautges, T.

    2012-01-01

    The reactor geometry (and mesh) generator RGG takes advantage of information about repeated structures in both assembly and core lattices to simplify the creation of geometry and mesh. It is released as open source software as a part of the MeshKit mesh generation library. The methodology operates in three stages. First, assembly geometry models of various types are generated by a tool called AssyGen. Next, the assembly model or models are meshed by using MeshKit tools or the CUBIT mesh generation tool-kit, optionally based on a journal file output by AssyGen. After one or more assembly model meshes have been constructed, a tool called CoreGen uses a copy/move/merge process to arrange the model meshes into a core model. In this paper, we present the current state of tools and new features in RGG. We also discuss the parallel-enabled CoreGen, which in several cases achieves super-linear speedups since the problems fit in available RAM at higher processor counts. Several RGG applications - 1/6 VHTR model, 1/4 PWR reactor core, and a full-core model for Monju - are reported. (authors)

  4. Parallel adaptive simulations on unstructured meshes

    International Nuclear Information System (INIS)

    Shephard, M S; Jansen, K E; Sahni, O; Diachin, L A

    2007-01-01

    This paper discusses methods being developed by the ITAPS center to support the execution of parallel adaptive simulations on unstructured meshes. The paper first outlines the ITAPS approach to the development of interoperable mesh, geometry and field services to support the needs of SciDAC application in these areas. The paper then demonstrates the ability of unstructured adaptive meshing methods built on such interoperable services to effectively solve important physics problems. Attention is then focused on ITAPs' developing ability to solve adaptive unstructured mesh problems on massively parallel computers

  5. The routine use of prosthetic mesh in austere environments: dogma vs data.

    Science.gov (United States)

    Kuckelman, John P; Barron, Morgan R; Blair, Kelly; Martin, Matthew J

    2016-05-01

    Mesh repair has become the standard in adult hernia repairs. Mesh infection is an uncommon but potentially devastating complication. Currently, there is widespread dogma against the use of prosthetic mesh (PM) in deployed or austere environments but little available data to support or refute this bias. Retrospective review of all hernia repairs over 1 year in a forward deployed surgical unit in Afghanistan. Demographics, hernia type, repair performed, and mesh type were evaluated. Follow-up was completed up to 6 weeks and then as needed for up to a year, and complications to include infection were recorded. Sixty-six patients were identified, mean age was 38 (range 3 to 80) and 98% were male. Single-dose perioperative antibiotics and standard sterile technique were used in all cases. The majority (70%) had PM placed. The mean operative time was 54 min, and mean estimated blood loss was less than 25 cm(3). The vast majority of our hernias were inguinal (95%) with 1 ventral and 2 umbilical hernias. In the PM group, there were no surgical site infections, no mesh infections, and no mesh explantation or reoperation. There were no recurrences in either group identified at up to 1-year postoperation. There was no statistically significant difference in any outcome measure between the PM and no-PM groups. The use of PM for hernia repairs in the austere or forward environment appears safe and did not increase the risk of wound infection, mesh infections, or recurrence. Published by Elsevier Inc.

  6. OUR EXPERINCE WITH USE OF POSTERIOR MESH RECTOPEXY IN COMPLETE RECTAL PROLAPSE

    Directory of Open Access Journals (Sweden)

    Sudhansu Sekhar Mohanty

    2017-12-01

    Full Text Available BACKGROUND Mesh rectopexy is one of the accepted treatment options for rectal prolapse. We used polypropylene posterior mesh rectopexy for prolapse rectum. The aim of the study was to see demographic, clinical and functional outcome of posterior mesh rectopexy in our setup. MATERIALS AND METHODS The case report of 33 patients under gone posterior abdominal mesh rectopexy in MKCG medical college and hospital from 1st July 2012 to 1st July 2017 were reviewed retrospectively and the patients were followed up in surgical OPD/telephonic questionnaire. All patients had undergone standard posterior abdominal mesh rectopexy without the division of lateral ligaments with utmost care for prevention of bleeding and nerve damage. RESULTS Out of 33 cases of abdominal rectopexy, 12 (36% were males and 21 (64% were females. 27 (82% were within 61-80 years of age group. The most common symptoms were mass per annum (100% followed by incontinence for liquid stool and flatus 24 (72%. There was no operative mortality. The average hospital stay 7.8 days (5-11 days. The constipation (p=0.019 and incontinence (p=0.0165 were better postoperatively. There was 1 (3% partial recurrence of rectal prolapse in 91-year-old lady in 2 years follow up. CONCLUSION The recurrence rate as well as clinical and functional outcome of open abdominal mesh rectopexy seems to be satisfactory, however, long-term effect has to be seen.

  7. Road to recovery after transvaginal surgery for urethral mesh perforation: evaluation of outcomes and subsequent procedures.

    Science.gov (United States)

    Kowalik, Casey G; Cohn, Joshua A; Kakos, Andrea; Lang, Patrick; Reynolds, W Stuart; Kaufman, Melissa R; Karram, Mickey M; Dmochowski, Roger R

    2018-01-29

    Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons. Data comprising preoperative symptoms, operative details, and postoperative outcomes were collected by telephone (n 13) or based on their last follow-up appointment. Nineteen women underwent transvaginal sling excision for urethral mesh perforation. Eight (42%) patients had undergone previous sling revision surgery. Sixty percent of women had resolution of their pelvic pain postoperatively. At follow-up, 92% reported urinary incontinence (UI), and three had undergone five additional procedures for vaginal prolapse mesh exposure (n 1), incontinence (onabotulinum toxin injection n 1, rectus fascia autologous sling n 1), prolapse (colpopexy n 1), and pain (trigger-point injection n 1). Patient global impression of improvement data was available for 13 patients, of whom seven (54%) rated their postoperative condition as Very much better or Much better. The management of urethral mesh perforation is complex. Most women reported resolution of their pelvic pain and a high rate of satisfaction with their postoperative condition despite high rates of incontinence.

  8. Surface modification of polypropylene mesh devices with cyclodextrin via cold plasma for hernia repair: Characterization and antibacterial properties

    Science.gov (United States)

    Sanbhal, Noor; Mao, Ying; Sun, Gang; Xu, Rui Fang; Zhang, Qian; Wang, Lu

    2018-05-01

    Light weight polypropylene (PP) mesh is the most widely used implant among all other synthetic meshes for hernia repair. However, infection is the complication associated to all synthetic meshes after hernia repair. Thus, to manage mesh related infection; antibacterial drug is generally loaded to surgical implants to supply drug locally in mesh implanted site. Nevertheless, PP mesh restricts the loading of antibacterial drug at operated area due to its low wettability. The aim of this study was to introduce a novel antimicrobial PP mesh modified with β-cyclodextrine (CD) and loaded with antimicrobial agent for infection prevention. A cold oxygen plasma treatment was able to activate the surfaces of polypropylene fibers, and then CD was incorporated onto the surfaces of PP fibers. Afterward, triclosan, as a model antibacterial agent, was loaded into CD cavity to provide desired antibacterial functions. The modified polypropylene mesh samples CD-Tric-1, CD-Tric-3 exhibited excellent inhibition zone and continuous antibacterial efficacy against E. coli and S. aureus up to 6 and 7 days respectively. Results of AFM, SEM, FTIR and antibacterial tests evidenced that oxygen plasma process is necessary to increase chemical connection between CD molecules and PP fibers. The samples were also characterized by using EDX, XRD, TGA, DSC and water contact angle.

  9. Tensile Behaviour of Welded Wire Mesh and Hexagonal Metal Mesh for Ferrocement Application

    Science.gov (United States)

    Tanawade, A. G.; Modhera, C. D.

    2017-08-01

    Tension tests were conducted on welded mesh and hexagonal Metal mesh. Welded Mesh is available in the market in different sizes. The two types are analysed viz. Ø 2.3 mm and Ø 2.7 mm welded mesh, having opening size 31.75 mm × 31.75 mm and 25.4 mm × 25.4 mm respectively. Tensile strength test was performed on samples of welded mesh in three different orientations namely 0°, 30° and 45° degrees with the loading axis and hexagonal Metal mesh of Ø 0.7 mm, having opening 19.05 × 19.05 mm. Experimental tests were conducted on samples of these meshes. The objective of this study was to investigate the behaviour of the welded mesh and hexagonal Metal mesh. The result shows that the tension load carrying capacity of welded mesh of Ø 2.7 mm of 0° orientation is good as compared to Ø2.3 mm mesh and ductility of hexagonal Metal mesh is good in behaviour.

  10. Mesh optimization for microbial fuel cell cathodes constructed around stainless steel mesh current collectors

    KAUST Repository

    Zhang, Fang; Merrill, Matthew D.; Tokash, Justin C.; Saito, Tomonori; Cheng, Shaoan; Hickner, Michael A.; Logan, Bruce E.

    2011-01-01

    that the mesh properties of these cathodes can significantly affect performance. Cathodes made from the coarsest mesh (30-mesh) achieved the highest maximum power of 1616 ± 25 mW m-2 (normalized to cathode projected surface area; 47.1 ± 0.7 W m-3 based on liquid

  11. Intravesical midurethral sling mesh erosion secondary to transvaginal mesh reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Sukanda Bin Jaili

    2015-05-01

    Conclusion: Repeated vaginal reconstructive surgery may jeopardize a primary mesh or sling, and pose a high risk of mesh erosion, which may be delayed for several years. Removal of the mesh erosion and bladder repair are feasible pervaginally with good outcome.

  12. Dynamic evaluation of pelvic floor reconstructive surgery using radiopaque meshes and three-dimensional helical CT

    Directory of Open Access Journals (Sweden)

    Paulo Palma

    2010-04-01

    Full Text Available PURPOSE: This prospective study was performed to achieve visualization of the reestablishment of anatomy after reconstructive surgery in the different pelvic compartments with non-absorbable radiopaque meshes, providing valuable anatomic information for surgeons implanting meshes. MATERIALS AND METHODS: A total of 30 female patients with stress urinary incontinence (SUI, anterior and posterior vaginal wall prolapse, or both underwent surgical repair using radiopaque meshes after written informed consent. Patients with SUI underwent five different surgeries. Patients with anterior vaginal prolapse underwent a procedure using a combined pre-pubic and transobturator mesh, and those with posterior vaginal prolapse underwent posterior slingplasty. Three-dimensional reconstruction using helical CT was performed four weeks postoperatively. RESULTS: In all cases, the mesh was clearly visualized. Transobturator slings were shown at the midurethra, and the anchoring tails perforated the obturator foramen at the safety region. Mini-slings were in the proper place, and computed angiography revealed that the anchoring system was away from the obturator vessels. In patients undergoing procedure for anterior vaginal prolapse, both pre-pubic armpit and obturator slings were clearly seen and the mesh was in the proper position, supporting the bladder base and occluding the distal part of the urogenital hiatus. Transcoccygeal sacropexy revealed indirectly a well-supported "neo rectovaginal fascia" and the anchoring tails at the level of ischial spines. CONCLUSION: Three-dimensional helical tomography images of the female pelvis using radiopaque meshes have a potential role in improving our understanding of pelvic floor reconstructive surgeries. These radiopaque meshes might be the basis of a new investigative methodology.

  13. Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Naoko Takazawa

    2018-03-01

    Full Text Available Purpose: This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP. Materials and Methods: This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS and prolapse quality of life questionnaire (P-QOL and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Results: Prolapse recurred in 10 of 91 patients (11.0%, and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2% and pelvic pain in one (1.1% of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Conclusions: Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP.

  14. Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse.

    Science.gov (United States)

    Takazawa, Naoko; Fujisaki, Akiko; Yoshimura, Yasukuni; Tsujimura, Akira; Horie, Shigeo

    2018-03-01

    This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q) stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS) and prolapse quality of life questionnaire (P-QOL) and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Prolapse recurred in 10 of 91 patients (11.0%), and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2%) and pelvic pain in one (1.1%) of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP.

  15. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Directory of Open Access Journals (Sweden)

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.

  16. Robust diamond meshes with unique wettability properties.

    Science.gov (United States)

    Yang, Yizhou; Li, Hongdong; Cheng, Shaoheng; Zou, Guangtian; Wang, Chuanxi; Lin, Quan

    2014-03-18

    Robust diamond meshes with excellent superhydrophobic and superoleophilic properties have been fabricated. Superhydrophobicity is observed for water with varying pH from 1 to 14 with good recyclability. Reversible superhydrophobicity and hydrophilicity can be easily controlled. The diamond meshes show highly efficient water-oil separation and water pH droplet transference.

  17. Mesh-graft urethroplasty: a case report

    OpenAIRE

    田中, 敏博; 滝川, 浩; 香川, 征; 長江, 浩朗

    1987-01-01

    We used a meshed free-foreskin transplant in a two-stage procedure for reconstruction of the extended stricture of urethra after direct vision urethrotomy. The results were excellent. Mesh-graft urethroplasty is a useful method for patients with extended strictures of the urethra or recurrent strictures after several operations.

  18. 7th International Meshing Roundtable '98

    Energy Technology Data Exchange (ETDEWEB)

    Eldred, T.J.

    1998-10-01

    The goal of the 7th International Meshing Roundtable is to bring together researchers and developers from industry, academia, and government labs in a stimulating, open environment for the exchange of technical information related to the meshing process. In the past, the Roundtable has enjoyed significant participation from each of these groups from a wide variety of countries.

  19. Converting skeletal structures to quad dominant meshes

    DEFF Research Database (Denmark)

    Bærentzen, Jakob Andreas; Misztal, Marek Krzysztof; Welnicka, Katarzyna

    2012-01-01

    We propose the Skeleton to Quad-dominant polygonal Mesh algorithm (SQM), which converts skeletal structures to meshes composed entirely of polar and annular regions. Both types of regions have a regular structure where all faces are quads except for a single ring of triangles at the center of each...

  20. Adaptive mesh refinement in titanium

    Energy Technology Data Exchange (ETDEWEB)

    Colella, Phillip; Wen, Tong

    2005-01-21

    In this paper, we evaluate Titanium's usability as a high-level parallel programming language through a case study, where we implement a subset of Chombo's functionality in Titanium. Chombo is a software package applying the Adaptive Mesh Refinement methodology to numerical Partial Differential Equations at the production level. In Chombo, the library approach is used to parallel programming (C++ and Fortran, with MPI), whereas Titanium is a Java dialect designed for high-performance scientific computing. The performance of our implementation is studied and compared with that of Chombo in solving Poisson's equation based on two grid configurations from a real application. Also provided are the counts of lines of code from both sides.

  1. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  2. Automatic mesh generation with QMESH program

    International Nuclear Information System (INIS)

    Ise, Takeharu; Tsutsui, Tsuneo

    1977-05-01

    Usage of the two-dimensional self-organizing mesh generation program, QMESH, is presented together with the descriptions and the experience, as it has recently been converted and reconstructed from the NEACPL version to the FACOM. The program package consists of the QMESH code to generate quadrilaterial meshes with smoothing techniques, the QPLOT code to plot the data obtained from the QMESH on the graphic COM, and the RENUM code to renumber the meshes by using a bandwidth minimization procedure. The technique of mesh reconstructuring coupled with smoothing techniques is especially useful when one generates the meshes for computer codes based on the finite element method. Several typical examples are given for easy access to the QMESH program, which is registered in the R.B-disks of JAERI for users. (auth.)

  3. Fog water collection effectiveness: Mesh intercomparisons

    Science.gov (United States)

    Fernandez, Daniel; Torregrosa, Alicia; Weiss-Penzias, Peter; Zhang, Bong June; Sorensen, Deckard; Cohen, Robert; McKinley, Gareth; Kleingartner, Justin; Oliphant, Andrew; Bowman, Matthew

    2018-01-01

    To explore fog water harvesting potential in California, we conducted long-term measurements involving three types of mesh using standard fog collectors (SFC). Volumetric fog water measurements from SFCs and wind data were collected and recorded in 15-minute intervals over three summertime fog seasons (2014–2016) at four California sites. SFCs were deployed with: standard 1.00 m2 double-layer 35% shade coefficient Raschel; stainless steel mesh coated with the MIT-14 hydrophobic formulation; and FogHa-Tin, a German manufactured, 3-dimensional spacer fabric deployed in two orientations. Analysis of 3419 volumetric samples from all sites showed strong relationships between mesh efficiency and wind speed. Raschel mesh collected 160% more fog water than FogHa-Tin at wind speeds less than 1 m s–1 and 45% less for wind speeds greater than 5 m s–1. MIT-14 coated stainless-steel mesh collected more fog water than Raschel mesh at all wind speeds. At low wind speeds of steel mesh collected 3% more and at wind speeds of 4–5 m s–1, it collected 41% more. FogHa-Tin collected 5% more fog water when the warp of the weave was oriented vertically, per manufacturer specification, than when the warp of the weave was oriented horizontally. Time series measurements of three distinct mesh across similar wind regimes revealed inconsistent lags in fog water collection and inconsistent performance. Since such differences occurred under similar wind-speed regimes, we conclude that other factors play important roles in mesh performance, including in-situ fog event and aerosol dynamics that affect droplet-size spectra and droplet-to-mesh surface interactions.

  4. Age-stratified analysis of long-term outcomes of transvaginal mesh repair for treatment of pelvic organ prolapse.

    Science.gov (United States)

    Dong, Shengnan; Zhong, Yanbo; Chu, Lei; Li, Huaifang; Tong, Xiaowen; Wang, Jianjun

    2016-10-01

    To investigate long-term outcomes after transvaginal mesh repair among patients with pelvic organ prolapse in different age groups. A retrospective cohort study was conducted among women who underwent transvaginal mesh repair with polypropylene mesh for pelvic organ prolapse of stage II or higher between January 2007 and November 2011 at a center in Shanghai, China. Patients were invited to attend a follow-up appointment between July 2014 and May 2015. Surgical outcomes were compared among three age groups (≤59, 60-74, and ≥75 years), and quality-of-life questionnaires were evaluated. Multivariate logistic regression was used to identify risk factors associated with recurrent prolapse and mesh exposure. Among 158 patients, 143 (90.5%) were objectively cured and 149 (94.3%) were subjectively cured at follow-up. Surgical outcomes were similar across all age groups. Significant improvements were observed on the Pelvic Floor Distress Inventory across all applicable subscales in all age groups (Pmesh exposure (odds ratio 11.89, 95% confidence interval 1.08-131.48; P=0.043). Transvaginal mesh repair was found to be a safe and effective technique for treating pelvic organ prolapse among women of all ages. An active postoperative sex life increased the odds of mesh exposure. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Short-term complications associated with the use of transvaginal mesh in pelvic floor reconstructive surgery: Results from a multi-institutional prospectively maintained dataset.

    Science.gov (United States)

    Caveney, Maxx; Haddad, Devin; Matthews, Catherine; Badlani, Gopal; Mirzazadeh, Majid

    2017-11-01

    Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding. We stratified this data by the modifier associated with mesh usage at the time of the procedure. We then compared 30-day perioperative outcomes, postoperative complications (bleeding, infection, etc), and readmission rates between women with and without mesh-based repairs. We identified 10 657 vaginal reconstructive procedures without mesh and 959 mesh-based repairs from 2009 through 2013. Patients undergoing mesh repair were more likely to experience at least one complication than native tissue repair (9.28% vs 6.15%, P mesh group (11.37% vs 9.39%, P = 0.03). Procedures with mesh had a higher rate of perioperative bleeding requiring transfusion than native tissue repair (2.3% vs 0.49%, P surgical site infection (SSI) (0.52% vs 0.17%, P = 0.02). There were no significant differences in rates of readmission, superficial, or deep SSIs, pneumonia, urinary tract infection, sepsis, or renal failure. The use of vaginal mesh for pelvic organ prolapse repair appears to result in a higher rate of perioperative complications than native tissue repair. Patients undergoing these procedures should be counselled preoperatively concerning these risks. © 2017 Wiley Periodicals, Inc.

  6. Fog water collection effectiveness: Mesh intercomparisons

    Science.gov (United States)

    Fernandez, Daniel; Torregrosa, Alicia; Weiss-Penzias, Peter; Zhang, Bong June; Sorensen, Deckard; Cohen, Robert; McKinley, Gareth; Kleingartner, Justin; Oliphant, Andrew; Bowman, Matthew

    2018-01-01

    To explore fog water harvesting potential in California, we conducted long-term measurements involving three types of mesh using standard fog collectors (SFC). Volumetric fog water measurements from SFCs and wind data were collected and recorded in 15-minute intervals over three summertime fog seasons (2014–2016) at four California sites. SFCs were deployed with: standard 1.00 m2 double-layer 35% shade coefficient Raschel; stainless steel mesh coated with the MIT-14 hydrophobic formulation; and FogHa-Tin, a German manufactured, 3-dimensional spacer fabric deployed in two orientations. Analysis of 3419 volumetric samples from all sites showed strong relationships between mesh efficiency and wind speed. Raschel mesh collected 160% more fog water than FogHa-Tin at wind speeds less than 1 m s–1 and 45% less for wind speeds greater than 5 m s–1. MIT-14 coated stainless-steel mesh collected more fog water than Raschel mesh at all wind speeds. At low wind speeds of wind speeds of 4–5 m s–1, it collected 41% more. FogHa-Tin collected 5% more fog water when the warp of the weave was oriented vertically, per manufacturer specification, than when the warp of the weave was oriented horizontally. Time series measurements of three distinct mesh across similar wind regimes revealed inconsistent lags in fog water collection and inconsistent performance. Since such differences occurred under similar wind-speed regimes, we conclude that other factors play important roles in mesh performance, including in-situ fog event and aerosol dynamics that affect droplet-size spectra and droplet-to-mesh surface interactions.

  7. Mesh optimization for microbial fuel cell cathodes constructed around stainless steel mesh current collectors

    KAUST Repository

    Zhang, Fang

    2011-02-01

    Mesh current collectors made of stainless steel (SS) can be integrated into microbial fuel cell (MFC) cathodes constructed of a reactive carbon black and Pt catalyst mixture and a poly(dimethylsiloxane) (PDMS) diffusion layer. It is shown here that the mesh properties of these cathodes can significantly affect performance. Cathodes made from the coarsest mesh (30-mesh) achieved the highest maximum power of 1616 ± 25 mW m-2 (normalized to cathode projected surface area; 47.1 ± 0.7 W m-3 based on liquid volume), while the finest mesh (120-mesh) had the lowest power density (599 ± 57 mW m-2). Electrochemical impedance spectroscopy showed that charge transfer and diffusion resistances decreased with increasing mesh opening size. In MFC tests, the cathode performance was primarily limited by reaction kinetics, and not mass transfer. Oxygen permeability increased with mesh opening size, accounting for the decreased diffusion resistance. At higher current densities, diffusion became a limiting factor, especially for fine mesh with low oxygen transfer coefficients. These results demonstrate the critical nature of the mesh size used for constructing MFC cathodes. © 2010 Elsevier B.V. All rights reserved.

  8. Polygonal Prism Mesh in the Viscous Layers for the Polyhedral Mesh Generator, PolyGen

    International Nuclear Information System (INIS)

    Lee, Sang Yong; Park, Chan Eok; Kim, Shin Whan

    2015-01-01

    Polyhedral mesh has been known to have some benefits over the tetrahedral mesh. Efforts have been made to set up a polyhedral mesh generation system with open source programs SALOME and TetGen. The evaluation has shown that the polyhedral mesh generation system is promising. But it is necessary to extend the capability of the system to handle the viscous layers to be a generalized mesh generator. A brief review to the previous works on the mesh generation for the viscous layers will be made in section 2. Several challenging issues for the polygonal prism mesh generation will be discussed as well. The procedure to generate a polygonal prism mesh will be discussed in detail in section 3. Conclusion will be followed in section 4. A procedure to generate meshes in the viscous layers with PolyGen has been successfully designed. But more efforts have to be exercised to find the best way for the generating meshes for viscous layers. Using the extrusion direction of the STL data will the first of the trials in the near future

  9. Evaluation of a transvaginal mesh delivery system for the correction of pelvic organ prolapse: subjective and objective findings at least 1 year after surgery.

    Science.gov (United States)

    Culligan, Patrick J; Littman, Paul M; Salamon, Charbel G; Priestley, Jennifer L; Shariati, Amir

    2010-11-01

    We sought to track objective and subjective outcomes ≥1 year after transvaginal mesh system to correct prolapse. This was a retrospective cohort study of 120 women who received a transvaginal mesh procedure (Avaulta Solo, CR Bard Inc, Covington, GA). Outcomes were pelvic organ prolapse quantification values; Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores; and a surgical satisfaction survey. "Surgical failure" was defined as pelvic organ prolapse quantification point >0, and/or any reports of vaginal bulge. Of 120 patients, 116 (97%) were followed up for a mean of 14.4 months (range, 12-30). In all, 74 patients had only anterior mesh, 21 only posterior mesh, and 21 both meshes. Surgical cure rate was 81%. Surgical failure was more common if preoperative point C ≥+2 (35% vs 16%; P = .04). Mesh erosion and de novo pain occurred in 11.7% and 3.3%, respectively. Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores improved (P < .01). Objective and subjective improvements occurred at ≥1 year, yet failure rates were high when preoperative point C was ≥+2. Copyright © 2010 Mosby, Inc. All rights reserved.

  10. Mesh Optimization for Ground Vehicle Aerodynamics

    OpenAIRE

    Adrian Gaylard; Essam F Abo-Serie; Nor Elyana Ahmad

    2010-01-01

    Mesh optimization strategy for estimating accurate drag of a ground vehicle is proposed based on examining the effect of different mesh parameters.  The optimized mesh parameters were selected using design of experiment (DOE) method to be able to work in a...

  11. Engagement of Metal Debris into Gear Mesh

    Science.gov (United States)

    handschuh, Robert F.; Krantz, Timothy L.

    2010-01-01

    A series of bench-top experiments was conducted to determine the effects of metallic debris being dragged through meshing gear teeth. A test rig that is typically used to conduct contact fatigue experiments was used for these tests. Several sizes of drill material, shim stock and pieces of gear teeth were introduced and then driven through the meshing region. The level of torque required to drive the "chip" through the gear mesh was measured. From the data gathered, chip size sufficient to jam the mechanism can be determined.

  12. Mesh requirements for neutron transport calculations

    International Nuclear Information System (INIS)

    Askew, J.R.

    1967-07-01

    Fine-structure calculations are reported for a cylindrical natural uranium-graphite cell using different solution methods (discrete ordinate and collision probability codes) and varying the spatial mesh. It is suggested that of formulations assuming the source constant in a mesh interval the differential approach is generally to be preferred. Due to cancellation between approximations made in the derivation of the finite difference equations and the errors in neglecting source variation, the discrete ordinate code gave a more accurate estimate of fine structure for a given mesh even for unusually coarse representations. (author)

  13. Indications and Complications Associated with the Removal of 506 Pieces of Vaginal Mesh Used in Pelvic Floor Reconstruction: A Multicenter Study.

    Science.gov (United States)

    Miklos, John R; Chinthakanan, Orawee; Moore, Robert D; Karp, Deborah R; Nogueiras, Gladys M; Davila, G Willy

    2016-10-26

    Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. This was a retrospective study. Design Classification: Canadian Task Force II-3. Three tertiary referral centers in the United States. We examined data from all patients at the three centers who underwent surgical removal of synthetic materials from previous SUS, TVM, and sacrocolpopexy procedures for mesh-related complications from 2011 to 2013. Patients underwent vaginal, intra-abdominal, and inguinal mesh revisions by cutting, partial removal, or total removal of the mesh for mesh-related complications. Overall, 445 patients with complications underwent mesh removal laparoscopically, via groin dissection and/or transvaginally. There were a total of 506 mesh products removed. Of these, 56.5% were slings and 43.5% were for pelvic organ prolapse (POP). Synthetic mesh removed from patients included: transvaginal mesh (TVM) anterior for anterior vaginal prolapse, TVM posterior for posterior vaginal prolapse, sacrocolpopexy mesh, and suburethral slings (SUS) for stress urinary incontinence. Synthetic SUS removed included: retropubic (RPS), transobturator (TOT), and single-incision slings (SIS). TOT was the most common type of sling removed. Patients with a sling who only complained of vaginal pain with or without intercourse underwent a vaginal approach for surgical revision/removal of the sling (86.6%). Patients with an RPS with lower abdominal/suprapubic pain and vaginal pain underwent a vaginal and laparoscopic approach for sling removal (18.4%). Patients with a TOT sling who complained of vaginal and

  14. Chest wall reconstruction in a canine model using polydioxanone mesh, demineralized bone matrix and bone marrow stromal cells.

    Science.gov (United States)

    Tang, Hua; Xu, Zhifei; Qin, Xiong; Wu, Bin; Wu, Lihui; Zhao, XueWei; Li, Yulin

    2009-07-01

    Extensive chest wall defect reconstruction remains a challenging problem for surgeons. In the past several years, little progress has been made in this area. In this study, a biodegradable polydioxanone (PDO) mesh and demineralized bone matrix (DBM) seeded with osteogenically induced bone marrow stromal cells (BMSCs) were used to reconstruct a 6 cm x 5.5 cm chest wall defect. Four experimental groups were evaluated (n=6 per group): polydioxanone (PDO) mesh/DBMs/BMSCs group, polydioxanone (PDO) mesh/DBMs group, polydioxanone (PDO) mesh group, and a blank group (no materials) in a canine model. All the animals survived except those in the blank group. In all groups receiving biomaterial implants, the polydioxanone (PDO) mesh completely degraded at 24 weeks and was replaced by fibrous tissue with thickness close to that of the normal intercostal tissue (P>0.05). In the polydioxanone (PDO) mesh/DBMs/BMSCs group, new bone formation and bone-union were observed by radiographic and histological examination. More importantly, the reconstructed rib could maintain its original radian and achieve satisfactory biomechanics close to normal ribs in terms of bending stress (P>0.05). However, in the other two groups, fibrous tissue was observed in the defect and junctions, and the reconstructed ribs were easily distorted under an outer force. Based on these results, a surgical approach utilizing biodegradable polydioxanone (PDO) mesh in combination with DBMs and BMSCs could repair the chest wall defect not only in function but also in structure.

  15. A Tissue Relevance and Meshing Method for Computing Patient-Specific Anatomical Models in Endoscopic Sinus Surgery Simulation

    Science.gov (United States)

    Audette, M. A.; Hertel, I.; Burgert, O.; Strauss, G.

    This paper presents on-going work on a method for determining which subvolumes of a patient-specific tissue map, extracted from CT data of the head, are relevant to simulating endoscopic sinus surgery of that individual, and for decomposing these relevant tissues into triangles and tetrahedra whose mesh size is well controlled. The overall goal is to limit the complexity of the real-time biomechanical interaction while ensuring the clinical relevance of the simulation. Relevant tissues are determined as the union of the pathology present in the patient, of critical tissues deemed to be near the intended surgical path or pathology, and of bone and soft tissue near the intended path, pathology or critical tissues. The processing of tissues, prior to meshing, is based on the Fast Marching method applied under various guises, in a conditional manner that is related to tissue classes. The meshing is based on an adaptation of a meshing method of ours, which combines the Marching Tetrahedra method and the discrete Simplex mesh surface model to produce a topologically faithful surface mesh with well controlled edge and face size as a first stage, and Almost-regular Tetrahedralization of the same prescribed mesh size as a last stage.

  16. A Wrapping Method for Inserting Titanium Micro-Mesh Implants in the Reconstruction of Blowout Fractures

    Directory of Open Access Journals (Sweden)

    Tae Joon Choi

    2016-01-01

    Full Text Available Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic.

  17. The Role of Vaginal Mesh Procedures in Pelvic Organ Prolapse Surgery in View of Complication Risk

    Directory of Open Access Journals (Sweden)

    David R. Ellington

    2013-01-01

    Full Text Available Synthetic transvaginal mesh has been employed in the treatment of pelvic organ prolapse for more than a decade. As the use of these devices increased during this period so did adverse event reporting. In 2008, the Food and Drug Administration (FDA Public Health Notification informed physicians and patients of rising concerns with the use of synthetic transvaginal mesh. Shortly thereafter and in parallel to marked increases in adverse event reporting within the Manufacturer and User Device Experience (MAUDE, the FDA released a Safety Communication regarding urogynecologic surgical mesh use. Following this report and in the wake of increased medical industry product withdrawal, growing medicolegal concerns, patient safety, and clinical practice controversy, many gynecologists and pelvic reconstructive surgeons are left with limited long-term data, clinical guidance, and growing uncertainty regarding the role of synthetic transvaginal mesh use in pelvic organ prolapse. This paper reviews the reported complications of synthetic transvaginal mesh with an evidence-based approach as well as providing suggested guidance for the future role of its use amidst the controversy.

  18. A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair.

    Science.gov (United States)

    Lau, Hui-Hsuan; Su, Tsung-Hsien; Huang, Wen-Chu; Hsieh, Ching-Hung; Su, Chin-Hui; Chang, Rhu-Chu

    2013-10-01

    The transobturator suburethral sling is a common surgical treatment for stress urinary incontinence (SUI). In patients with incontinence after trocar-guided transvaginal mesh repair (Prolift), data on outcome remain limited. In the present study, we hypothesized that transobturator tape in such cases is assumed to be as effective as surgery alone. This was a prospective analysis of outcomes of transobturator slings in women who had undergone transvaginal mesh repair and in those who underwent sling surgery alone (controls). Objective cure was defined as the absence of urinary leakage during the stress test at filling cystometry and a negative cough test during pelvic examination. The success rates were evaluated 3-6 months postoperatively. One hundred women were recruited for the study. Compared to the control group, women after transvaginal mesh repair had a significantly lower objective success rate (62 vs 86%, p = 0.005) and poorer bladder neck mobility (0.5 ± 0.8 vs 1.1 ± 0.5 cm, p = 0.001). The transobturator sling has lower objective success rate in women after transvaginal mesh that may be due to decreased bladder neck mobility. Patients with post-mesh repair SUI who opt for sling surgery should be informed of these less satisfactory outcomes during preoperative counseling.

  19. The Role of Vaginal Mesh Procedures in Pelvic Organ Prolapse Surgery in View of Complication Risk

    Science.gov (United States)

    Ellington, David R.; Richter, Holly E.

    2013-01-01

    Synthetic transvaginal mesh has been employed in the treatment of pelvic organ prolapse for more than a decade. As the use of these devices increased during this period so did adverse event reporting. In 2008, the Food and Drug Administration (FDA) Public Health Notification informed physicians and patients of rising concerns with the use of synthetic transvaginal mesh. Shortly thereafter and in parallel to marked increases in adverse event reporting within the Manufacturer and User Device Experience (MAUDE), the FDA released a Safety Communication regarding urogynecologic surgical mesh use. Following this report and in the wake of increased medical industry product withdrawal, growing medicolegal concerns, patient safety, and clinical practice controversy, many gynecologists and pelvic reconstructive surgeons are left with limited long-term data, clinical guidance, and growing uncertainty regarding the role of synthetic transvaginal mesh use in pelvic organ prolapse. This paper reviews the reported complications of synthetic transvaginal mesh with an evidence-based approach as well as providing suggested guidance for the future role of its use amidst the controversy. PMID:24069035

  20. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  1. Transvaginal Resection of an Infected Sacrocolpopexy Mesh by Single-Port Trocar.

    Science.gov (United States)

    Schaub, Marie; Lecointre, Lise; Faller, Emilie; Boisramé, Thomas; Baldauf, Jean-Jacques; Akladios, Cherif Youssef

    Laparoscopy using a single port improves morbidity while keeping the same level of requirement. This technique has been evaluated in gynecology for salpingectomy, ovarian surgery, and hysterectomy. Here, the authors illustrate a new use of a single port using the transvaginal approach. Case report (Canadian Task Force classification III). Tertiary referral center in Strasbourg, France. Woman age 59 years. Single-port platform used in the transvaginal approach for resection of sacrocolpopexy mesh. The local institutional review board approved the video. A 59-year-old woman suffering from insulin-dependent diabetes and a tobacco user had 2 laparoscopic sacrocolpopexies for recurrent rectocele, the first in 2007 and the second in 2012. The sequences were marked by mesh erosion and granuloma in the vagina, requiring its surgical excision in 2016. The patient was then symptomatic, with an increasingly foul-smelling vaginal discharge with recurrent mesh erosion. Magnetic resonance imaging showed an abscess formation along the length of the mesh to the promontory. The patient then underwent surgery, realized under probabilistic antibiotic therapy, consisting of complete excision of the sacrocolpopexy mesh by the transvaginal approach. After putting the single-port trocar (GelPoint; Applied Medical, Rancho Santa Margarita, CA) into the vagina and obtaining distension with the insufflator (AirSeal; Conmed, Utica, NY), classic laparoscopic instruments were introduced by the single-port trocar. The mesh was entirely resected in the retroperitoneal space. Mesh was again used because the exposed space is almost always surrounded by loose granulation tissue that facilitates dissection and also prevents injury to adjacent structures such as bladder, rectum, and peritoneum. Moreover, the opening of adjacent structures will manifest gas leaks and, consequently, loss of the pneumovagina. At the end of procedure, the vagina is not closed to permit optimal drainage with a multitubular

  2. Obtuse triangle suppression in anisotropic meshes

    KAUST Repository

    Sun, Feng; Choi, Yi King; Wang, Wen Ping; Yan, Dongming; Liu, Yang; Lé vy, Bruno L.

    2011-01-01

    Anisotropic triangle meshes are used for efficient approximation of surfaces and flow data in finite element analysis, and in these applications it is desirable to have as few obtuse triangles as possible to reduce the discretization error. We present a variational approach to suppressing obtuse triangles in anisotropic meshes. Specifically, we introduce a hexagonal Minkowski metric, which is sensitive to triangle orientation, to give a new formulation of the centroidal Voronoi tessellation (CVT) method. Furthermore, we prove several relevant properties of the CVT method with the newly introduced metric. Experiments show that our algorithm produces anisotropic meshes with much fewer obtuse triangles than using existing methods while maintaining mesh anisotropy. © 2011 Elsevier B.V. All rights reserved.

  3. Connectivity editing for quad-dominant meshes

    KAUST Repository

    Peng, Chihan; Wonka, Peter

    2013-01-01

    and illustrate the advantages and disadvantages of different strategies for quad-dominant mesh design. © 2013 The Author(s) Computer Graphics Forum © 2013 The Eurographics Association and John Wiley & Sons Ltd.

  4. Grid adaptation using chimera composite overlapping meshes

    Science.gov (United States)

    Kao, Kai-Hsiung; Liou, Meng-Sing; Chow, Chuen-Yen

    1994-01-01

    The objective of this paper is to perform grid adaptation using composite overlapping meshes in regions of large gradient to accurately capture the salient features during computation. The chimera grid scheme, a multiple overset mesh technique, is used in combination with a Navier-Stokes solver. The numerical solution is first converged to a steady state based on an initial coarse mesh. Solution-adaptive enhancement is then performed by using a secondary fine grid system which oversets on top of the base grid in the high-gradient region, but without requiring the mesh boundaries to join in any special way. Communications through boundary interfaces between those separated grids are carried out using trilinear interpolation. Application to the Euler equations for shock reflections and to shock wave/boundary layer interaction problem are tested. With the present method, the salient features are well-resolved.

  5. Grid adaption using Chimera composite overlapping meshes

    Science.gov (United States)

    Kao, Kai-Hsiung; Liou, Meng-Sing; Chow, Chuen-Yen

    1993-01-01

    The objective of this paper is to perform grid adaptation using composite over-lapping meshes in regions of large gradient to capture the salient features accurately during computation. The Chimera grid scheme, a multiple overset mesh technique, is used in combination with a Navier-Stokes solver. The numerical solution is first converged to a steady state based on an initial coarse mesh. Solution-adaptive enhancement is then performed by using a secondary fine grid system which oversets on top of the base grid in the high-gradient region, but without requiring the mesh boundaries to join in any special way. Communications through boundary interfaces between those separated grids are carried out using tri-linear interpolation. Applications to the Euler equations for shock reflections and to a shock wave/boundary layer interaction problem are tested. With the present method, the salient features are well resolved.

  6. Shape space exploration of constrained meshes

    KAUST Repository

    Yang, Yongliang

    2011-12-12

    We present a general computational framework to locally characterize any shape space of meshes implicitly prescribed by a collection of non-linear constraints. We computationally access such manifolds, typically of high dimension and co-dimension, through first and second order approximants, namely tangent spaces and quadratically parameterized osculant surfaces. Exploration and navigation of desirable subspaces of the shape space with regard to application specific quality measures are enabled using approximants that are intrinsic to the underlying manifold and directly computable in the parameter space of the osculant surface. We demonstrate our framework on shape spaces of planar quad (PQ) meshes, where each mesh face is constrained to be (nearly) planar, and circular meshes, where each face has a circumcircle. We evaluate our framework for navigation and design exploration on a variety of inputs, while keeping context specific properties such as fairness, proximity to a reference surface, etc. © 2011 ACM.

  7. Shape space exploration of constrained meshes

    KAUST Repository

    Yang, Yongliang; Yang, Yijun; Pottmann, Helmut; Mitra, Niloy J.

    2011-01-01

    We present a general computational framework to locally characterize any shape space of meshes implicitly prescribed by a collection of non-linear constraints. We computationally access such manifolds, typically of high dimension and co-dimension, through first and second order approximants, namely tangent spaces and quadratically parameterized osculant surfaces. Exploration and navigation of desirable subspaces of the shape space with regard to application specific quality measures are enabled using approximants that are intrinsic to the underlying manifold and directly computable in the parameter space of the osculant surface. We demonstrate our framework on shape spaces of planar quad (PQ) meshes, where each mesh face is constrained to be (nearly) planar, and circular meshes, where each face has a circumcircle. We evaluate our framework for navigation and design exploration on a variety of inputs, while keeping context specific properties such as fairness, proximity to a reference surface, etc. © 2011 ACM.

  8. Obtuse triangle suppression in anisotropic meshes

    KAUST Repository

    Sun, Feng

    2011-12-01

    Anisotropic triangle meshes are used for efficient approximation of surfaces and flow data in finite element analysis, and in these applications it is desirable to have as few obtuse triangles as possible to reduce the discretization error. We present a variational approach to suppressing obtuse triangles in anisotropic meshes. Specifically, we introduce a hexagonal Minkowski metric, which is sensitive to triangle orientation, to give a new formulation of the centroidal Voronoi tessellation (CVT) method. Furthermore, we prove several relevant properties of the CVT method with the newly introduced metric. Experiments show that our algorithm produces anisotropic meshes with much fewer obtuse triangles than using existing methods while maintaining mesh anisotropy. © 2011 Elsevier B.V. All rights reserved.

  9. Mesh Processing in Medical Image Analysis

    DEFF Research Database (Denmark)

    The following topics are dealt with: mesh processing; medical image analysis; interactive freeform modeling; statistical shape analysis; clinical CT images; statistical surface recovery; automated segmentation; cerebral aneurysms; and real-time particle-based representation....

  10. Capacity Analysis of Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    M. I. Gumel

    2012-06-01

    Full Text Available The next generation wireless networks experienced a great development with emergence of wireless mesh networks (WMNs, which can be regarded as a realistic solution that provides wireless broadband access. The limited available bandwidth makes capacity analysis of the network very essential. While the network offers broadband wireless access to community and enterprise users, the problems that limit the network capacity must be addressed to exploit the optimum network performance. The wireless mesh network capacity analysis shows that the throughput of each mesh node degrades in order of l/n with increasing number of nodes (n in a linear topology. The degradation is found to be higher in a fully mesh network as a result of increase in interference and MAC layer contention in the network.

  11. Energy-efficient wireless mesh networks

    CSIR Research Space (South Africa)

    Ntlatlapa, N

    2007-06-01

    Full Text Available This paper outlines the objectives of a recently formed research group at Meraka Institute. The authors consider application of wireless mesh networks in rural infrastructure deficient parts of the African continent where nodes operate on batteries...

  12. LR: Compact connectivity representation for triangle meshes

    Energy Technology Data Exchange (ETDEWEB)

    Gurung, T; Luffel, M; Lindstrom, P; Rossignac, J

    2011-01-28

    We propose LR (Laced Ring) - a simple data structure for representing the connectivity of manifold triangle meshes. LR provides the option to store on average either 1.08 references per triangle or 26.2 bits per triangle. Its construction, from an input mesh that supports constant-time adjacency queries, has linear space and time complexity, and involves ordering most vertices along a nearly-Hamiltonian cycle. LR is best suited for applications that process meshes with fixed connectivity, as any changes to the connectivity require the data structure to be rebuilt. We provide an implementation of the set of standard random-access, constant-time operators for traversing a mesh, and show that LR often saves both space and traversal time over competing representations.

  13. MHD simulations on an unstructured mesh

    International Nuclear Information System (INIS)

    Strauss, H.R.; Park, W.; Belova, E.; Fu, G.Y.; Sugiyama, L.E.

    1998-01-01

    Two reasons for using an unstructured computational mesh are adaptivity, and alignment with arbitrarily shaped boundaries. Two codes which use finite element discretization on an unstructured mesh are described. FEM3D solves 2D and 3D RMHD using an adaptive grid. MH3D++, which incorporates methods of FEM3D into the MH3D generalized MHD code, can be used with shaped boundaries, which might be 3D

  14. Towards Blockchain-enabled Wireless Mesh Networks

    OpenAIRE

    Selimi, Mennan; Kabbinale, Aniruddh Rao; Ali, Anwaar; Navarro, Leandro; Sathiaseelan, Arjuna

    2018-01-01

    Recently, mesh networking and blockchain are two of the hottest technologies in the telecommunications industry. Combining both can reformulate internet access and make connecting to the Internet not only easy, but affordable too. Hyperledger Fabric (HLF) is a blockchain framework implementation and one of the Hyperledger projects hosted by The Linux Foundation. We evaluate HLF in a real production mesh network and in the laboratory, quantify its performance, bottlenecks and limitations of th...

  15. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure.

    Science.gov (United States)

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P

    2016-01-01

    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.

  16. Unstructured Mesh Movement and Viscous Mesh Generation for CFD-Based Design Optimization, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovations proposed are twofold: 1) a robust unstructured mesh movement method able to handle isotropic (Euler), anisotropic (viscous), mixed element (hybrid)...

  17. MHD simulations on an unstructured mesh

    International Nuclear Information System (INIS)

    Strauss, H.R.; Park, W.

    1996-01-01

    We describe work on a full MHD code using an unstructured mesh. MH3D++ is an extension of the PPPL MH3D resistive full MHD code. MH3D++ replaces the structured mesh and finite difference / fourier discretization of MH3D with an unstructured mesh and finite element / fourier discretization. Low level routines which perform differential operations, solution of PDEs such as Poisson's equation, and graphics, are encapsulated in C++ objects to isolate the finite element operations from the higher level code. The high level code is the same, whether it is run in structured or unstructured mesh versions. This allows the unstructured mesh version to be benchmarked against the structured mesh version. As a preliminary example, disruptions in DIIID reverse shear equilibria are studied numerically with the MH3D++ code. Numerical equilibria were first produced starting with an EQDSK file containing equilibrium data of a DIII-D L-mode negative central shear discharge. Using these equilibria, the linearized equations are time advanced to get the toroidal mode number n = 1 linear growth rate and eigenmode, which is resistively unstable. The equilibrium and linear mode are used to initialize 3D nonlinear runs. An example shows poloidal slices of 3D pressure surfaces: initially, on the left, and at an intermediate time, on the right

  18. How to model wireless mesh networks topology

    International Nuclear Information System (INIS)

    Sanni, M L; Hashim, A A; Anwar, F; Ali, S; Ahmed, G S M

    2013-01-01

    The specification of network connectivity model or topology is the beginning of design and analysis in Computer Network researches. Wireless Mesh Networks is an autonomic network that is dynamically self-organised, self-configured while the mesh nodes establish automatic connectivity with the adjacent nodes in the relay network of wireless backbone routers. Researches in Wireless Mesh Networks range from node deployment to internetworking issues with sensor, Internet and cellular networks. These researches require modelling of relationships and interactions among nodes including technical characteristics of the links while satisfying the architectural requirements of the physical network. However, the existing topology generators model geographic topologies which constitute different architectures, thus may not be suitable in Wireless Mesh Networks scenarios. The existing methods of topology generation are explored, analysed and parameters for their characterisation are identified. Furthermore, an algorithm for the design of Wireless Mesh Networks topology based on square grid model is proposed in this paper. The performance of the topology generated is also evaluated. This research is particularly important in the generation of a close-to-real topology for ensuring relevance of design to the intended network and validity of results obtained in Wireless Mesh Networks researches

  19. Transvaginal Excision of an Eroded Sacrocolpopexy Mesh by Using Single-Incision Laparoscopic Surgery Equipment.

    Science.gov (United States)

    Mohr, Stefan; Siegenthaler, Franziska; Imboden, Sara; Kuhn, Annette; Mueller, Michael D

    To show a new technique of using single-incision laparoscopic surgery (SILS) equipment in vaginal surgery to create a "pneumovagina." Explanatory video demonstrating the technique and intraoperative findings. University hospital. The 68-year-old patient was referred with a vaginal mesh erosion that resulted in abscess formation at the vaginal apex. The patient was symptomatic with an increasingly foul-smelling vaginal discharge for about 1 year. She had a laparoscopic sacrocolpopexy in a remote hospital 22 months before the current operation and had a total abdominal hysterectomy 15 years ago. The, patient's history was uneventful without dyspareunia, incontinence or voiding difficulties, and she was otherwise content with the sacrocolpopexy result. The local institutional review board granted exemption for this publication. Frequently, pelvic organ prolapse can only be effectively treated if the surgical procedure comprises support of the central compartment. Laparoscopic sacrocolpopexy shows superior outcomes for this indication, with success rates of up to 96%. However, a rare side effect of laparoscopic sacrocolpopexy is mesh erosion, occurring in up to 2.4% [1]. These erosions are usually treated laparoscopically [2]. In this video we show an alternative route for excision of a symptomatic exposed mesh by using a transvaginal approach: The SILS trocar is used vaginally for abscess irrigation and mesh excision with minimally invasive instruments. For treatment of the abscess and removal of the exposed mesh, the SILS trocar was placed vaginally, and laparoscopic instruments were used. The abscess was incised, cleansed and irrigated, debrided, and the mesh excised. Because no mesh material was exposed after excision, the vagina was not closed to avoid creating a cavity with the risk of promoting reabscess formation, and secondary wound healing was anticipated. Laparoscopy was used to confirm that no intra-abdominal lesion coexisted or occurred. There were

  20. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  1. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  2. Fire performance of basalt FRP mesh reinforced HPC thin plates

    DEFF Research Database (Denmark)

    Hulin, Thomas; Hodicky, Kamil; Schmidt, Jacob Wittrup

    2013-01-01

    An experimental program was carried out to investigate the influence of basalt FRP (BFRP) reinforcing mesh on the fire behaviour of thin high performance concrete (HPC) plates applied to sandwich elements. Samples with BFRP mesh were compared to samples with no mesh, samples with steel mesh...

  3. An eFTD-VP framework for efficiently generating patient-specific anatomically detailed facial soft tissue FE mesh for craniomaxillofacial surgery simulation.

    Science.gov (United States)

    Zhang, Xiaoyan; Kim, Daeseung; Shen, Shunyao; Yuan, Peng; Liu, Siting; Tang, Zhen; Zhang, Guangming; Zhou, Xiaobo; Gateno, Jaime; Liebschner, Michael A K; Xia, James J

    2018-04-01

    Accurate surgical planning and prediction of craniomaxillofacial surgery outcome requires simulation of soft tissue changes following osteotomy. This can only be achieved by using an anatomically detailed facial soft tissue model. The current state-of-the-art of model generation is not appropriate to clinical applications due to the time-intensive nature of manual segmentation and volumetric mesh generation. The conventional patient-specific finite element (FE) mesh generation methods are to deform a template FE mesh to match the shape of a patient based on registration. However, these methods commonly produce element distortion. Additionally, the mesh density for patients depends on that of the template model. It could not be adjusted to conduct mesh density sensitivity analysis. In this study, we propose a new framework of patient-specific facial soft tissue FE mesh generation. The goal of the developed method is to efficiently generate a high-quality patient-specific hexahedral FE mesh with adjustable mesh density while preserving the accuracy in anatomical structure correspondence. Our FE mesh is generated by eFace template deformation followed by volumetric parametrization. First, the patient-specific anatomically detailed facial soft tissue model (including skin, mucosa, and muscles) is generated by deforming an eFace template model. The adaptation of the eFace template model is achieved by using a hybrid landmark-based morphing and dense surface fitting approach followed by a thin-plate spline interpolation. Then, high-quality hexahedral mesh is constructed by using volumetric parameterization. The user can control the resolution of hexahedron mesh to best reflect clinicians' need. Our approach was validated using 30 patient models and 4 visible human datasets. The generated patient-specific FE mesh showed high surface matching accuracy, element quality, and internal structure matching accuracy. They can be directly and effectively used for clinical

  4. [Vaginal mesh operations in the urogynecological practice after the FDA warnings. Use or not to use mesh?

    Science.gov (United States)

    Fekete, Zoltán; Körösi, Szilvia; Németh, Gábor

    2018-03-01

    The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations. We analysed the clinical data from 120 patients with stage II-III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2013 and January 2014. Sixty patients underwent Kelly-Stoeckel vaginoplasty and the other 60 cases had TVM operation. The surgical complications were classified using the Clavien-Dindo (CD) classification system. The anti-POP (91.6% vs. 63.3%; pmesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications. Orv Hetil. 2018; 159(10): 397-404.

  5. Biological Mesh Implants for Abdominal Hernia Repair: US Food and Drug Administration Approval Process and Systematic Review of Its Efficacy.

    Science.gov (United States)

    Huerta, Sergio; Varshney, Anubodh; Patel, Prachi M; Mayo, Helen G; Livingston, Edward H

    2016-04-01

    Expensive biological mesh materials are increasingly used to reinforce abdominal wall hernia repairs. The clinical and cost benefit of these materials are unknown. To review the published evidence on the use of biological mesh materials and to examine the US Food and Drug Administration (FDA) approval history for these devices. Search of multiple electronic databases (Ovid, MEDLINE, EMBASE, Cochrane Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Cochrane National Health Service Economic Evaluation Database) to identify articles published between 1948 and June 30, 2015, on the use of biological mesh materials used to reinforce abdominal wall hernia repair. Keywords searched included surgical mesh, abdominal hernia, recurrence, infection, fistula, bioprosthesis, biocompatible materials, absorbable implants, dermis, and collagen. The FDA online database for 510(k) clearances was reviewed for all commercially available biological mesh materials. The median national price for mesh materials was established by a benchmarking query through several Integrated Delivery Network and Group Purchasing Organization tools. Of 274 screened articles, 20 met the search criteria. Most were case series that reported results of convenience samples of patients at single institutions with a variety of clinical problems. Only 3 of the 20 were comparative studies. There were no randomized clinical trials. In total, outcomes for 1033 patients were described. Studies varied widely in follow-up time, operative technique, meshes used, and patient selection criteria. Reported outcomes and clinical outcomes, such as fistula formation and infection, were inconsistently reported across studies. Conflicts of interest were not reported in 16 of the 20 studies. Recurrence rates ranged from 0% to 80%. All biological mesh devices were approved by the FDA based on substantial equivalence to a group of nonbiological predicate

  6. The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study.

    Science.gov (United States)

    Miklos, John R; Chinthakanan, Orawee; Moore, Robert D; Mitchell, Gretchen K; Favors, Sheena; Karp, Deborah R; Northington, Gina M; Nogueiras, Gladys M; Davila, G Willy

    2016-06-01

    The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications. This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized. We identified 445 patients with mesh complications, 506 pieces of synthetic mesh were removed, and 587 prostheses-related complications were classified. 3.7 % of patients had viscus organ penetration or vaginal exposure as their presenting chief complaint and 59.7 % were classified as not having any vaginal epithelial separation or category 1. The most common category was spontaneous pain (1Be: 32.5 %) followed by dyspareunia (1Bc: 14.7 %). The sling group was 20 % more likely to have pain compared with the pelvic organ prolapse (POP) mesh group (OR 1.2, 95 % CI 0.8-1.6). The most commonly affected site (S2) was away from the suture line (49 %). Compared with the sling group, the POP group had a higher rate of mesh exposure, which mostly occurred at the suture line area. The majority of patients presented with mesh-related complications more than 1 year post-insertion (T4; average 3.68 ± 2.47 years). Surgeons should be aware that patients with vaginal mesh complications routinely exhibit complications more than 1 year after the implantation with pain as the most common presenting symptom.

  7. Feature-Sensitive Tetrahedral Mesh Generation with Guaranteed Quality

    OpenAIRE

    Wang, Jun; Yu, Zeyun

    2012-01-01

    Tetrahedral meshes are being extensively used in finite element methods (FEM). This paper proposes an algorithm to generate feature-sensitive and high-quality tetrahedral meshes from an arbitrary surface mesh model. A top-down octree subdivision is conducted on the surface mesh and a set of tetrahedra are constructed using adaptive body-centered cubic (BCC) lattices. Special treatments are given to the tetrahedra near the surface such that the quality of the resulting tetrahedral mesh is prov...

  8. Cartesian anisotropic mesh adaptation for compressible flow

    International Nuclear Information System (INIS)

    Keats, W.A.; Lien, F.-S.

    2004-01-01

    Simulating transient compressible flows involving shock waves presents challenges to the CFD practitioner in terms of the mesh quality required to resolve discontinuities and prevent smearing. This paper discusses a novel two-dimensional Cartesian anisotropic mesh adaptation technique implemented for compressible flow. This technique, developed for laminar flow by Ham, Lien and Strong, is efficient because it refines and coarsens cells using criteria that consider the solution in each of the cardinal directions separately. In this paper the method will be applied to compressible flow. The procedure shows promise in its ability to deliver good quality solutions while achieving computational savings. The convection scheme used is the Advective Upstream Splitting Method (Plus), and the refinement/ coarsening criteria are based on work done by Ham et al. Transient shock wave diffraction over a backward step and shock reflection over a forward step are considered as test cases because they demonstrate that the quality of the solution can be maintained as the mesh is refined and coarsened in time. The data structure is explained in relation to the computational mesh, and the object-oriented design and implementation of the code is presented. Refinement and coarsening algorithms are outlined. Computational savings over uniform and isotropic mesh approaches are shown to be significant. (author)

  9. Mesh networks: an optimum solution for AMR

    Energy Technology Data Exchange (ETDEWEB)

    Mimno, G.

    2003-12-01

    Characteristics of mesh networks and the advantage of using them in automatic meter reading equipment (AMR) are discussed. Mesh networks are defined as being similar to a fishing net made of knots and links. In mesh networks the knots represent meter sites and the links are the radio paths between the meter sites and the neighbourhood concentrator. In mesh networks any knot in the communications chain can link to any other and the optimum path is calculated by the network by hopping from meter to meter until the radio message reaches a concentrator. This mesh communications architecture is said to be vastly superior to many older types of radio-based meter reading technologies; its main advantage is that it not only significantly improves the economics of fixed network deployment, but also supports time-of-use metering, remote disconnect services and advanced features, such as real-time pricing, demand response, and other efficiency measures, providing a better return on investment and reliability.

  10. Protection from radiation enteritis by an absorbable polyglycolic acid mesh sling

    International Nuclear Information System (INIS)

    Devereux, D.F.; Thompson, D.; Sandhaus, L.; Sweeney, W.; Haas, A.

    1987-01-01

    Patients with malignant tumors of the pelvis who cannot be cured surgically often are treated with radiation after surgery. A devastating side effect of this treatment is radiation-associated small bowel injury (RASBI). The purpose of this study was to test the hypothesis that removal of the small bowel from the radiation field would protect it against RASBI. Twenty cebus monkeys underwent low anterior resection. In 10 animals an absorbable polyglycolic acid (PGA) mesh was sewn circumferentially around the interior of the abdominal cavity as a supporting apron, which prevented the small bowel's descent into the pelvis. The other 10 monkeys did not receive the mesh. All animals received 2000 rads by linear acceleration in a single dose. Twenty-four-hour stool fat, serum vitamin B12, and other serum values were obtained during the study. Animals were sacrificed after 1, 2, 3, 6, and 12 months, and the small bowel and rectum were examined histologically in a blind manner. Two monkeys who did not undergo surgery, or exposure to radiation served as controls. At all sacrifice periods, the animals with PGA mesh slings demonstrated normal small bowel function and histologic structure. Animals without mesh slings had abnormal stool and blood values at 1 month, and by 2 months all had died of small bowel necrosis. The animals that received the slings had no evidence of infection or obstruction, and by 6 months all evidence of the mesh was gone. Support of the small bowel out of the pelvis by an absorbable PGA mesh sling protects against RASBI and is without apparent complications

  11. Repair of large frontal temporal parietal skull defect with digitally reconstructed titanium mesh: a report of 20 cases

    Directory of Open Access Journals (Sweden)

    Gang-ge CHENG

    2013-09-01

    Full Text Available Objective To explore the clinical effect and surgical technique of the repair of large defect involving frontal, temporal, and parietal regions using digitally reconstructed titanium mesh. Methods Twenty patients with large frontal, temporal, and parietal skull defect hospitalized in Air Force General Hospital from November 2006 to May 2012 were involved in this study. In these 20 patients, there were 13 males and 7 females, aged 18-58 years (mean 39 years, and the defect size measured from 7.0cm×9.0cm to 11.5cm×14.0cm (mean 8.5cm×12.0cm. Spiral CT head scan and digital three-dimensional reconstruction of skull were performed in all the patients. The shape and geometric size of skull defect was traced based on the symmetry principle, and then the data were transferred into digital precision lathe to reconstruct a titanium mesh slightly larger (1.0-1.5cm than the skull defect, and the finally the prosthesis was perfected after pruning the border. Cranioplasty was performed 6-12 months after craniotomy using the digitally reconstructed titanium mesh. Results The digitally reconstructed titanium mesh was used in 20 patients with large frontal, temporal, parietal skull defect. The surgical technique was relatively simple, and the surgical duration was shorter than before. The titanium mesh fit to the defect of skull accurately with satisfactory molding effect, good appearance and symmetrical in shape. No related complication was found in all the patients. Conclusion Repair of large frontal, temporal, parietal skull defect with digitally reconstructed titanium mesh is more advantageous than traditional manual reconstruction, and it can improve the life quality of patients.

  12. Connectivity editing for quad-dominant meshes

    KAUST Repository

    Peng, Chihan

    2013-08-01

    We propose a connectivity editing framework for quad-dominant meshes. In our framework, the user can edit the mesh connectivity to control the location, type, and number of irregular vertices (with more or fewer than four neighbors) and irregular faces (non-quads). We provide a theoretical analysis of the problem, discuss what edits are possible and impossible, and describe how to implement an editing framework that realizes all possible editing operations. In the results, we show example edits and illustrate the advantages and disadvantages of different strategies for quad-dominant mesh design. © 2013 The Author(s) Computer Graphics Forum © 2013 The Eurographics Association and John Wiley & Sons Ltd.

  13. ZONE: a finite element mesh generator

    International Nuclear Information System (INIS)

    Burger, M.J.

    1976-05-01

    The ZONE computer program is a finite-element mesh generator which produces the nodes and element description of any two-dimensional geometry. The geometry is subdivided into a mesh of quadrilateral and triangular zones arranged sequentially in an ordered march through the geometry. The order of march can be chosen so that the minimum bandwidth is obtained. The node points are defined in terms of the x and y coordinates in a global rectangular coordinate system. The zones generated are quadrilaterals or triangles defined by four node points in a counterclockwise sequence. Node points defining the outside boundary are generated to describe pressure boundary conditions. The mesh that is generated can be used as input to any two-dimensional as well as any axisymmetrical structure program. The output from ZONE is essentially the input file to NAOS, HONDO, and other axisymmetric finite element programs. 14 figures

  14. Unstructured Adaptive Meshes: Bad for Your Memory?

    Science.gov (United States)

    Biswas, Rupak; Feng, Hui-Yu; VanderWijngaart, Rob

    2003-01-01

    This viewgraph presentation explores the need for a NASA Advanced Supercomputing (NAS) parallel benchmark for problems with irregular dynamical memory access. This benchmark is important and necessary because: 1) Problems with localized error source benefit from adaptive nonuniform meshes; 2) Certain machines perform poorly on such problems; 3) Parallel implementation may provide further performance improvement but is difficult. Some examples of problems which use irregular dynamical memory access include: 1) Heat transfer problem; 2) Heat source term; 3) Spectral element method; 4) Base functions; 5) Elemental discrete equations; 6) Global discrete equations. Nonconforming Mesh and Mortar Element Method are covered in greater detail in this presentation.

  15. Local adaptive mesh refinement for shock hydrodynamics

    International Nuclear Information System (INIS)

    Berger, M.J.; Colella, P.; Lawrence Livermore Laboratory, Livermore, 94550 California)

    1989-01-01

    The aim of this work is the development of an automatic, adaptive mesh refinement strategy for solving hyperbolic conservation laws in two dimensions. There are two main difficulties in doing this. The first problem is due to the presence of discontinuities in the solution and the effect on them of discontinuities in the mesh. The second problem is how to organize the algorithm to minimize memory and CPU overhead. This is an important consideration and will continue to be important as more sophisticated algorithms that use data structures other than arrays are developed for use on vector and parallel computers. copyright 1989 Academic Press, Inc

  16. Adaptive mesh refinement for storm surge

    KAUST Repository

    Mandli, Kyle T.; Dawson, Clint N.

    2014-01-01

    An approach to utilizing adaptive mesh refinement algorithms for storm surge modeling is proposed. Currently numerical models exist that can resolve the details of coastal regions but are often too costly to be run in an ensemble forecasting framework without significant computing resources. The application of adaptive mesh refinement algorithms substantially lowers the computational cost of a storm surge model run while retaining much of the desired coastal resolution. The approach presented is implemented in the GeoClaw framework and compared to ADCIRC for Hurricane Ike along with observed tide gauge data and the computational cost of each model run. © 2014 Elsevier Ltd.

  17. MUSIC: a mesh-unrestricted simulation code

    International Nuclear Information System (INIS)

    Bonalumi, R.A.; Rouben, B.; Dastur, A.R.; Dondale, C.S.; Li, H.Y.H.

    1978-01-01

    A general formalism to solve the G-group neutron diffusion equation is described. The G-group flux is represented by complementing an ''asymptotic'' mode with (G-1) ''transient'' modes. A particular reduction-to-one-group technique gives a high computational efficiency. MUSIC, a 2-group code using the above formalism, is presented. MUSIC is demonstrated on a fine-mesh calculation and on 2 coarse-mesh core calculations: a heavy-water reactor (HWR) problem and the 2-D lightwater reactor (LWR) IAEA benchmark. Comparison is made to finite-difference results

  18. Adaptive mesh refinement for storm surge

    KAUST Repository

    Mandli, Kyle T.

    2014-03-01

    An approach to utilizing adaptive mesh refinement algorithms for storm surge modeling is proposed. Currently numerical models exist that can resolve the details of coastal regions but are often too costly to be run in an ensemble forecasting framework without significant computing resources. The application of adaptive mesh refinement algorithms substantially lowers the computational cost of a storm surge model run while retaining much of the desired coastal resolution. The approach presented is implemented in the GeoClaw framework and compared to ADCIRC for Hurricane Ike along with observed tide gauge data and the computational cost of each model run. © 2014 Elsevier Ltd.

  19. First human use of hybrid synthetic/biologic mesh in ventral hernia repair: a multicenter trial.

    Science.gov (United States)

    Bittner, James G; El-Hayek, Kevin; Strong, Andrew T; LaPinska, Melissa Phillips; Yoo, Jin S; Pauli, Eric M; Kroh, Matthew

    2018-03-01

    Mesh options for reinforcement of ventral/incisional hernia (VIH) repair include synthetic or biologic materials. While each material has known advantages and disadvantages, little is understood about outcomes when these materials are used in combination. This multicenter study reports on the first human use of a novel synthetic/biologic hybrid mesh (Zenapro ® Hybrid Hernia Repair Device) for VIH repair. This prospective, multicenter post-market clinical trial enrolled consecutive adults who underwent elective VIH repair with hybrid mesh placed in the intraperitoneal or retromuscular/preperitoneal position. Patients were classified as Ventral Hernia Working Group (VHWG) grades 1-3 and had clean or clean-contaminated wounds. Outcomes of ventral and incisional hernia were compared using appropriate parametric tests. In all, 63 patients underwent VIH repair with hybrid mesh. Most were females (54.0%), had a mean age of 54.8 ± 10.9 years and mean body mass index of 34.5 ± 7.8 kg/m 2 , and classified as VHWG grade 2 (87.3%). Most defects were midline (92.1%) with a mean area of 106 ± 155 cm 2 . Cases were commonly classified as clean (92.1%) and were performed laparoscopically (60.3%). Primary fascial closure was achieved in 82.5% with 28.2% requiring component separation. Mesh location was frequently intraperitoneal (69.8%). Overall, 39% of patients available for follow-up at 12 months suffered surgical site events, which were generally more frequent after incisional hernia repair. Of these, seroma (23.7%) was most common, but few (8.5%) required procedural intervention. Other surgical site events that required procedural intervention included hematoma (1.7%), wound dehiscence (1.7%), and surgical site infection (3.4%). Recurrence rate was 6.8% (95% CI 2.2-16.6%) at 12-months postoperatively. Zenapro ® Hybrid Hernia Repair Device is safe and effective in VHWG grade 1-2 patients with clean wounds out to 12 months. Short-term outcomes and recurrence rate

  20. Mesh size in Lichtenstein repair: a systematic review and meta-analysis to determine the importance of mesh size.

    Science.gov (United States)

    Seker, D; Oztuna, D; Kulacoglu, H; Genc, Y; Akcil, M

    2013-04-01

    Small mesh size has been recognized as one of the factors responsible for recurrence after Lichtenstein hernia repair due to insufficient coverage or mesh shrinkage. The Lichtenstein Hernia Institute recommends a 7 × 15 cm mesh that can be trimmed up to 2 cm from the lateral side. We performed a systematic review to determine surgeons' mesh size preference for the Lichtenstein hernia repair and made a meta-analysis to determine the effect of mesh size, mesh type, and length of follow-up time on recurrence. Two medical databases, PubMed and ISI Web of Science, were systematically searched using the key word "Lichtenstein repair." All full text papers were selected. Publications mentioning mesh size were brought for further analysis. A mesh surface area of 90 cm(2) was accepted as the threshold for defining the mesh as small or large. Also, a subgroup analysis for recurrence pooled proportion according to the mesh size, mesh type, and follow-up period was done. In total, 514 papers were obtained. There were no prospective or retrospective clinical studies comparing mesh size and clinical outcome. A total of 141 papers were duplicated in both databases. As a result, 373 papers were obtained. The full text was available in over 95 % of papers. Only 41 (11.2 %) papers discussed mesh size. In 29 studies, a mesh larger than 90 cm(2) was used. The most frequently preferred commercial mesh size was 7.5 × 15 cm. No papers mentioned the size of the mesh after trimming. There was no information about the relationship between mesh size and patient BMI. The pooled proportion in recurrence for small meshes was 0.0019 (95 % confidence interval: 0.007-0.0036), favoring large meshes to decrease the chance of recurrence. Recurrence becomes more marked when follow-up period is longer than 1 year (p < 0.001). Heavy meshes also decreased recurrence (p = 0.015). This systematic review demonstrates that the size of the mesh used in Lichtenstein hernia repair is rarely

  1. Properties of meshes used in hernia repair: a comprehensive review of synthetic and biologic meshes.

    Science.gov (United States)

    Ibrahim, Ahmed M S; Vargas, Christina R; Colakoglu, Salih; Nguyen, John T; Lin, Samuel J; Lee, Bernard T

    2015-02-01

    Data on the mechanical properties of the adult human abdominal wall have been difficult to obtain rendering manufacture of the ideal mesh for ventral hernia repair a challenge. An ideal mesh would need to exhibit greater biomechanical strength and elasticity than that of the abdominal wall. The aim of this study is to quantitatively compare the biomechanical properties of the most commonly used synthetic and biologic meshes in ventral hernia repair and presents a comprehensive literature review. A narrative review of the literature was performed using the PubMed database spanning articles from 1982 to 2012 including a review of company Web sites to identify all available information relating to the biomechanical properties of various synthetic and biologic meshes used in ventral hernia repair. There exist differences in the mechanical properties and the chemical nature of different meshes. In general, most synthetic materials have greater stiffness and elasticity than what is required for abdominal wall reconstruction; however, each exhibits unique properties that may be beneficial for clinical use. On the contrary, biologic meshes are more elastic but less stiff and with a lower tensile strength than their synthetic counterparts. The current standard of practice for the treatment of ventral hernias is the use of permanent synthetic mesh material. Recently, biologic meshes have become more frequently used. Most meshes exhibit biomechanical properties over the known abdominal wall thresholds. Augmenting strength requires increasing amounts of material contributing to more stiffness and foreign body reaction, which is not necessarily an advantage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Treatment of Mesh Skin Grafted Scars Using a Plasma Skin Regeneration System

    Directory of Open Access Journals (Sweden)

    Takamitsu Higashimori

    2010-01-01

    Full Text Available Objectives. Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR system has been investigated. There are no reports on plasma treatment of mesh skin grafted scars. The objective of our study is to evaluate the effectiveness and complications of plasma treatment of mesh skin grafted scars in Asian patients. Materials and Methods. Four Asian patients with mesh skin grafted scars were enrolled in the study. The plasma treatments were performed at monthly intervals with PSR, using energy settings of 3 to 4 J. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 months post treatment. The patients were also evaluated for any side effects from the treatment. Results. All patients showed more than 50% improvement. The average pain score on a 10-point scale was 6.9 +/− 1.2 SD and all patients tolerated the treatments. Temporary, localized hypopigmentation was observed in two patients. Hyperpigmentation and worsening of scarring were not observed. Conclusions. Plasma treatment is clinically effective and is associated with minimal complications when used to treat mesh skin grafted scars in Asian patients.

  3. Removal of Polypropylene Sling Mesh From the Urethra: An Anatomic Technique.

    Science.gov (United States)

    Freilich, Drew A; Rovner, Eric S

    2015-07-01

    To describe a technique for removal of intraurethral mesh with minimal disruption of the periurethral anatomy. Through a midline transvaginal approach the sling is located lateral to the urethra and divided. The medial portion of the divided sling is carefully dissected back to its entrance laterally into the urethral lumen. A stay suture is placed on the dissected sling. The sling is located on the contralateral side and likewise divided and dissected back to the urethral lumen. The completely dissected sling is pulled through such that the holding stitch is through and through the urethral lumen, allowing easy localization of the urethral defect on lateral walls of the urethra. These defects are closed with an absorbable suture and the vaginal incision is closed. Three patients have undergone a transvaginal removal of their intraurethral mesh using the described technique. At a mean follow-up of 6.0 months, there were no intraoperative or postoperative complications. All patients were obstructed preoperatively and all developed stress urinary incontinence postoperatively requiring 0-1 pads per day. Current approaches to the surgical repair of chronic intraurethral mesh have significant limitations that are minimized by the described technique. This anatomic removal of mesh from the urethra has several advantages including no disruption of the ventral wall of the urethra, complete removal of foreign body from the urethra, and simplified localization of the urethral wall defect to allow for anatomic closure. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Highly Symmetric and Congruently Tiled Meshes for Shells and Domes

    Science.gov (United States)

    Rasheed, Muhibur; Bajaj, Chandrajit

    2016-01-01

    We describe the generation of all possible shell and dome shapes that can be uniquely meshed (tiled) using a single type of mesh face (tile), and following a single meshing (tiling) rule that governs the mesh (tile) arrangement with maximal vertex, edge and face symmetries. Such tiling arrangements or congruently tiled meshed shapes, are frequently found in chemical forms (fullerenes or Bucky balls, crystals, quasi-crystals, virus nano shells or capsids), and synthetic shapes (cages, sports domes, modern architectural facades). Congruently tiled meshes are both aesthetic and complete, as they support maximal mesh symmetries with minimal complexity and possess simple generation rules. Here, we generate congruent tilings and meshed shape layouts that satisfy these optimality conditions. Further, the congruent meshes are uniquely mappable to an almost regular 3D polyhedron (or its dual polyhedron) and which exhibits face-transitive (and edge-transitive) congruency with at most two types of vertices (each type transitive to the other). The family of all such congruently meshed polyhedra create a new class of meshed shapes, beyond the well-studied regular, semi-regular and quasi-regular classes, and their duals (platonic, Catalan and Johnson). While our new mesh class is infinite, we prove that there exists a unique mesh parametrization, where each member of the class can be represented by two integer lattice variables, and moreover efficiently constructable. PMID:27563368

  5. Anterior Z-plate and titanic mesh fixation for acute burst thoracolumbar fracture.

    Science.gov (United States)

    Xu, Jian-Guang; Zeng, Bing-Fang; Zhou, Wei; Kong, Wei-Qing; Fu, Yi-Shan; Zhao, Bi-Zeng; Zhang, Tao; Lian, Xiao-Feng

    2011-04-01

    A retrospective study. To evaluate the clinical outcome, effectiveness, and security of the surgical management of acute thoracolumbar burst fracture with corpectomy, titanic mesh autograft, and Z-plate fixation by anterior approach. Many surgical methods were adopted to treat acute burst thoracolumbar fracture. But the optimal surgical management remains controversial. A retrospective review of a consecutive series of 48 patients with thoracolumbar burst fracture treated with anterior corpectomy, titanic mesh autograft, and Z-plate internal fixation was carried out. Preoperative clinical and radiographic data of all cases were originally collected. Surgical indications were motor neurologic deficit and thoracolumbar column instability. Twenty-two patients (45.8%) with acute thoracolumbar burst fractures presented with a neurologic deficit. The postoperative recovery of neural function, restoration of anterior cortex collapse, kyphotic angle, and spinal canal compromise were observed. The preoperative kyphotic angle was improved to a mean of 5.6°, radiographic height restored to 95.8% of the adjacent normal levels, and canal compromise was 0%. None of the patients had neurologic deterioration. Mean follow-up time was 32.4 months (range, 24-47 months). All 22 patients with neurologic deficit demonstrated at least one Frankel grade improvement on final observation, with 16 (73%) patients had accomplished complete neurologic recovery. Forty-six (96%) patients reported minimal or no pain at final follow-up observation, and 40 (83%) patients who had been working before injury returned to original work. The authors considered spinal cord decompression with anterior corpectomy and stability reconstruction with titanic mesh autograft and Z-plate fixation at same time in one incision as an effective technique for unstable thoracolumbar burst fracture with and without neurologic deficit.

  6. Markov Random Fields on Triangle Meshes

    DEFF Research Database (Denmark)

    Andersen, Vedrana; Aanæs, Henrik; Bærentzen, Jakob Andreas

    2010-01-01

    In this paper we propose a novel anisotropic smoothing scheme based on Markov Random Fields (MRF). Our scheme is formulated as two coupled processes. A vertex process is used to smooth the mesh by displacing the vertices according to a MRF smoothness prior, while an independent edge process label...

  7. Performance Evaluation of Coded Meshed Networks

    DEFF Research Database (Denmark)

    Krigslund, Jeppe; Hansen, Jonas; Pedersen, Morten Videbæk

    2013-01-01

    of the former to enhance the gains of the latter. We first motivate our work through measurements in WiFi mesh networks. Later, we compare state-of-the-art approaches, e.g., COPE, RLNC, to CORE. Our measurements show the higher reliability and throughput of CORE over other schemes, especially, for asymmetric...

  8. Solid Mesh Registration for Radiotherapy Treatment Planning

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Sørensen, Thomas Sangild

    2010-01-01

    We present an algorithm for solid organ registration of pre-segmented data represented as tetrahedral meshes. Registration of the organ surface is driven by force terms based on a distance field representation of the source and reference shapes. Registration of internal morphology is achieved usi...

  9. ROLE OF MESH REPAIR IN PELVIC ORGAN PROLAPSE, WITH PARTICULAR REFERENCE TO VAULT PROLAPSE & NULLIPAROUS PROLAPSE

    Directory of Open Access Journals (Sweden)

    Geeta Vandana Reddi

    2017-12-01

    Full Text Available BACKGROUND Pelvic organ prolapse is a common complaint in gynaecological practice. Nulliparous prolapse is seen in 2% of female population and vault prolapse in 0.5% following hysterectomy. Various surgical procedures have been described for the repair of vault prolapse e.g. transvaginal sacrospinous colpopexy, transabdominal sacral colpopexy, Le Forte's operation, colpoclesis, posterior intravaginal sling plasty etc. The introduction of synthetic mesh like Prolene, Mersilene for the repair of vault prolapse have the advantage of tensile strength. In nulliparous prolapse and uterovaginal prolapse also, the supports of uterus are weakened, so there seems to be a definite advantage of mesh repair over sling surgeries. MATERIALS AND METHODS A prospective study done in 50 patients with vault prolapse, Nulliparous prolapse and patients with UV prolapse who want to retain their menstrual and reproductive function were identified and repair of defects were done. 2 cases who underwent both hysterectomy and sacral colpopexy in two sittings were included in the study. They were followed up for a period of 6 weeks - 29 months. RESULTS In the present study, the mean age for vault prolapse was 52.14 years, mean parity was 3.36. Vault prolapses were found to be more common after abdominal hysterectomy 60.97% compared to vaginal 39.02%. Common indication for hysterectomy is pelvic organ prolapse followed by DUB in this study. The mean time between the hysterectomy and vault prolapse in this study was 5.46 years. Importance should be given to proper enterocoele repair and vault suspense time of primary surgery. In this study incidence of smoking in vault prolapse cases was 34.14% significant. In cases of sacral colpopexy for vault prolapse in this study there were no major mesh related complications and the cure rate was 97.5%. So, sacral colpopexy with prolene mesh i.e. abdominal mesh repair can be employed as the primary surgery for vault prolapse. The safety

  10. Vertex Normals and Face Curvatures of Triangle Meshes

    KAUST Repository

    Sun, Xiang; Jiang, Caigui; Wallner, Johannes; Pottmann, Helmut

    2016-01-01

    This study contributes to the discrete differential geometry of triangle meshes, in combination with discrete line congruences associated with such meshes. In particular we discuss when a congruence defined by linear interpolation of vertex normals

  11. Recurrence and Pain after Mesh Repair of Inguinal Hernias

    African Journals Online (AJOL)

    Abstract. Background: Surgery for inguinal hernias has ... repair. Methods: The study was conducted on all inguinal hernia patients operated between 1st. October ... bilateral (1.6%). Only 101 .... Open Mesh Versus Laparoscopic Mesh. Repair ...

  12. VARIABLE MESH STIFFNESS OF SPUR GEAR TEETH USING ...

    African Journals Online (AJOL)

    gear engagement. A gear mesh kinematic simulation ... model is appropnate for VMS of a spur gear tooth. The assumptions for ... This process has been continued until one complete tooth meshing cycle is ..... Element Method. Using MATLAB,.

  13. Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management.

    Science.gov (United States)

    MacDonald, Susan; Terlecki, Ryan; Costantini, Elisabetta; Badlani, Gopal

    2016-08-01

    Mesh-related complications following transvaginal management of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) have received significant attention in the last decade. We sought to identify patient, product, and technical factors associated with an increased risk of complications after mesh-based transvaginal repair of anterior POP and SUI. In this review we clarify the different pattern of complications after POP and SUI repairs. Our aim is to provide a practical evidence-based guide for physicians to prevent and, if necessary, manage product-associated complications in a stepwise manner. We conducted a comprehensive PubMed search of all English-language articles published from 2010 to June 2016, using these search terms: mesh, pelvic organ prolapse, and stress urinary incontinence. Expert opinion is also provided. Mesh-related complications are much lower after repair of SUI compared with POP, despite its more frequent use. Vaginal exposure is the most common mesh-specific complication. Patients may present with vaginal discharge, dyspareunia, pain, recurrent urinary tract infection, and/or hematuria. Conversely, patients may be asymptomatic. Small asymptomatic mesh exposures (mesh encountered within the urinary tract must be fully excised. Following excision, pain may persist in up to 50% of patients. Vaginal extrusion, persistent pain, and urethral and/or bladder erosion are the three most common product-specific complications following mesh-based repair for SUI or POP. Conservative therapies may be attempted, but most patients ultimately require partial or complete mesh excision. We reviewed the recent literature on mesh-related complications after repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Vaginal exposure, persistent pain, and erosion into the urinary tract are the most common. These often require surgical management, best suited to a urologist with training and experience in this area. Evidence supports

  14. On Reducing Delay in Mesh-Based P2P Streaming: A Mesh-Push Approach

    Science.gov (United States)

    Liu, Zheng; Xue, Kaiping; Hong, Peilin

    The peer-assisted streaming paradigm has been widely employed to distribute live video data on the internet recently. In general, the mesh-based pull approach is more robust and efficient than the tree-based push approach. However, pull protocol brings about longer streaming delay, which is caused by the handshaking process of advertising buffer map message, sending request message and scheduling of the data block. In this paper, we propose a new approach, mesh-push, to address this issue. Different from the traditional pull approach, mesh-push implements block scheduling algorithm at sender side, where the block transmission is initiated by the sender rather than by the receiver. We first formulate the optimal upload bandwidth utilization problem, then present the mesh-push approach, in which a token protocol is designed to avoid block redundancy; a min-cost flow model is employed to derive the optimal scheduling for the push peer; and a push peer selection algorithm is introduced to reduce control overhead. Finally, we evaluate mesh-push through simulation, the results of which show mesh-push outperforms the pull scheduling in streaming delay, and achieves comparable delivery ratio at the same time.

  15. LAPAROSCOPIC MANAGEMENT OF GIANT PARAESOPHAGEAL HERNIA WITH A SILICONE-COATED BIFACIAL MESH

    Directory of Open Access Journals (Sweden)

    S. Unguryanu

    2016-01-01

    Full Text Available BACKGROUND. Paraesophageal hernias are relatively uncommon. The incidence of this disease has increased recently, and esophageal hernias now account for 5–10% of all hiatus hernias. Surgical treatment is recommended for all patients with this disease because of high risk of complications: strangulation or perforation.CASE REPORT. A 44-year-old male patient with a giant and symptomatic paraesophageal hernia. The diagnosis was confirmed by instrumental examination. We performed laparoscopic repair using silicone-coated polypropylene bifacial mesh. The postoperative period was uneventful.CONCLUSION. The laparoscopic approach may be successfully used as a therapeutic option in the treatment for hiatal hernias. Our clinical experience showed, that the technique appeared to be valid and safe. In cases of large hiatal hernia with a defect greater than 5 cm, it is recommended to apply the mesh in order to minimize the recurrence rate.

  16. Repairing a Facial Cleft by Polyether-Ether-Ketone Implant Combined With Titanium Mesh.

    Science.gov (United States)

    Deng, Yuan; Tang, Weiwei; Li, Zhengkang

    2018-05-15

    The Tessier Number 4 cleft is one of the rarest, most complex craniofacial anomalies that presents difficulties in surgical treatment. In this article, we report a case of simultaneous facial depression, eye displacement, and medial canthus deformity. In this case, the maxillary bony defect was reconstructed using computer-assisted design computer-assisted manufacturing (CAD-CAM) polyether-ether-ketone (PEEK) material, and the orbital floor defect was repaired with AO prefabricated titanium mesh. Additionally, the medial canthus was modified with canthopexy and a single Z-plasty flap. Owing to its relative rarity and varied clinical presentations, no definitive operative methods have been accepted for Tessier No. 4 facial cleft. This study presents the combination of CAD-CAM manufactured PEEK material and titanium mesh as an alternative approach for reconstructing the bony defect of Tessier No. 4 facial clefts.

  17. Cesarean section after abdominal mesh repair for pregnancy-related desmoid tumor: a case report.

    Science.gov (United States)

    Ooi, Sara; Ngo, Harry

    2017-01-01

    We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT) arising from the previous cesarean section (CS) scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair. It provides evidence that CS can be safely accomplished following abdominal wall reconstructions and further arguments against elective lower segment CS.

  18. Comparative analysis of early adverse events of pelvic organ prolapse repair with or without transvaginal mesh using Clavien-Dindo classification.

    Science.gov (United States)

    Besser, Limor; Schwarzman, Polina; Mastrolia, Salvatore A; Rotem, Reut; Leron, Elad; Yohay, David; Weintraub, Adi Y

    2018-04-10

    To assess adverse events following surgical repair of pelvic organ prolapse (POP) with or without the use of transvaginal mesh. The present retrospective study was conducted among women who underwent surgical POP repair at Soroka University Medical Center, Beer Sheva, Israel, between January 1, 2013, and December 31, 2015. Patients underwent anterior and posterior colporrhaphy either with transvaginal mesh (Elevate Prolapse Repair System; American Medical Systems, Minnetonka, MN, USA) or without transvaginal mesh (native tissue repair). Perioperative adverse events were assessed using the Clavien-Dindo classification; multivariate regression models were constructed to predict minor and major adverse events. There were 111 women included; 35 were treated with transvaginal mesh, and 76 underwent native tissue repair. Women undergoing native tissue repair had a lower mean grade of cystocele (P=0.023) and a higher rate of urinary stress incontinence (P=0.017) than patients treated with transvaginal mesh. The duration of surgery (P=0.002), duration of hospitalization (Ptransvaginal mesh was not associated with increased odds of major or minor adverse events (P>0.05 for all models examined). Perioperative and postoperative adverse events were comparable regardless of the operative approach. © 2018 International Federation of Gynecology and Obstetrics.

  19. 21 CFR 870.3650 - Pacemaker polymeric mesh bag.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker polymeric mesh bag. 870.3650 Section 870...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3650 Pacemaker polymeric mesh bag. (a) Identification. A pacemaker polymeric mesh bag is an implanted device used to hold a...

  20. Multiphase flow of immiscible fluids on unstructured moving meshes

    DEFF Research Database (Denmark)

    Misztal, Marek Krzysztof; Erleben, Kenny; Bargteil, Adam

    2012-01-01

    In this paper, we present a method for animating multiphase flow of immiscible fluids using unstructured moving meshes. Our underlying discretization is an unstructured tetrahedral mesh, the deformable simplicial complex (DSC), that moves with the flow in a Lagrangian manner. Mesh optimization op...

  1. Multiphase Flow of Immiscible Fluids on Unstructured Moving Meshes

    DEFF Research Database (Denmark)

    Misztal, Marek Krzysztof; Erleben, Kenny; Bargteil, Adam

    2013-01-01

    In this paper, we present a method for animating multiphase flow of immiscible fluids using unstructured moving meshes. Our underlying discretization is an unstructured tetrahedral mesh, the deformable simplicial complex (DSC), that moves with the flow in a Lagrangian manner. Mesh optimization op...

  2. Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair.

    Science.gov (United States)

    Scott, Jeffrey R; Deeken, Corey R; Martindale, Robert G; Rosen, Michael J

    2016-09-01

    The objective of this study was to evaluate the mechanical and histological properties of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh (Phasix™ ST) compared to partially absorbable (Ventralight™ ST), fully absorbable (Phasix™), and biologically derived (Strattice™) meshes in a porcine model of ventral hernia repair. Bilateral abdominal surgical defects were created in twenty-four Yucatan pigs, repaired with intraperitoneal (Phasix™ ST, Ventralight™ ST) or retromuscular (Phasix™, Strattice™) mesh, and evaluated at 12 and 24 weeks (n = 6 mesh/group/time point). Prior to implantation, Strattice™ demonstrated significantly higher (p weeks, mesh/repair strength was significantly greater than NAW (p weeks (p > 0.05). Phasix™ mesh/repair strength was significantly greater than Strattice™ (p weeks, and Ventralight™ ST mesh/repair strength was significantly greater than Phasix™ ST mesh (p weeks. At 12 and 24 weeks, Phasix™ ST and Ventralight™ ST were associated with mild inflammation and minimal-mild fibrosis/neovascularization, with no significant differences between groups. At both time points, Phasix™ was associated with minimal-mild inflammation/fibrosis and mild neovascularization. Strattice™ was associated with minimal inflammation/fibrosis, with minimal neovascularization at 12 weeks, which increased to mild by 24 weeks. Strattice™ exhibited significantly less neovascularization than Phasix™ at 12 weeks and significantly greater inflammation at 24 weeks due to remodeling. Phasix™ ST demonstrated mechanical and histological properties comparable to partially absorbable (Ventralight™ ST) and fully resorbable (Phasix™) meshes at 12 and 24 weeks in this model. Data also suggest that fully absorbable meshes with longer-term resorption profiles may provide improved mechanical and histological properties compared to biologically derived scaffolds.

  3. Porcine dermis compared with polypropylene mesh for laparoscopic sacrocolpopexy: a randomized controlled trial.

    Science.gov (United States)

    Culligan, Patrick J; Salamon, Charbel; Priestley, Jennifer L; Shariati, Amir

    2013-01-01

    To compare the surgical outcomes 12 months after laparoscopic sacrocolpopexy performed with porcine dermis and the current gold standard of polypropylene mesh. Patients scheduled for laparoscopic sacrocolpopexy were eligible for this randomized controlled trial. Both our clinical research nurse and the patients were blinded as to which material was used. Our primary end point was objective anatomic cure defined as no pelvic organ prolapse quantification (POP-Q) points Stage 2 or greater at any postoperative interval. Our sample size calculation called for 57 patients in each group to achieve 90% power to detect a 23% difference in objective anatomic cure at 12 months (α=0.05). Our secondary end point was clinical cure. Any patient with a POP-Q point greater than zero, or Point C less than or equal to -5, or any complaints of prolapse symptoms whatsoever on Pelvic Floor Distress Inventory-20 or Pelvic Floor Impact Questionnaire, Short Form 7, or reoperation for prolapse were considered "clinical failures"; the rest were "clinical cures." Statistical comparisons were performed using the χ or independent samples t test as appropriate. As expected, there were no preoperative differences between the porcine (n=57) and mesh (n=58) groups. The 12-month objective anatomic cure rates for the porcine and mesh groups were 80.7% and 86.2%, respectively (P=.24), and the "clinical cure" rates for the porcine and mesh groups were 84.2% and 89.7%, respectively (P=.96). Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire, Short Form 7 score improvements were significant for both groups with no differences found between groups. There were no major operative complications. There were similar outcomes in subjective or objective results 12 months after laparoscopic sacrocolpopexy performed with either porcine dermis or polypropylene mesh. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00564083. I.

  4. Complications of grafts used in female pelvic floor reconstruction: Mesh erosion and extrusion

    Directory of Open Access Journals (Sweden)

    Tanya M Nazemi

    2007-01-01

    Full Text Available Introduction: Various grafts have been used in the treatment of urinary incontinence and pelvic prolapse. Autologous materials such as muscle and fascia were first utilized to provide additional anatomic support to the periurethral and pelvic tissues; however, attempts to minimize the invasiveness of the procedures have led to the use of synthetic materials. Complications such as infection and erosion or extrusion associated with these materials may be troublesome to manage. We review the literature and describe a brief overview of grafts used in pelvic floor reconstruction and focus on the management complications specifically related to synthetic materials. Materials and Methods: We performed a comprehensive review of the literature on grafts used in pelvic floor surgery using MEDLINE and resources cited in those peer-reviewed manuscripts. The results are presented. Results: Biologic materials provide adequate cure rates but have associated downfalls including potential complications from harvesting, variable tissue quality and cost. The use of synthetic materials as an alternative graft in pelvic floor repairs has become a popular option. Of all synthetic materials, the type I macroporous polypropylene meshes have demonstrated superiority in terms of efficacy and fewer complication rates due to their structure and composition. Erosion and extrusion of mesh are common and troublesome complications that may be managed conservatively with observation with or without local hormone therapy, with transvaginal debridement or with surgical exploration and total mesh excision, dependent upon the location of the mesh and the mesh type utilized. Conclusions: The ideal graft would provide structural integrity and durability with minimal adverse reaction by the host tissue. Biologic materials in general tend to have fewer associated complications, however, the risks of harvesting, variable integrity of allografts, availability and high cost has led to the

  5. Sexual function in women following transvaginal mesh procedures for the treatment of pelvic organ prolapse.

    Science.gov (United States)

    Liang, Ching-Chung; Lo, Tsia-Shu; Tseng, Ling-Hong; Lin, Yi-Hao; Lin, Yu-Jr; Chang, Shuenn-Dhy

    2012-10-01

    Synthetic mesh kits recently adopted in pelvic reconstructive surgeries have achieved great surgical efficacy, but the effects of transvaginal synthetic mesh procedures on women's sexual function are still controversial. This study was conducted to demonstrate sexual function in women before and after surgery with transvaginal mesh (TVM) repair for pelvic organ prolapse (POP). A total of 93 sexually active women scheduled for correcting POP with synthetic mesh kits were recruited. In addition to urogynecological history, pelvic examination by the Pelvic Organ Prolapse Quantification system, and urodynamic testing, consenting participants were asked to complete the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to evaluate sexual function before and after surgery. At the 3-month urodynamic studies, among the 25 patients with coexistent urodynamic stress incontinence (USI) who had undergone a concomitant transobturator suburethral tape procedure (TOT), 1 (4 %) had persistent USI; 8 of 68 (11.8 %) patients with a negative pessary test developed postoperative USI. Six-month prolapse recurrence rates following TVM alone and TVM with concomitant TOT were 9 and 12 %, respectively. The total PISQ-12 score after surgery showed worse results in the TVM alone group but not in the TVM with concomitant TOT group. The individual scores of PISQ-12 after surgery demonstrated prolapse-related items improved in both TVM groups; sexual function worsened in dyspareunia and behavior domains. Our data revealed that transvaginal synthetic mesh procedures for the treatment of POP generated favorable clinical outcomes, but situations might worsen in dyspareunia and behavior domains, thereby invoking a negative emotional reaction during intercourse after surgery.

  6. Mesh complications and failure rates after transvaginal mesh repair compared with abdominal or laparoscopic sacrocolpopexy and to native tissue repair in treating apical prolapse.

    Science.gov (United States)

    Dandolu, Vani; Akiyama, Megumi; Allenback, Gayle; Pathak, Prathamesh

    2017-02-01

    Our objective was to quantitate the extent of complications and failure rate for apical prolapse repair with transvaginal mesh (TVM) use versus sacrocolpopexy over a minimum of 2 years of follow-up. Truven CCAE and Medicare Supplemental databases 2008-2013 were used for analysis. Patients with apical prolapse repair via transvaginal mesh (TVMR), abdominal sacrocolpopexy (ASCP), laparoscopic sacrocolpopexy (LSCP), or native tissue repair (NTR) and continuously enrolled for years were in the study cohort. Surgical failures were identified by reoperation for any prolapse or subsequent use of pessary. SAS® 9.3 was used for analysis. Mesh removal/revision was reported highest in TVMR (5.1 %), followed by LSCP (1.7 %) and ASCP (1.2 %). In those with concomitant sling, combined rates for mesh/sling revision were high, at 9.0 % in TVMR + sling, 5.6 % in ASCP + sling, and 4.5 % LSCP + sling. Sling-alone cases reported a 3.5 % revision rate. Pelvic pain (16.4-22.7 %) and dyspareunia (5.6-7.5 %) were high in all three approaches for apical prolapse repairs. Reoperation for apical prolapse was more common for TVMR (2.9 %) compared with NTR (2.3 %) [odds ratio (OR) 1.27; confidence interval (CI) 1.1-1.47; p 0.002]. Both ASCP and LSCP were superior to NTR (ASCP 1.5 %, OR 0.63, CI 0.46-0.86; p 0.003) and LSCP 1.8 % (OR 0.79, CI 0.62-1.01; p 0.07). Overall prolapse recurrence, as indicated by any compartment surgery for prolapse and/or pessary use, was also noted highest in TVMR (5.9 % OR 1.23, CI 1.11-1.36; p mesh is used for repair, mesh revision is highest with TVMR and lowest with ASCP.

  7. Fixation of Light Weight Polypropylene Mesh with n-Butyl-2-cyanocrylate in Pelvic Floor Surgery: Experimental Design Approach in Sheep for Effectiveness Evaluation

    Directory of Open Access Journals (Sweden)

    Sandra Barbosa

    2015-01-01

    Full Text Available Objective. The aim of this study was to find a proper experimental design and to evaluate n-butyl-2-cyanoacrylate (Histoacryl as a fixation method for a light-weight and large pore PP mesh (Synthetic PP Mesh-1 using the sheep as an animal model. Methods. Posterior vaginal implantation by means of episiotomy was used to implant 8 ewes which were evaluated macroscopically and histologically at 3 months (n=4 and 6 months (n=4 post-surgery. In previous pilot studies anterior vaginal implantation was evaluated, as well as different synthetic mesh materials, sizes and fixation methods (n=1 to 3 during three weeks. In all cases a clinical evaluation of the animal was performed. Results. A reduction in the mesh size (Synthetic PP Mesh-1 together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P<0.01 compared to larger size or other fixation methods. Conclusion. The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

  8. Partitioning of unstructured meshes for load balancing

    International Nuclear Information System (INIS)

    Martin, O.C.; Otto, S.W.

    1994-01-01

    Many large-scale engineering and scientific calculations involve repeated updating of variables on an unstructured mesh. To do these types of computations on distributed memory parallel computers, it is necessary to partition the mesh among the processors so that the load balance is maximized and inter-processor communication time is minimized. This can be approximated by the problem, of partitioning a graph so as to obtain a minimum cut, a well-studied combinatorial optimization problem. Graph partitioning algorithms are discussed that give good but not necessarily optimum solutions. These algorithms include local search methods recursive spectral bisection, and more general purpose methods such as simulated annealing. It is shown that a general procedure enables to combine simulated annealing with Kernighan-Lin. The resulting algorithm is both very fast and extremely effective. (authors) 23 refs., 3 figs., 1 tab

  9. Adaptive upscaling with the dual mesh method

    Energy Technology Data Exchange (ETDEWEB)

    Guerillot, D.; Verdiere, S.

    1997-08-01

    The objective of this paper is to demonstrate that upscaling should be calculated during the flow simulation instead of trying to enhance the a priori upscaling methods. Hence, counter-examples are given to motivate our approach, the so-called Dual Mesh Method. The main steps of this numerical algorithm are recalled. Applications illustrate the necessity to consider different average relative permeability values depending on the direction in space. Moreover, these values could be different for the same average saturation. This proves that an a priori upscaling cannot be the answer even in homogeneous cases because of the {open_quotes}dynamical heterogeneity{close_quotes} created by the saturation profile. Other examples show the efficiency of the Dual Mesh Method applied to heterogeneous medium and to an actual field case in South America.

  10. Variational mesh segmentation via quadric surface fitting

    KAUST Repository

    Yan, Dongming

    2012-11-01

    We present a new variational method for mesh segmentation by fitting quadric surfaces. Each component of the resulting segmentation is represented by a general quadric surface (including plane as a special case). A novel energy function is defined to evaluate the quality of the segmentation, which combines both L2 and L2 ,1 metrics from a triangle to a quadric surface. The Lloyd iteration is used to minimize the energy function, which repeatedly interleaves between mesh partition and quadric surface fitting. We also integrate feature-based and simplification-based techniques in the segmentation framework, which greatly improve the performance. The advantages of our algorithm are demonstrated by comparing with the state-of-the-art methods. © 2012 Elsevier Ltd. All rights reserved.

  11. Variational mesh segmentation via quadric surface fitting

    KAUST Repository

    Yan, Dongming; Wang, Wen Ping; Liu, Yang; Yang, Zhouwang

    2012-01-01

    We present a new variational method for mesh segmentation by fitting quadric surfaces. Each component of the resulting segmentation is represented by a general quadric surface (including plane as a special case). A novel energy function is defined to evaluate the quality of the segmentation, which combines both L2 and L2 ,1 metrics from a triangle to a quadric surface. The Lloyd iteration is used to minimize the energy function, which repeatedly interleaves between mesh partition and quadric surface fitting. We also integrate feature-based and simplification-based techniques in the segmentation framework, which greatly improve the performance. The advantages of our algorithm are demonstrated by comparing with the state-of-the-art methods. © 2012 Elsevier Ltd. All rights reserved.

  12. Meshed split skin graft for extensive vitiligo

    Directory of Open Access Journals (Sweden)

    Srinivas C

    2004-05-01

    Full Text Available A 30 year old female presented with generalized stable vitiligo involving large areas of the body. Since large areas were to be treated it was decided to do meshed split skin graft. A phototoxic blister over recipient site was induced by applying 8 MOP solution followed by exposure to UVA. The split skin graft was harvested from donor area by Padgett dermatome which was meshed by an ampligreffe to increase the size of the graft by 4 times. Significant pigmentation of the depigmented skin was seen after 5 months. This procedure helps to cover large recipient areas, when pigmented donor skin is limited with minimal risk of scarring. Phototoxic blister enables easy separation of epidermis thus saving time required for dermabrasion from recipient site.

  13. Energy-efficient wireless mesh infrastructures

    OpenAIRE

    Al-Hazmi, Y.; de Meer, Hermann; Hummel, Karin Anna; Meyer, Harald; Meo, Michela; Remondo Bueno, David

    2011-01-01

    The Internet comprises access segments with wired and wireless technologies. In the future, we can expect wireless mesh infrastructures (WMIs) to proliferate in this context. Due to the relatively low energy efficiency of wireless transmission, as compared to wired transmission, energy consumption of WMIs can represent a significant part of the energy consumption of the Internet as a whole. We explore different approaches to reduce energy consumption in WMIs, taking into accoun...

  14. MESHREF, Finite Elements Mesh Combination with Renumbering

    International Nuclear Information System (INIS)

    1973-01-01

    1 - Nature of physical problem solved: The program can assemble different meshes stored on tape or cards. Renumbering is performed in order to keep band width low. Voids and/ or local refinement are possible. 2 - Method of solution: Topology and geometry are read according to input specifications. Abundant nodes and elements are eliminated. The new topology and geometry are stored on tape. 3 - Restrictions on the complexity of the problem: Maximum number of nodes = 2000. Maximum number of elements = 1500

  15. Symmetries and the coarse-mesh method

    International Nuclear Information System (INIS)

    Makai, M.

    1980-10-01

    This report approaches the basic problem of the coarse-mesh method from a new side. Group theory is used for the determination of the space dependency of the flux. The result is a method called ANANAS after the analytic-analytic solution. This method was tested on two benchmark problems: one given by Melice and the IAEA benchmark. The ANANAS program is an experimental one. The method was intended for use in hexagonal geometry. (Auth.)

  16. Wireless experiments on a Motorola mesh testbed.

    Energy Technology Data Exchange (ETDEWEB)

    Riblett, Loren E., Jr.; Wiseman, James M.; Witzke, Edward L.

    2010-06-01

    Motomesh is a Motorola product that performs mesh networking at both the client and access point levels and allows broadband mobile data connections with or between clients moving at vehicular speeds. Sandia National aboratories has extensive experience with this product and its predecessors in infrastructure-less mobile environments. This report documents experiments, which characterize certain aspects of how the Motomesh network performs when obile units are added to a fixed network infrastructure.

  17. Orbital Reconstruction: Patient-Specific Orbital Floor Reconstruction Using a Mirroring Technique and a Customized Titanium Mesh.

    Science.gov (United States)

    Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio

    2016-10-01

    Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device. Using a computed tomography data set, the normal, uninjured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor mesh was designed virtually on the mirrored orbital bone surface. The solid-to-layer files of the mesh were then manufactured using direct metal laser sintering, which resolves the shaping and bending biases inherent in the indirect method. An intraoperative navigation system ensured accuracy of the entire procedure. Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography data in 7 treated patients. The technique described here appears to be a viable method to correct complex orbital floor defects needing delayed reconstruction. This study represents the first step in the development of a wider experimental protocol for orbital floor reconstruction using computer-assisted design-computer-assisted manufacturing technology.

  18. Prevention of parastomal herniation with biologic/composite prosthetic mesh: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wijeyekoon, Sanjaya Prabhath; Gurusamy, Kurinchi; El-Gendy, Khalid; Chan, Christopher L

    2010-11-01

    Parastomal herniation is a frequent complication of stoma formation and can be difficult to repair satisfactorily, making it a recognized cause of significant morbidity. A systematic review with meta-analysis of randomized clinical trials was performed to determine the benefits and risks of mesh reinforcement versus conventional stoma formation in preventing parastomal herniation. Trials were identified from The Cochrane Library trials register, Medline, Embase, Science Citation Index Expanded, and reference lists. The primary outcome was the incidence of parastomal herniation. The secondary outcomes were the incidence of parastomal herniation requiring surgical repair, postoperative morbidity, and mortality. Meta-analysis was performed using a random-effects model. The risk ratio (RR) was estimated with 95% confidence intervals (CI) based on an intention-to-treat analysis. Three trials with 129 patients were included. Composite or biologic mesh was used in either the preperitoneal or sublay position. Mesh reinforcement was associated with a reduction in parastomal herniation versus conventional stoma formation (RR 0.23, 95%CI 0.06 to 0.81; p = 0.02), and a reduction in the percentage of parastomal hernias requiring surgical treatment (RR 0.13, 95%CI 0.02 to 1.02; p = 0.05). There was no difference between groups in stoma-related morbidity (2 of 58, 3.4% in the mesh group versus 2 of 57, 3.5% in the conventional group; p = 0.97), nor was there any mortality related to the placement of mesh. Composite or biologic mesh reinforcement of stomas in the preperitoneal/sublay position is associated with a reduced incidence of parastomal herniation with no excess morbidity. Mesh reinforcement also demonstrates a trend toward a decreased incidence of parastomal herniation requiring surgical repair. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Predicting mesh density for adaptive modelling of the global atmosphere.

    Science.gov (United States)

    Weller, Hilary

    2009-11-28

    The shallow water equations are solved using a mesh of polygons on the sphere, which adapts infrequently to the predicted future solution. Infrequent mesh adaptation reduces the cost of adaptation and load-balancing and will thus allow for more accurate mapping on adaptation. We simulate the growth of a barotropically unstable jet adapting the mesh every 12 h. Using an adaptation criterion based largely on the gradient of the vorticity leads to a mesh with around 20 per cent of the cells of a uniform mesh that gives equivalent results. This is a similar proportion to previous studies of the same test case with mesh adaptation every 1-20 min. The prediction of the mesh density involves solving the shallow water equations on a coarse mesh in advance of the locally refined mesh in order to estimate where features requiring higher resolution will grow, decay or move to. The adaptation criterion consists of two parts: that resolved on the coarse mesh, and that which is not resolved and so is passively advected on the coarse mesh. This combination leads to a balance between resolving features controlled by the large-scale dynamics and maintaining fine-scale features.

  20. Topological patterns of mesh textures in serpentinites

    Science.gov (United States)

    Miyazawa, M.; Suzuki, A.; Shimizu, H.; Okamoto, A.; Hiraoka, Y.; Obayashi, I.; Tsuji, T.; Ito, T.

    2017-12-01

    Serpentinization is a hydration process that forms serpentine minerals and magnetite within the oceanic lithosphere. Microfractures crosscut these minerals during the reactions, and the structures look like mesh textures. It has been known that the patterns of microfractures and the system evolutions are affected by the hydration reaction and fluid transport in fractures and within matrices. This study aims at quantifying the topological patterns of the mesh textures and understanding possible conditions of fluid transport and reaction during serpentinization in the oceanic lithosphere. Two-dimensional simulation by the distinct element method (DEM) generates fracture patterns due to serpentinization. The microfracture patterns are evaluated by persistent homology, which measures features of connected components of a topological space and encodes multi-scale topological features in the persistence diagrams. The persistence diagrams of the different mesh textures are evaluated by principal component analysis to bring out the strong patterns of persistence diagrams. This approach help extract feature values of fracture patterns from high-dimensional and complex datasets.

  1. Improved Mesh_Based Image Morphing ‎

    Directory of Open Access Journals (Sweden)

    Mohammed Abdullah Taha

    2017-11-01

    Full Text Available Image morphing is a multi-step process that generates a sequence of transitions between two images. The thought is to get a ₔgrouping of middle pictures which, when ₔassembled with the first pictures would represent the change from one picture to the other.  The process of morphing requires time and attention to detail in order to get good results. Morphing image requires at least two processes warping and cross dissolve. Warping is the process of geometric transformation of images. The cross dissolve is the process interpolation of color of eachₔ pixel from the first image value to theₔ corresponding second imageₔ value over the time. Image morphing techniques differ from in the approach of image warping procedure. This work presents a survey of different techniques to construct morphing images by review the different warping techniques. One of the predominant approaches of warping process is mesh warping which suffers from some problems including ghosting. This work proposed and implements an improved mesh warping technique to construct morphing images. The results show that the proposed approach can overcome the problems of the traditional mesh technique

  2. Cu mesh for flexible transparent conductive electrodes.

    Science.gov (United States)

    Kim, Won-Kyung; Lee, Seunghun; Hee Lee, Duck; Hee Park, In; Seong Bae, Jong; Woo Lee, Tae; Kim, Ji-Young; Hun Park, Ji; Chan Cho, Yong; Ryong Cho, Chae; Jeong, Se-Young

    2015-06-03

    Copper electrodes with a micromesh/nanomesh structure were fabricated on a polyimide substrate using UV lithography and wet etching to produce flexible transparent conducting electrodes (TCEs). Well-defined mesh electrodes were realized through the use of high-quality Cu thin films. The films were fabricated using radio-frequency (RF) sputtering with a single-crystal Cu target--a simple but innovative approach that overcame the low oxidation resistance of ordinary Cu. Hybrid Cu mesh electrodes were fabricated by adding a capping layer of either ZnO or Al-doped ZnO. The sheet resistance and the transmittance of the electrode with an Al-doped ZnO capping layer were 6.197 ohm/sq and 90.657%, respectively, and the figure of merit was 60.502 × 10(-3)/ohm, which remained relatively unchanged after thermal annealing at 200 °C and 1,000 cycles of bending. This fabrication technique enables the mass production of large-area flexible TCEs, and the stability and high performance of Cu mesh hybrid electrodes in harsh environments suggests they have strong potential for application in smart displays and solar cells.

  3. Numerical Investigation of Corrugated Wire Mesh Laminate

    Directory of Open Access Journals (Sweden)

    Jeongho Choi

    2013-01-01

    Full Text Available The aim of this work is to develop a numerical model of Corrugated Wire Mesh Laminate (CWML capturing all its complexities such as nonlinear material properties, nonlinear geometry and large deformation behaviour, and frictional behaviour. Development of such a model will facilitate numerical simulation of the mechanical behaviour of the wire mesh structure under various types of loading as well as the variation of the CWML configuration parameters to tailor its mechanical properties to suit the intended application. Starting with a single strand truss model consisting of four waves with a bilinear stress-strain model to represent the plastic behaviour of stainless steel, the finite element model is gradually built up to study single-layer structures with 18 strands of corrugated wire meshes consistency and double- and quadruple-layered laminates with alternating crossply orientations. The compressive behaviour of the CWML model is simulated using contact elements to model friction and is compared to the load-deflection behaviour determined experimentally in uniaxial compression tests. The numerical model of the CWML is then employed to conduct the aim of establishing the upper and lower bounds of stiffness and load capacity achievable by such structures.

  4. MeSH Now: automatic MeSH indexing at PubMed scale via learning to rank.

    Science.gov (United States)

    Mao, Yuqing; Lu, Zhiyong

    2017-04-17

    MeSH indexing is the task of assigning relevant MeSH terms based on a manual reading of scholarly publications by human indexers. The task is highly important for improving literature retrieval and many other scientific investigations in biomedical research. Unfortunately, given its manual nature, the process of MeSH indexing is both time-consuming (new articles are not immediately indexed until 2 or 3 months later) and costly (approximately ten dollars per article). In response, automatic indexing by computers has been previously proposed and attempted but remains challenging. In order to advance the state of the art in automatic MeSH indexing, a community-wide shared task called BioASQ was recently organized. We propose MeSH Now, an integrated approach that first uses multiple strategies to generate a combined list of candidate MeSH terms for a target article. Through a novel learning-to-rank framework, MeSH Now then ranks the list of candidate terms based on their relevance to the target article. Finally, MeSH Now selects the highest-ranked MeSH terms via a post-processing module. We assessed MeSH Now on two separate benchmarking datasets using traditional precision, recall and F 1 -score metrics. In both evaluations, MeSH Now consistently achieved over 0.60 in F-score, ranging from 0.610 to 0.612. Furthermore, additional experiments show that MeSH Now can be optimized by parallel computing in order to process MEDLINE documents on a large scale. We conclude that MeSH Now is a robust approach with state-of-the-art performance for automatic MeSH indexing and that MeSH Now is capable of processing PubMed scale documents within a reasonable time frame. http://www.ncbi.nlm.nih.gov/CBBresearch/Lu/Demo/MeSHNow/ .

  5. Data-Parallel Mesh Connected Components Labeling and Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, Cyrus; Childs, Hank; Gaither, Kelly

    2011-04-10

    We present a data-parallel algorithm for identifying and labeling the connected sub-meshes within a domain-decomposed 3D mesh. The identification task is challenging in a distributed-memory parallel setting because connectivity is transitive and the cells composing each sub-mesh may span many or all processors. Our algorithm employs a multi-stage application of the Union-find algorithm and a spatial partitioning scheme to efficiently merge information across processors and produce a global labeling of connected sub-meshes. Marking each vertex with its corresponding sub-mesh label allows us to isolate mesh features based on topology, enabling new analysis capabilities. We briefly discuss two specific applications of the algorithm and present results from a weak scaling study. We demonstrate the algorithm at concurrency levels up to 2197 cores and analyze meshes containing up to 68 billion cells.

  6. Prolonged amelioration of experimental postoperative pain by bupivacaine released from microsphere-coated hernia mesh.

    Science.gov (United States)

    Ohri, Rachit; Wang, Jeffery Chi-Fei; Pham, Lan; Blaskovich, Phillip D; Costa, Daniel; Nichols, Gary; Hildebrand, William; Scarborough, Nelson; Herman, Clifford; Strichartz, Gary R

    2014-01-01

    Postoperative pain alters physiological functions and delays discharge. Perioperative local anesthetics are effective analgesics in the immediate 1- to 2-day postoperative period, but acute pain often lasts longer. The goal of this work was to develop a local anesthetic formulation adhering to an intraoperative implanted device that reduces pain for at least 3 days after surgery. Six groups, each with 8 rats, were studied. In a control group (group I), one 1.2-cm-long incision of the skin was followed by blunt dissection to separate the skin away from the underlying tissues and closing with 2 sutures. In 3 of the treatment groups, the same surgical procedure was used, with the subcutaneous space formed by the blunt dissection lined with a 1-cm square patch of hernia mesh coated with poly lactide co-glycolic acid microspheres containing approximately 17 mg of bupivacaine (group II), no drug (placebo; group III), or bupivacaine free-base powder (group IV). Uncoated mesh implants (group V) served as a secondary control. A standard bupivacaine solution (0.4 mL, 0.5%; 2-mg dose) was infiltrated subcutaneously 30 minutes before the surgery and served as a standard control (group VI). Mechanosensitivity of the skin was tested by the local subcutaneous muscle responses to cutaneous tactile stimulation by von Frey hairs with forces of 4 g (for allodynia) and 15 g (for hyperalgesia) preoperatively and for 7 postoperative days. Control rats (group I) showed mechanohypersensitivity, indicative of postoperative allodynia and hyperalgesia, for all 7 postoperative days. Mechanohyperalgesia in rats that received mesh coated with bupivacaine-releasing microspheres (group II) was reduced during this period to 13% of control postoperative values (P < 0.001); mesh coated with bupivacaine base (group IV) reduced it by 50% (P = 0.034). The placebo mesh (group III) and uncoated mesh (group V) caused no significant reduction of mechanohypersensitivity, and bupivacaine solution infiltrated

  7. Anterior lumbar fusion with titanium threaded and mesh interbody cages.

    Science.gov (United States)

    Rauzzino, M J; Shaffrey, C I; Nockels, R P; Wiggins, G C; Rock, J; Wagner, J

    1999-12-15

    metastatic breast cancer who had undergone an L-3 corpectomy with placement of a mesh cage. Although her back pain was immediately resolved, she died of systemic disease 3 months after surgery and before fusion could occur. Complications related to the anterior approach included two vascular injuries (two left common iliac vein lacerations); one injury to the sympathetic plexus; one case of superficial phlebitis; two cases of prolonged ileus (greater than 48 hours postoperatively); one anterior femoral cutaneous nerve palsy; and one superficial wound infection. No deaths were directly related to the surgical procedure. There were no cases of dural laceration and no nerve root injury. There were no cases of deep venous thrombosis, pulmonary embolus, retrograde ejaculation, abdominal hernia, bowel or ureteral injury, or deep wound infection. Fusion-related complications included an iliac crest hematoma and prolonged donor-site pain in one patient. There were no complications related to placement or migration of the cages, but there was one case of screw fracture of the Kaneda device that did not require revision. The authors conclude that anterior lumbar fusion performed using titanium interbody or mesh cages, packed with autologous bone, is an effective, safe method to achieve fusion in a wide variety of pathological conditions of the thoracolumbar spine. The fusion rate of 96% compares favorably with results reported in the literature. The complication rate mirrors the low morbidity rate associated with the anterior approach. A detailed study of clinical outcomes is in progress. Patient selection and strategies for avoiding complication are discussed.

  8. Texturing of continuous LOD meshes with the hierarchical texture atlas

    Science.gov (United States)

    Birkholz, Hermann

    2006-02-01

    For the rendering of detailed virtual environments, trade-offs have to be made between image quality and rendering time. An immersive experience of virtual reality always demands high frame-rates with the best reachable image qual-ity. Continuous Level of Detail (cLoD) triangle-meshes provide an continuous spectrum of detail for a triangle mesh that can be used to create view-dependent approximations of the environment in real-time. This enables the rendering with a constant number of triangles and thus with constant frame-rates. Normally the construction of such cLoD mesh representations leads to the loss of all texture information of the original mesh. To overcome this problem, a parameter domain can be created, in order to map the surface properties (colour, texture, normal) to it. This parameter domain can be used to map the surface properties back to arbitrary approximations of the original mesh. The parameter domain is often a simplified version of the mesh to be parameterised. This limits the reachable simplification to the domain mesh which has to map the surface of the original mesh with the least possible stretch. In this paper, a hierarchical domain mesh is presented, that scales between very coarse domain meshes and good property-mapping.

  9. Performance of the hybrid wireless mesh protocol for wireless mesh networks

    DEFF Research Database (Denmark)

    Boye, Magnus; Staalhagen, Lars

    2010-01-01

    Wireless mesh networks offer a new way of providing end-user access and deploying network infrastructure. Though mesh networks offer a price competitive solution to wired networks, they also come with a set of new challenges such as optimal path selection, channel utilization, and load balancing....... and proactive. Two scenarios of different node density are considered for both path selection modes. The results presented in this paper are based on a simulation model of the HWMP specification in the IEEE 802.11s draft 4.0 implemented in OPNET Modeler....

  10. Unbiased Sampling and Meshing of Isosurfaces

    KAUST Repository

    Yan, Dongming

    2014-05-07

    In this paper, we present a new technique to generate unbiased samples on isosurfaces. An isosurface, F(x,y,z) = c , of a function, F , is implicitly defined by trilinear interpolation of background grid points. The key idea of our approach is that of treating the isosurface within a grid cell as a graph (height) function in one of the three coordinate axis directions, restricted to where the slope is not too high, and integrating / sampling from each of these three. We use this unbiased sampling algorithm for applications in Monte Carlo integration, Poisson-disk sampling, and isosurface meshing.

  11. Performance of FACTS equipment in Meshed systems

    Energy Technology Data Exchange (ETDEWEB)

    Lerch, E; Povh, D [Siemens AG, Berlin (Germany)

    1994-12-31

    Modern power electronic devices such as thyristors and GTOs have made it possible to design controllable network elements, which will play a considerable role in ensuring reliable economic operation of transmission systems as a result of their capability to rapidly change active and reactive power. A number of FACTS elements for high-speed active and reactive power control will be described. Control of power system fluctuations in meshed systems by modulation of active and reactive power will be demonstrated using a number of examples. (author) 7 refs., 11 figs.

  12. Symbolic Block Decomposition In Hexahedral Mesh Generation

    Directory of Open Access Journals (Sweden)

    Andrzej Adamek

    2005-01-01

    Full Text Available Hexahedral mesh generation for three-dimensional solid objects is often done in stages. Usually an object is first subdivided into simple-shaped subregions, which then are filled withhexahedral finite elements. This article presents an automatic subdividing method of polyhedron with planar faces. The subdivision is based on medial surface, axes and nodes of a solid.The main emphasis is put on creating a topology of subregions. Obtaining such a topologyinvolves defining a graph structure OMG which contains necessary information about medialsurface topology and object topology, followed by simple symbolic processing on it.

  13. Shadowfax: Moving mesh hydrodynamical integration code

    Science.gov (United States)

    Vandenbroucke, Bert

    2016-05-01

    Shadowfax simulates galaxy evolution. Written in object-oriented modular C++, it evolves a mixture of gas, subject to the laws of hydrodynamics and gravity, and any collisionless fluid only subject to gravity, such as cold dark matter or stars. For the hydrodynamical integration, it makes use of a (co-) moving Lagrangian mesh. The code has a 2D and 3D version, contains utility programs to generate initial conditions and visualize simulation snapshots, and its input/output is compatible with a number of other simulation codes, e.g. Gadget2 (ascl:0003.001) and GIZMO (ascl:1410.003).

  14. Unbiased Sampling and Meshing of Isosurfaces

    KAUST Repository

    Yan, Dongming; Wallner, Johannes; Wonka, Peter

    2014-01-01

    In this paper, we present a new technique to generate unbiased samples on isosurfaces. An isosurface, F(x,y,z) = c , of a function, F , is implicitly defined by trilinear interpolation of background grid points. The key idea of our approach is that of treating the isosurface within a grid cell as a graph (height) function in one of the three coordinate axis directions, restricted to where the slope is not too high, and integrating / sampling from each of these three. We use this unbiased sampling algorithm for applications in Monte Carlo integration, Poisson-disk sampling, and isosurface meshing.

  15. Moving mesh generation with a sequential approach for solving PDEs

    DEFF Research Database (Denmark)

    In moving mesh methods, physical PDEs and a mesh equation derived from equidistribution of an error metrics (so-called the monitor function) are simultaneously solved and meshes are dynamically concentrated on steep regions (Lim et al., 2001). However, the simultaneous solution procedure...... a simple and robust moving mesh algorithm in one or multidimension. In this study, we propose a sequential solution procedure including two separate parts: prediction step to obtain an approximate solution to a next time level (integration of physical PDEs) and regriding step at the next time level (mesh...... generation and solution interpolation). Convection terms, which appear in physical PDEs and a mesh equation, are discretized by a WENO (Weighted Essentially Non-Oscillatory) scheme under the consrvative form. This sequential approach is to keep the advantages of robustness and simplicity for the static...

  16. Improved mesh generator for the POISSON Group Codes

    International Nuclear Information System (INIS)

    Gupta, R.C.

    1987-01-01

    This paper describes the improved mesh generator of the POISSON Group Codes. These improvements enable one to have full control over the way the mesh is generated and in particular the way the mesh density is distributed throughout this model. A higher mesh density in certain regions coupled with a successively lower mesh density in others keeps the accuracy of the field computation high and the requirements on the computer time and computer memory low. The mesh is generated with the help of codes AUTOMESH and LATTICE; both have gone through a major upgrade. Modifications have also been made in the POISSON part of these codes. We shall present an example of a superconducting dipole magnet to explain how to use this code. The results of field computations are found to be reliable within a few parts in a hundred thousand even in such complex geometries

  17. Image-Based Geometric Modeling and Mesh Generation

    CERN Document Server

    2013-01-01

    As a new interdisciplinary research area, “image-based geometric modeling and mesh generation” integrates image processing, geometric modeling and mesh generation with finite element method (FEM) to solve problems in computational biomedicine, materials sciences and engineering. It is well known that FEM is currently well-developed and efficient, but mesh generation for complex geometries (e.g., the human body) still takes about 80% of the total analysis time and is the major obstacle to reduce the total computation time. It is mainly because none of the traditional approaches is sufficient to effectively construct finite element meshes for arbitrarily complicated domains, and generally a great deal of manual interaction is involved in mesh generation. This contributed volume, the first for such an interdisciplinary topic, collects the latest research by experts in this area. These papers cover a broad range of topics, including medical imaging, image alignment and segmentation, image-to-mesh conversion,...

  18. HypGrid2D. A 2-d mesh generator

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, N N

    1998-03-01

    The implementation of a hyperbolic mesh generation procedure, based on an equation for orthogonality and an equation for the cell face area is described. The method is fast, robust and gives meshes with good smoothness and orthogonality. The procedure is implemented in a program called HypGrid2D. The HypGrid2D program is capable of generating C-, O- and `H`-meshes for use in connection with the EllipSys2D Navier-Stokes solver. To illustrate the capabilities of the program, some test examples are shown. First a series of C-meshes are generated around a NACA-0012 airfoil. Secondly a series of O-meshes are generated around a NACA-65-418 airfoil. Finally `H`-meshes are generated over a Gaussian hill and a linear escarpment. (au)

  19. Full-thickness skin graft vs. synthetic mesh in the repair of giant incisional hernia: a randomized controlled multicenter study.

    Science.gov (United States)

    Clay, L; Stark, B; Gunnarsson, U; Strigård, K

    2018-04-01

    Repair of large incisional hernias includes the implantation of a synthetic mesh, but this may lead to pain, stiffness, infection and enterocutaneous fistulae. Autologous full-thickness skin graft as on-lay reinforcement has been tested in eight high-risk patients in a proof-of-concept study, with satisfactory results. In this multicenter randomized study, the use of skin graft was compared to synthetic mesh in giant ventral hernia repair. Non-smoking patients with a ventral hernia > 10 cm wide were randomized to repair using an on-lay autologous full-thickness skin graft or a synthetic mesh. The primary endpoint was surgical site complications during the first 3 months. A secondary endpoint was patient comfort. Fifty-three patients were included. Clinical evaluation was performed at a 3-month follow-up appointment. There were fewer patients in the skin graft group reporting discomfort: 3 (13%) vs. 12 (43%) (p = 0.016). Skin graft patients had less pain and a better general improvement. No difference was seen regarding seroma; 13 (54%) vs. 13 (46%), or subcutaneous wound infection; 5 (20%) vs. 7 (25%). One recurrence appeared in each group. Three patients in the skin graft group and two in the synthetic mesh group were admitted to the intensive care unit. No difference was seen for the primary endpoint short-term surgical complication. Full-thickness skin graft appears to be a reliable material for ventral hernia repair producing no more complications than when using synthetic mesh. Patients repaired with a skin graft have less subjective abdominal wall symptoms.

  20. Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)--a case series multicentric study.

    Science.gov (United States)

    Fatton, B; Amblard, J; Debodinance, P; Cosson, M; Jacquetin, B

    2007-07-01

    Our goal was to report the preliminary results of a transvaginal mesh repair of genital prolapse using the Prolift system. This retrospective multicentric study includes 110 patients. All patients had a stage 3 (at the hymen) or stage 4 (beyond the hymen) prolapse. Total mesh was used in 59 patients (53.6%), an isolated anterior mesh in 22 patients (20%) and an isolated posterior mesh in 29 patients (26.4%). We report one bladder injury sutured at surgery and two haematomas requiring secondary surgical management. At 3 months, 106 patients were available for follow-up. Mesh exposure occurred in five patients (4.7%), two of them requiring a surgical management. Granuloma without exposure occurred in three patients (2.8%). Failure rate (recurrent prolapse even asymptomatic or low grade symptomatic prolapse) was 4.7%. According to the perioperative and immediate post-operative results, Prolift repair seems to be a safe technique to correct pelvic organ prolapse. Anatomical and functional results must be assessed with a long-term follow-up to confirm the effectiveness and safety of the procedure.

  1. Dynamic Mesh Adaptation for Front Evolution Using Discontinuous Galerkin Based Weighted Condition Number Mesh Relaxation

    Energy Technology Data Exchange (ETDEWEB)

    Greene, Patrick T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Schofield, Samuel P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Nourgaliev, Robert [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-06-21

    A new mesh smoothing method designed to cluster mesh cells near a dynamically evolving interface is presented. The method is based on weighted condition number mesh relaxation with the weight function being computed from a level set representation of the interface. The weight function is expressed as a Taylor series based discontinuous Galerkin projection, which makes the computation of the derivatives of the weight function needed during the condition number optimization process a trivial matter. For cases when a level set is not available, a fast method for generating a low-order level set from discrete cell-centered elds, such as a volume fraction or index function, is provided. Results show that the low-order level set works equally well for the weight function as the actual level set. Meshes generated for a number of interface geometries are presented, including cases with multiple level sets. Dynamic cases for moving interfaces are presented to demonstrate the method's potential usefulness to arbitrary Lagrangian Eulerian (ALE) methods.

  2. AUTOMATIC MESH GENERATION OF 3-D GEOMETRIC MODELS

    Institute of Scientific and Technical Information of China (English)

    刘剑飞

    2003-01-01

    In this paper the presentation of the ball-packing method is reviewed,and a scheme to generate mesh for complex 3-D geometric models is given,which consists of 4 steps:(1)create nodes in 3-D models by ball-packing method,(2)connect nodes to generate mesh by 3-D Delaunay triangulation,(3)retrieve the boundary of the model after Delaunay triangulation,(4)improve the mesh.

  3. A moving mesh method with variable relaxation time

    OpenAIRE

    Soheili, Ali Reza; Stockie, John M.

    2006-01-01

    We propose a moving mesh adaptive approach for solving time-dependent partial differential equations. The motion of spatial grid points is governed by a moving mesh PDE (MMPDE) in which a mesh relaxation time \\tau is employed as a regularization parameter. Previously reported results on MMPDEs have invariably employed a constant value of the parameter \\tau. We extend this standard approach by incorporating a variable relaxation time that is calculated adaptively alongside the solution in orde...

  4. Bilateral Laparoscopic Totally Extraperitoneal Repair Without Mesh Fixation

    OpenAIRE

    Dehal, Ahmed; Woodward, Brandon; Johna, Samir; Yamanishi, Frank

    2014-01-01

    Background and Objectives: Mesh fixation during laparoscopic totally extraperitoneal repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative chronic pain. This study aimed to describe the experience of a single surgeon at our institution performing this operation. Methods: We performed a retrospective review of the medical records of all patients who underwent bilateral laparoscopic totally extraperitoneal repair without mesh fixation for ing...

  5. Automated quadrilateral mesh generation for digital image structures

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    With the development of advanced imaging technology, digital images are widely used. This paper proposes an automatic quadrilateral mesh generation algorithm for multi-colour imaged structures. It takes an original arbitrary digital image as an input for automatic quadrilateral mesh generation, this includes removing the noise, extracting and smoothing the boundary geometries between different colours, and automatic all-quad mesh generation with the above boundaries as constraints. An application example is...

  6. An Agent Based Collaborative Simplification of 3D Mesh Model

    Science.gov (United States)

    Wang, Li-Rong; Yu, Bo; Hagiwara, Ichiro

    Large-volume mesh model faces the challenge in fast rendering and transmission by Internet. The current mesh models obtained by using three-dimensional (3D) scanning technology are usually very large in data volume. This paper develops a mobile agent based collaborative environment on the development platform of mobile-C. Communication among distributed agents includes grasping image of visualized mesh model, annotation to grasped image and instant message. Remote and collaborative simplification can be efficiently conducted by Internet.

  7. Adaptive-mesh zoning by the equipotential method

    Energy Technology Data Exchange (ETDEWEB)

    Winslow, A.M.

    1981-04-01

    An adaptive mesh method is proposed for the numerical solution of differential equations which causes the mesh lines to move closer together in regions where higher resolution in some physical quantity T is desired. A coefficient D > 0 is introduced into the equipotential zoning equations, where D depends on the gradient of T . The equations are inverted, leading to nonlinear elliptic equations for the mesh coordinates with source terms which depend on the gradient of D. A functional form of D is proposed.

  8. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  9. Biomimetic collagen/elastin meshes for ventral hernia repair in a rat model.

    Science.gov (United States)

    Minardi, Silvia; Taraballi, Francesca; Wang, Xin; Cabrera, Fernando J; Van Eps, Jeffrey L; Robbins, Andrew B; Sandri, Monica; Moreno, Michael R; Weiner, Bradley K; Tasciotti, Ennio

    2017-03-01

    E Sheets and Scaffolds) not only showed promising mechanical performance, but also allowed for an efficient neovascularization, resulting in new adipose and muscle tissue formation within the implant, in only 6weeks. In addition, our meshes allowed for the use of the same surgical procedure utilized in clinical practice, with the commercially available grafts. This study represents a significant step in the design of bioactive acellular off-the-shelf biomimetic meshes for ventral hernia repair. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  10. [Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique].

    Science.gov (United States)

    El Harrech, Y; Ameur, A; Janane, A; Moufide, K; Ghadouane, M; Abbar, M

    2010-01-01

    -free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of anterior vaginal wall prolapse. This procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. The results seem to be stable after three years of follow up.

  11. Monitoring and evaluation of wire mesh forming life

    Science.gov (United States)

    Enemuoh, Emmanuel U.; Zhao, Ping; Kadlec, Alec

    2018-03-01

    Forming tables are used with stainless steel wire mesh conveyor belts to produce variety of products. The forming tables will typically run continuously for several days, with some hours of scheduled downtime for maintenance, cleaning and part replacement after several weeks of operation. The wire mesh conveyor belts show large variation in their remaining life due to associated variations in their nominal thicknesses. Currently the industry is dependent on seasoned operators to determine the replacement time for the wire mesh formers. The drawback of this approach is inconsistency in judgements made by different operators and lack of data knowledge that can be used to develop decision making system that will be more consistent with wire mesh life prediction and replacement time. In this study, diagnostic measurements about the health of wire mesh former is investigated and developed. The wire mesh quality characteristics considered are thermal measurement, tension property, gage thickness, and wire mesh wear. The results show that real time thermal sensor and wear measurements would provide suitable data for the estimation of wire mesh failure, therefore, can be used as a diagnostic parameter for developing structural health monitoring (SHM) system for stainless steel wire mesh formers.

  12. SALOME PLATFORM and TetGen for Polyhedral Mesh Generation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Yong; Park, Chan Eok; Kim, Shin Whan [KEPCO E and C Company, Inc., Daejeon (Korea, Republic of)

    2014-05-15

    SPACE and CUPID use the unstructured mesh and they also require reliable mesh generation system. The combination of CAD system and mesh generation system is necessary to cope with a large number of cells and the complex fluid system with structural materials inside. In the past, a CAD system Pro/Engineer and mesh generator Pointwise were evaluated for this application. But, the cost of those commercial CAD and mesh generator is sometimes a great burden. Therefore, efforts have been made to set up a mesh generation system with open source programs. The evaluation of the TetGen has been made in focusing the application for the polyhedral mesh generation. In this paper, SALOME will be evaluated for the efforts in conjunction with TetGen. In section 2, review will be made on the CAD and mesh generation capability of SALOME. SALOME and TetGen codes are being integrated to construct robust polyhedral mesh generator. Edge removal on the flat surface and vertex reattachment to the solid are two challenging tasks. It is worthwhile to point out that the Python script capability of the SALOME should be fully utilized for the future investigation.

  13. An Algorithm for Parallel Sn Sweeps on Unstructured Meshes

    International Nuclear Information System (INIS)

    Pautz, Shawn D.

    2002-01-01

    A new algorithm for performing parallel S n sweeps on unstructured meshes is developed. The algorithm uses a low-complexity list ordering heuristic to determine a sweep ordering on any partitioned mesh. For typical problems and with 'normal' mesh partitionings, nearly linear speedups on up to 126 processors are observed. This is an important and desirable result, since although analyses of structured meshes indicate that parallel sweeps will not scale with normal partitioning approaches, no severe asymptotic degradation in the parallel efficiency is observed with modest (≤100) levels of parallelism. This result is a fundamental step in the development of efficient parallel S n methods

  14. Reconfigurable lattice mesh designs for programmable photonic processors.

    Science.gov (United States)

    Pérez, Daniel; Gasulla, Ivana; Capmany, José; Soref, Richard A

    2016-05-30

    We propose and analyse two novel mesh design geometries for the implementation of tunable optical cores in programmable photonic processors. These geometries are the hexagonal and the triangular lattice. They are compared here to a previously proposed square mesh topology in terms of a series of figures of merit that account for metrics that are relevant to on-chip integration of the mesh. We find that that the hexagonal mesh is the most suitable option of the three considered for the implementation of the reconfigurable optical core in the programmable processor.

  15. A Reconfigurable Mesh-Ring Topology for Bluetooth Sensor Networks

    Directory of Open Access Journals (Sweden)

    Ben-Yi Wang

    2018-05-01

    Full Text Available In this paper, a Reconfigurable Mesh-Ring (RMR algorithm is proposed for Bluetooth sensor networks. The algorithm is designed in three stages to determine the optimal configuration of the mesh-ring network. Firstly, a designated root advertises and discovers its neighboring nodes. Secondly, a scatternet criterion is built to compute the minimum number of piconets and distributes the connection information for piconet and scatternet. Finally, a peak-search method is designed to determine the optimal mesh-ring configuration for various sizes of networks. To maximize the network capacity, the research problem is formulated by determining the best connectivity of available mesh links. During the formation and maintenance phases, three possible configurations (including piconet, scatternet, and hybrid are examined to determine the optimal placement of mesh links. The peak-search method is a systematic approach, and is implemented by three functional blocks: the topology formation block generates the mesh-ring topology, the routing efficiency block computes the routing performance, and the optimum decision block introduces a decision-making criterion to determine the optimum number of mesh links. Simulation results demonstrate that the optimal mesh-ring configuration can be determined and that the scatternet case achieves better overall performance than the other two configurations. The RMR topology also outperforms the conventional ring-based and cluster-based mesh methods in terms of throughput performance for Bluetooth configurable networks.

  16. Mesh-based parallel code coupling interface

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, K.; Steckel, B. (eds.) [GMD - Forschungszentrum Informationstechnik GmbH, St. Augustin (DE). Inst. fuer Algorithmen und Wissenschaftliches Rechnen (SCAI)

    2001-04-01

    MpCCI (mesh-based parallel code coupling interface) is an interface for multidisciplinary simulations. It provides industrial end-users as well as commercial code-owners with the facility to combine different simulation tools in one environment. Thereby new solutions for multidisciplinary problems will be created. This opens new application dimensions for existent simulation tools. This Book of Abstracts gives a short overview about ongoing activities in industry and research - all presented at the 2{sup nd} MpCCI User Forum in February 2001 at GMD Sankt Augustin. (orig.) [German] MpCCI (mesh-based parallel code coupling interface) definiert eine Schnittstelle fuer multidisziplinaere Simulationsanwendungen. Sowohl industriellen Anwender als auch kommerziellen Softwarehersteller wird mit MpCCI die Moeglichkeit gegeben, Simulationswerkzeuge unterschiedlicher Disziplinen miteinander zu koppeln. Dadurch entstehen neue Loesungen fuer multidisziplinaere Problemstellungen und fuer etablierte Simulationswerkzeuge ergeben sich neue Anwendungsfelder. Dieses Book of Abstracts bietet einen Ueberblick ueber zur Zeit laufende Arbeiten in der Industrie und in der Forschung, praesentiert auf dem 2{sup nd} MpCCI User Forum im Februar 2001 an der GMD Sankt Augustin. (orig.)

  17. Basic Algorithms for the Asynchronous Reconfigurable Mesh

    Directory of Open Access Journals (Sweden)

    Yosi Ben-Asher

    2002-01-01

    Full Text Available Many constant time algorithms for various problems have been developed for the reconfigurable mesh (RM in the past decade. All these algorithms are designed to work with synchronous execution, with no regard for the fact that large size RMs will probably be asynchronous. A similar observation about the PRAM model motivated many researchers to develop algorithms and complexity measures for the asynchronous PRAM (APRAM. In this work, we show how to define the asynchronous reconfigurable mesh (ARM and how to measure the complexity of asynchronous algorithms executed on it. We show that connecting all processors in a row of an n×n ARM (the analog of barrier synchronization in the APRAM model can be solved with complexity Θ(nlog⁡n. Intuitively, this is average work time for solving such a problem. Next, we describe general a technique for simulating T -step synchronous RM algorithms on the ARM with complexity of Θ(T⋅n2log⁡n. Finally, we consider the simulation of the classical synchronous algorithm for counting the number of non-zero bits in an n bits vector using (k

  18. Distribution of isodose curves in urological surgical procedures

    International Nuclear Information System (INIS)

    Lanfredi, M.P.; Dias, J.H.; Ravazio, R.C.; Anés, M.; Bacelar, A.; Lykawka, R.

    2017-01-01

    During urological surgical procedures with fluoroscopy, the doses of the care team may be significant. However, the knowledge of the occupational exposure of these professionals is still very incipient in the national surgical centers. The objective of the study is to determine the isodose curves of the urological surgical procedures, in order to estimate the exposure of the personnel involved. The equipment used was a Arco-C BV Philips Bracelet. Patients with thicknesses of 20 and 28 cm were simulated using acrylic plates. The dose rates were measured with RaySafe i2 Unfors dosimeters positioned in a 50 x 50 cm mesh at three different heights of the floor: 95, 125 and 165 centimeters respectively corresponding to the gonadal, thoracic and crystalline regions of a typical adult . The isodose curves applied to the distribution of the surgical team suggest that the exposures are in the following descending order of intensity: primary physician, auxiliary physician, scrub nurse, anesthetist and nurse

  19. Long-term outcome after transvaginal mesh repair of pelvic organ prolapse.

    Science.gov (United States)

    Heinonen, Pia; Aaltonen, Riikka; Joronen, Kirsi; Ala-Nissilä, Seija

    2016-07-01

    The aim of this study was to report long-term subjective and objective outcomes after the transvaginal mesh (TVM) procedure in long-term. Possible late-onset complications were of particular interest. This was a retrospective analysis of TVM performed using Prolift™ transvaginal mesh measuring subjective outcome using validated questionnaires. Objective outcome was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system using two definitions: POP-Q stage ≤ 1, and vaginal wall prolapse at or above the hymen or vaginal apex not descending below the upper third of the vagina. Complications were reported with the Prosthesis/Graft Complication Classification Code designed by the International Continence Society/International Urogynecological Association (ICS/IUGA). Of 195 patients, 161 (82.6 %) participated this study after a median of 7 years. The scores in questionnaires evaluating urinary (UI) or anal incontinence and constipation or pelvic floor symptoms were low, indicating favorable surgical outcomes. Altogether, 80.1 % of patients were satisfied with the procedure. Anatomical cure was 56.4 % and 69.3 % depending on the definition used. Reoperation due to POP in any compartment was performed in 16.2 % of patients. Mesh exposure rate was 23 %, most of these being asymptomatic and of late onset. Outcome of the TVM procedure was satisfactory. Anatomical cure was inferior to subjective cure. Mesh exposure rate was high; most exposures observed in the long-term were of late onset and were asymptomatic.

  20. Prophylactic mesh to prevent parastomal hernia after end colostomy: a meta-analysis and trial sequential analysis.

    Science.gov (United States)

    López-Cano, M; Brandsma, H-T; Bury, K; Hansson, B; Kyle-Leinhase, I; Alamino, J G; Muysoms, F

    2017-04-01

    Prevention of parastomal hernia (PSH) formation is crucial, given the high prevalence and difficulties in the surgical repair of PSH. To investigate the effect of a preventive mesh in PSH formation after an end colostomy, we aimed to meta-analyze all relevant randomized controlled trials (RCTs). We searched five databases. For each trial, we extracted risk ratios (RRs) of the effects of mesh or no mesh. The primary outcome was incidence of PSH with a minimum follow-up of 12 months with a clinical and/or computed tomography diagnosis. RRs were combined using the random-effect model (Mantel-Haenszel). To control the risk of type I error, we performed a trial sequential analysis (TSA). Seven RCTs with low risk of bias (451 patients) were included. Meta-analysis for primary outcome showed a significant reduction of the incidence of PSH using a mesh (RR 0.43, 95% CI 0.26-0.71; P = 0.0009). Regarding TSA calculation for the primary outcome, the accrued information size (451) was 187.1% of the estimated required information size (RIS) (241). Wound infection showed no statistical differences between groups (RR 0.77, 95% CI 0.39-1.54; P = 0.46). PSH repair rate showed a significant reduction in the mesh group (RR 0.28 (95% CI 0.10-0.78; P = 0.01). PSH prevention with mesh when creating an end colostomy reduces the incidence of PSH, the risk for subsequent PSH repair and does not increase wound infections. TSA shows that the RIS is reached for the primary outcome. Additional RCTs in the previous context are not needed.

  1. Advanced 3D Mesh Manipulation in Stereolithographic Files and Post-Print Processing for the Manufacturing of Patient-Specific Vascular Flow Phantoms.

    Science.gov (United States)

    O'Hara, Ryan P; Chand, Arpita; Vidiyala, Sowmya; Arechavala, Stacie M; Mitsouras, Dimitrios; Rudin, Stephen; Ionita, Ciprian N

    2016-02-27

    Complex vascular anatomies can cause the failure of image-guided endovascular procedures. 3D printed patient-specific vascular phantoms provide clinicians and medical device companies the ability to preemptively plan surgical treatments, test the likelihood of device success, and determine potential operative setbacks. This research aims to present advanced mesh manipulation techniques of stereolithographic (STL) files segmented from medical imaging and post-print surface optimization to match physiological vascular flow resistance. For phantom design, we developed three mesh manipulation techniques. The first method allows outlet 3D mesh manipulations to merge superfluous vessels into a single junction, decreasing the number of flow outlets and making it feasible to include smaller vessels. Next we introduced Boolean operations to eliminate the need to manually merge mesh layers and eliminate errors of mesh self-intersections that previously occurred. Finally we optimize support addition to preserve the patient anatomical geometry. For post-print surface optimization, we investigated various solutions and methods to remove support material and smooth the inner vessel surface. Solutions of chloroform, alcohol and sodium hydroxide were used to process various phantoms and hydraulic resistance was measured and compared with values reported in literature. The newly mesh manipulation methods decrease the phantom design time by 30 - 80% and allow for rapid development of accurate vascular models. We have created 3D printed vascular models with vessel diameters less than 0.5 mm. The methods presented in this work could lead to shorter design time for patient specific phantoms and better physiological simulations.

  2. Transvaginal six-arm mesh OPUR in women with apical pelvic organ prolapse - analysis of short-term results, pelvic floor ultrasound evaluation.

    Science.gov (United States)

    Kluz, Tomasz; Wlaźlak, Edyta; Surkont, Grzegorz

    2017-01-01

    Analysis of feasibility, efficacy and short-term results after six-arm transvaginal mesh OPUR implantation in women with apical prolapse. The same surgeon operated all of 39 women using mesh OPUR. Preoperatively patients had a standardized interview and clinical examination. Intraoperative and postoperative complications were analyzed. Postoperative evaluation included standardized interview, clinical examination and standardized pelvic floor ultrasound performed with 2D transvaginal probe and 4D abdominal probe. There was no complication that needed operative intervention. Hematomas in 3 patients resolved spontaneously. Transient voiding difficulties which lasted less than 7 days were observed in 5 patients. No erosion was observed. Comparison of pre- and postoperative results in 34 women revealed that in all 3 compartments improvement in POP-Q scale was statistically significant (p mesh needed re-operation. During PFS-TV in 94.1% of patients urethra was normobile or hypermobile. In all of the patients urethral end of the mesh was positioned far enough from the middle part of the urethra (ultrasound) to implant suburethral sling without risk of collision. Sexually active women did not inform of any important discomfort or pain during intercourse. It seems that six-arm OPUR mesh, if implanted under strict surgical rules, gives low risk of complications and high chance to successfully reduce POP symptoms in short term after the operation. It seems that OPUR mesh should not have negative influence on the results after anti-incontinence suburethral sling.

  3. Refficientlib: an efficient load-rebalanced adaptive mesh refinement algorithm for high-performance computational physics meshes

    OpenAIRE

    Baiges Aznar, Joan; Bayona Roa, Camilo Andrés

    2017-01-01

    No separate or additional fees are collected for access to or distribution of the work. In this paper we present a novel algorithm for adaptive mesh refinement in computational physics meshes in a distributed memory parallel setting. The proposed method is developed for nodally based parallel domain partitions where the nodes of the mesh belong to a single processor, whereas the elements can belong to multiple processors. Some of the main features of the algorithm presented in this paper a...

  4. MeshVoro: A Three-Dimensional Voronoi Mesh Building Tool for the TOUGH Family of Codes

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, C. M.; Boyle, K. L.; Reagan, M.; Johnson, J.; Rycroft, C.; Moridis, G. J.

    2013-09-30

    Few tools exist for creating and visualizing complex three-dimensional simulation meshes, and these have limitations that restrict their application to particular geometries and circumstances. Mesh generation needs to trend toward ever more general applications. To that end, we have developed MeshVoro, a tool that is based on the Voro (Rycroft 2009) library and is capable of generating complex threedimensional Voronoi tessellation-based (unstructured) meshes for the solution of problems of flow and transport in subsurface geologic media that are addressed by the TOUGH (Pruess et al. 1999) family of codes. MeshVoro, which includes built-in data visualization routines, is a particularly useful tool because it extends the applicability of the TOUGH family of codes by enabling the scientifically robust and relatively easy discretization of systems with challenging 3D geometries. We describe several applications of MeshVoro. We illustrate the ability of the tool to straightforwardly transform a complex geological grid into a simulation mesh that conforms to the specifications of the TOUGH family of codes. We demonstrate how MeshVoro can describe complex system geometries with a relatively small number of grid blocks, and we construct meshes for geometries that would have been practically intractable with a standard Cartesian grid approach. We also discuss the limitations and appropriate applications of this new technology.

  5. The effect of music on robot-assisted laparoscopic surgical performance.

    Science.gov (United States)

    Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

    2010-12-01

    Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

  6. Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand’s Hernia with Non-Inflamed Appendices

    Directory of Open Access Journals (Sweden)

    Emin Kose

    2017-01-01

    Full Text Available Amyand’s hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand’s hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand’s hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months, there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand’s hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy.

  7. The application of TINA in the MESH project

    NARCIS (Netherlands)

    van Sinderen, Marten J.; Ferreira Pires, Luis; Pires, L.F.; Plagemann, Thomas; Goebel, Vera

    1998-01-01

    This paper discusses the application of TINA concepts, architectures and related design paradigms in the MESH project. MESH adopted TINA as a means to facilitate the design and implementation of a flexible platform for developing and providing interactive multimedia services. This paper reports on

  8. Capacity analysis of wireless mesh networks | Gumel | Nigerian ...

    African Journals Online (AJOL)

    ... number of nodes (n) in a linear topology. The degradation is found to be higher in a fully mesh network as a result of increase in interference and MAC layer contention in the network. Key words: Wireless mesh network (WMN), Adhoc network, Network capacity analysis, Bottleneck collision domain, Medium access control ...

  9. Volume Decomposition and Feature Recognition for Hexahedral Mesh Generation

    Energy Technology Data Exchange (ETDEWEB)

    GADH,RAJIT; LU,YONG; TAUTGES,TIMOTHY J.

    1999-09-27

    Considerable progress has been made on automatic hexahedral mesh generation in recent years. Several automatic meshing algorithms have proven to be very reliable on certain classes of geometry. While it is always worth pursuing general algorithms viable on more general geometry, a combination of the well-established algorithms is ready to take on classes of complicated geometry. By partitioning the entire geometry into meshable pieces matched with appropriate meshing algorithm the original geometry becomes meshable and may achieve better mesh quality. Each meshable portion is recognized as a meshing feature. This paper, which is a part of the feature based meshing methodology, presents the work on shape recognition and volume decomposition to automatically decompose a CAD model into meshable volumes. There are four phases in this approach: (1) Feature Determination to extinct decomposition features, (2) Cutting Surfaces Generation to form the ''tailored'' cutting surfaces, (3) Body Decomposition to get the imprinted volumes; and (4) Meshing Algorithm Assignment to match volumes decomposed with appropriate meshing algorithms. The feature determination procedure is based on the CLoop feature recognition algorithm that is extended to be more general. Results are demonstrated over several parts with complicated topology and geometry.

  10. Micro-mesh fabric pollination bags for switchgrass

    Science.gov (United States)

    Pollination bags for making controlled crosses between switchgrass plants were made from a polyester micro-mesh fabric with a mesh size of 41 µm which is smaller than the mean reported 43 µm diameter of switchgrass pollen. When used in paired plant crosses between switchgrass plants, the mean amoun...

  11. Lagrangian fluid dynamics using the Voronoi-Delauanay mesh

    International Nuclear Information System (INIS)

    Dukowicz, J.K.

    1981-01-01

    A Lagrangian technique for numerical fluid dynamics is described. This technique makes use of the Voronoi mesh to efficiently locate new neighbors, and it uses the dual (Delaunay) triangulation to define computational cells. This removes all topological restrictions and facilitates the solution of problems containing interfaces and multiple materials. To improve computational accuracy a mesh smoothing procedure is employed

  12. CAPAClTYANALYSIS OF WIRELESS MESH NET\\VORKS

    African Journals Online (AJOL)

    The limited available bandwidth makes capacity analysis of the network very essential. ... Wireless mesh networks can also be employed for wide variety ofapplications such ... wireless mesh networks using OPNET (Optimized Network Engineering Tool) Modeller 1-J..5. The .... /bps using I I Mbps data rate and 12000 bits.

  13. Sending policies in dynamic wireless mesh using network coding

    DEFF Research Database (Denmark)

    Pandi, Sreekrishna; Fitzek, Frank; Pihl, Jeppe

    2015-01-01

    This paper demonstrates the quick prototyping capabilities of the Python-Kodo library for network coding based performance evaluation and investigates the problem of data redundancy in a network coded wireless mesh with opportunistic overhearing. By means of several wireless meshed architectures ...

  14. Plated nickel wire mesh makes superior catalyst bed

    Science.gov (United States)

    Sill, M.

    1965-01-01

    Porous nickel mesh screen catalyst bed produces gas evolution in hydrogen peroxide thrust chambers used for attitude control of space vehicles. The nickel wire mesh disks in the catalyst bed are plated in rugose form with a silver-gold coating.

  15. Mesh Processing in Medical-Image Analysis-a Tutorial

    DEFF Research Database (Denmark)

    Levine, Joshua A.; Paulsen, Rasmus Reinhold; Zhang, Yongjie

    2012-01-01

    Medical-image analysis requires an understanding of sophisticated scanning modalities, constructing geometric models, building meshes to represent domains, and downstream biological applications. These four steps form an image-to-mesh pipeline. For research in this field to progress, the imaging...

  16. Scalable Video Streaming in Wireless Mesh Networks for Education

    Science.gov (United States)

    Liu, Yan; Wang, Xinheng; Zhao, Liqiang

    2011-01-01

    In this paper, a video streaming system for education based on a wireless mesh network is proposed. A wireless mesh network is a self-organizing, self-managing and reliable intelligent network, which allows educators to deploy a network quickly. Video streaming plays an important role in this system for multimedia data transmission. This new…

  17. Staged Closure of Giant Omphalocele using Synthetic Mesh

    OpenAIRE

    Parida, Lalit; Pal, Kamalesh; Al Buainain, Hussah; Elshafei, Hossam

    2014-01-01

    Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.

  18. Adaptive mesh generation for image registration and segmentation

    DEFF Research Database (Denmark)

    Fogtmann, Mads; Larsen, Rasmus

    2013-01-01

    measure. The method was tested on a T1 weighted MR volume of an adult brain and showed a 66% reduction in the number of mesh vertices compared to a red-subdivision strategy. The deformation capability of the mesh was tested by registration to five additional T1-weighted MR volumes....

  19. Energy mesh optimization for multi-level calculation schemes

    International Nuclear Information System (INIS)

    Mosca, P.; Taofiki, A.; Bellier, P.; Prevost, A.

    2011-01-01

    The industrial calculations of third generation nuclear reactors are based on sophisticated strategies of homogenization and collapsing at different spatial and energetic levels. An important issue to ensure the quality of these calculation models is the choice of the collapsing energy mesh. In this work, we show a new approach to generate optimized energy meshes starting from the SHEM 281-group library. The optimization model is applied on 1D cylindrical cells and consists of finding an energy mesh which minimizes the errors between two successive collision probability calculations. The former is realized over the fine SHEM mesh with Livolant-Jeanpierre self-shielded cross sections and the latter is performed with collapsed cross sections over the energy mesh being optimized. The optimization is done by the particle swarm algorithm implemented in the code AEMC and multigroup flux solutions are obtained from standard APOLLO2 solvers. By this new approach, a set of new optimized meshes which encompass from 10 to 50 groups has been defined for PWR and BWR calculations. This set will allow users to adapt the energy detail of the solution to the complexity of the calculation (assembly, multi-assembly, two-dimensional whole core). Some preliminary verifications, in which the accuracy of the new meshes is measured compared to a direct 281-group calculation, show that the 30-group optimized mesh offers a good compromise between simulation time and accuracy for a standard 17 x 17 UO 2 assembly with and without control rods. (author)

  20. Water Penetration through a Superhydrophobic Mesh During a Drop Impact

    Science.gov (United States)

    Ryu, Seunggeol; Sen, Prosenjit; Nam, Youngsuk; Lee, Choongyeop

    2017-01-01

    When a water drop impacts a mesh having submillimeter pores, a part of the drop penetrates through the mesh if the impact velocity is sufficiently large. Here we show that different surface wettability, i.e., hydrophobicity and superhydrophobicity, leads to different water penetration dynamics on a mesh during drop impact. We show, despite the water repellence of a superhydrophobic surface, that water can penetrate a superhydrophobic mesh more easily (i.e., at a lower impact velocity) over a hydrophobic mesh via a penetration mechanism unique to a superhydrophobic mesh. On a superhydrophobic mesh, the water penetration can occur during the drop recoil stage, which appears at a lower impact velocity than the critical impact velocity for water penetration right upon impact. We propose that this unique water penetration on a superhydrophobic mesh can be attributed to the combination of the hydrodynamic focusing and the momentum transfer from the water drop when it is about to bounce off the surface, at which point the water drop retrieves most of its kinetic energy due to the negligible friction on superhydrophobic surfaces.

  1. COSMOLOGICAL ADAPTIVE MESH REFINEMENT MAGNETOHYDRODYNAMICS WITH ENZO

    International Nuclear Information System (INIS)

    Collins, David C.; Xu Hao; Norman, Michael L.; Li Hui; Li Shengtai

    2010-01-01

    In this work, we present EnzoMHD, the extension of the cosmological code Enzo to include the effects of magnetic fields through the ideal magnetohydrodynamics approximation. We use a higher order Godunov method for the computation of interface fluxes. We use two constrained transport methods to compute the electric field from those interface fluxes, which simultaneously advances the induction equation and maintains the divergence of the magnetic field. A second-order divergence-free reconstruction technique is used to interpolate the magnetic fields in the block-structured adaptive mesh refinement framework already extant in Enzo. This reconstruction also preserves the divergence of the magnetic field to machine precision. We use operator splitting to include gravity and cosmological expansion. We then present a series of cosmological and non-cosmological test problems to demonstrate the quality of solution resulting from this combination of solvers.

  2. Parallel-In-Time For Moving Meshes

    Energy Technology Data Exchange (ETDEWEB)

    Falgout, R. D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Manteuffel, T. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Southworth, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Schroder, J. B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-02-04

    With steadily growing computational resources available, scientists must develop e ective ways to utilize the increased resources. High performance, highly parallel software has be- come a standard. However until recent years parallelism has focused primarily on the spatial domain. When solving a space-time partial di erential equation (PDE), this leads to a sequential bottleneck in the temporal dimension, particularly when taking a large number of time steps. The XBraid parallel-in-time library was developed as a practical way to add temporal parallelism to existing se- quential codes with only minor modi cations. In this work, a rezoning-type moving mesh is applied to a di usion problem and formulated in a parallel-in-time framework. Tests and scaling studies are run using XBraid and demonstrate excellent results for the simple model problem considered herein.

  3. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  4. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  5. Challenges in Second-Generation Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Pescapé Antonio

    2008-01-01

    Full Text Available Wireless mesh networks have the potential to provide ubiquitous high-speed Internet access at low costs. The good news is that initial deployments of WiFi meshes show the feasibility of providing ubiquitous Internet connectivity. However, their performance is far below the necessary and achievable limit. Moreover, users' subscription in the existing meshes is dismal even though the technical challenges to get connectivity are low. This paper provides an overview of the current status of mesh networks' deployment, and highlights the technical, economical, and social challenges that need to be addressed in the next years. As a proof-of-principle study, we discuss the above-mentioned challenges with reference to three real networks: (i MagNets, an operator-driven planned two-tier mesh network; (ii Berlin Freifunk network as a pure community-driven single-tier network; (iii Weimar Freifunk network, also a community-driven but two-tier network.

  6. Multi-phase Volume Segmentation with Tetrahedral Mesh

    DEFF Research Database (Denmark)

    Nguyen Trung, Tuan; Dahl, Vedrana Andersen; Bærentzen, Jakob Andreas

    Volume segmentation is efficient for reconstructing material structure, which is important for several analyses, e.g. simulation with finite element method, measurement of quantitative information like surface area, surface curvature, volume, etc. We are concerned about the representations of the 3......D volumes, which can be categorized into two groups: fixed voxel grids [1] and unstructured meshes [2]. Among these two representations, the voxel grids are more popular since manipulating a fixed grid is easier than an unstructured mesh, but they are less efficient for quantitative measurements....... In many cases, the voxel grids are converted to explicit meshes, however the conversion may reduce the accuracy of the segmentations, and the effort for meshing is also not trivial. On the other side, methods using unstructured meshes have difficulty in handling topology changes. To reduce the complexity...

  7. Open and laparo-endoscopic repair of incarcerated abdominal wall hernias by the use of biological and biosynthetic meshes

    Directory of Open Access Journals (Sweden)

    René H Fortelny

    2016-02-01

    Full Text Available Introduction: Although recently published guidelines recommend against the use of synthetic non-absorbable materials in cases of potentially contaminated or contaminated surgical fields due to the increased risk of infection [1, 2], the use of bio-prosthetic meshes for abdominal wall or ventral hernia repair is still controversially discussed in such cases. Bio-prosthetic meshes have been recommended due to less susceptibility for infection and the decreased risk of subsequent mesh explantation. The purpose of this review is to elucidate if there are any indications for the use of biological and biosynthetic meshes in incarcerated abdominal wall hernias based on the recently published literature.Methods: A literature search of the Medline database using the PubMed search engine, using the keywords returned 486 articles up to June 2015. The full text of 486 articles was assessed and 13 relevant papers were identified including 5 retrospective case cohort studies, 2 case controlled studies, 6 case series.Results: The results of Franklin et al [23, 24, 25] included the highest number of biological mesh repairs (Surgisis® by laparoscopic IPOM in infected fields which demonstrated a very low incidence of infection and recurrence (0,7% and 5,2%. Han et al [26] reported in his retrospective study the highest number of treated patients due to incarcerated hernias by open approach using acellular dermal matrix (ADM® with very low rate of infection as well as recurrences (1,6% and 15,9. Both studies achieved acceptable outcome in a follow up of at least 3,5 years compared to the use of synthetic mesh in this high-risk population [3]Conclusion:Currently there is a very limited evidence for the use of biological and biosynthetic meshes in strangulated hernias in either open or laparo-endoscopic repair. Finally, there is an urgent need to start with randomized controlled comparative trials as well as to support registries with data to achieve more

  8. Evidence to justify retention of transvaginal mesh: comparison between laparoscopic sacral colpopexy and transvaginal Elevate™ mesh.

    Science.gov (United States)

    To, Valérie; Hengrasmee, Pattaya; Lam, Alan; Luscombe, Georgina; Lawless, Anna; Lam, Justin

    2017-12-01

    To determine if laparoscopic sacral colpopexy (LSC) offers better apical support with a lower exposure rate than transvaginal mesh surgery with Elevate™. This was a retrospective cohort study comparing patients with apical prolapse (POP-Q point C ≥ -1) who underwent Elevate™ mesh repair (n = 146) with patients who underwent laparoscopic sacral colpopexy (n = 267). The sacral colpopexy group had a mean age of 59 years and a BMI of 25.7. Patients in the Elevate™ group were older, with a mean age of 63 and a BMI of 26.3. Most of the patients of both groups presented with pelvic organ prolapse stage III (LSC 73.8% and Elevate™ 87.0%) and their mean POP-Q point C were not significantly different (LSC 1.4 vs Elevate™ 1.2 cm). Operative time was longer in the LSC group (113 vs 91 min, p < 0.001), but estimated blood loss was lower (75 cm 3 vs 137 cm 3 , p < 0.001). No difference in mesh exposure rate could be found between the two groups at one year (Elevate™ 0.7% vs LSC 2.6%, OR 0.26, 95% CI 0.03 to 2.10, p = 0.21). One-year objective cure rate, defined as no descent beyond the hymen, was 97.0% in the LSC group and 96.6% in the Elevate™ group (p = .81). The overall recurrence (objective, subjective recurrence or reoperation) was also not different between the groups (LSC 4.5% vs Elevate 4.8%, p = 0.89). Transvaginal Elevate™ mesh delivers comparable apical support with a low exposure rate similar to that of laparoscopic sacral colpopexy.

  9. A coarse-mesh nodal method-diffusive-mesh finite difference method

    International Nuclear Information System (INIS)

    Joo, H.; Nichols, W.R.

    1994-01-01

    Modern nodal methods have been successfully used for conventional light water reactor core analyses where the homogenized, node average cross sections (XSs) and the flux discontinuity factors (DFs) based on equivalence theory can reliably predict core behavior. For other types of cores and other geometries characterized by tightly-coupled, heterogeneous core configurations, the intranodal flux shapes obtained from a homogenized nodal problem may not accurately portray steep flux gradients near fuel assembly interfaces or various reactivity control elements. This may require extreme values of DFs (either very large, very small, or even negative) to achieve a desired solution accuracy. Extreme values of DFs, however, can disrupt the convergence of the iterative methods used to solve for the node average fluxes, and can lead to a difficulty in interpolating adjacent DF values. Several attempts to remedy the problem have been made, but nothing has been satisfactory. A new coarse-mesh nodal scheme called the Diffusive-Mesh Finite Difference (DMFD) technique, as contrasted with the coarse-mesh finite difference (CMFD) technique, has been developed to resolve this problem. This new technique and the development of a few-group, multidimensional kinetics computer program are described in this paper

  10. Robust, multidimensional mesh motion based on Monge-Kantorovich equidistribution

    Energy Technology Data Exchange (ETDEWEB)

    Delzanno, G L [Los Alamos National Laboratory; Finn, J M [Los Alamos National Laboratory

    2009-01-01

    Mesh-motion (r-refinement) grid adaptivity schemes are attractive due to their potential to minimize the numerical error for a prescribed number of degrees of freedom. However, a key roadblock to a widespread deployment of the technique has been the formulation of robust, reliable mesh motion governing principles, which (1) guarantee a solution in multiple dimensions (2D and 3D), (2) avoid grid tangling (or folding of the mesh, whereby edges of a grid cell cross somewhere in the domain), and (3) can be solved effectively and efficiently. In this study, we formulate such a mesh-motion governing principle, based on volume equidistribution via Monge-Kantorovich optimization (MK). In earlier publications [1, 2], the advantages of this approach in regards to these points have been demonstrated for the time-independent case. In this study, demonstrate that Monge-Kantorovich equidistribution can in fact be used effectively in a time stepping context, and delivers an elegant solution to the otherwise pervasive problem of grid tangling in mesh motion approaches, without resorting to ad-hoc time-dependent terms (as in moving-mesh PDEs, or MMPDEs [3, 4]). We explore two distinct r-refinement implementations of MK: direct, where the current mesh relates to an initial, unchanging mesh, and sequential, where the current mesh is related to the previous one in time. We demonstrate that the direct approach is superior in regards to mesh distortion and robustness. The properties of the approach are illustrated with a paradigmatic hyperbolic PDE, the advection of a passive scalar. Imposed velocity flow fields or varying vorticity levels and flow shears are considered.

  11. In-vitro examination of the biocompatibility of fibroblast cell lines on alloplastic meshes and sterilized polyester mosquito mesh.

    Science.gov (United States)

    Wiessner, R; Kleber, T; Ekwelle, N; Ludwig, K; Richter, D-U

    2017-06-01

    The use of alloplastic implants for tissue strengthening when treating hernias is an established therapy worldwide. Despite the high incidence of hernias in Africa and Asia, the implantation of costly mesh netting is not financially feasible. Because of that various investigative groups have examined the use of sterilized mosquito netting. The animal experiments as well as the clinical trials have both shown equivalent short- and long-term results. The goal of this paper is the comparison of biocompatibility of human fibroblasts on the established commercially available nets and on sterilized polyester mosquito mesh over a period of 12 weeks. Three commercially available plastic mesh types and a gas-sterilized mosquito polyethylenterephtalate (polyester) mesh were examined. Human fibroblasts from subcutaneous healthy tissue were used. Various tests for evaluating the growth behavior and the cell morphology of human fibroblasts were conducted. The semi-quantitative (light microscopy) and qualitative (scanning electron microscopy) analyses were performed after 1 week and then again after 12 weeks. The cell proliferation and cytotoxicity of the implants were investigated with the help of the 5'-bromo-2'-deoxyuridine (BrdU)-cell proliferation test and the LDH-cytotoxicity test. The number of live cells per ml was determined with the Bürker counting chamber. In addition, analyses were made of the cell metabolism (oxidative stress) by measuring the pH value, hydrogen peroxide, and glycolysis. After 12 weeks, a proliferation of fibroblasts on all mesh is documented. No mesh showed a complete apoptosis of the cells. This qualitative observation could be confirmed quantitatively in a biochemical assay by marking the proliferating cells with BrdU. The biochemical analysis brought the proof that the materials used, including the polyester of the mosquito mesh, are not cytotoxic for the fibroblasts. The vitality of the cells was between 94 and 98%. The glucose metabolism

  12. Male infertility after mesh hernia repair: A prospective study.

    Science.gov (United States)

    Hallén, Magnus; Sandblom, Gabriel; Nordin, Pär; Gunnarsson, Ulf; Kvist, Ulrik; Westerdahl, Johan

    2011-02-01

    Several animal studies have raised concern about the risk for obstructive azoospermia owing to vasal fibrosis caused by the use of alloplastic mesh prosthesis in inguinal hernia repair. The aim of this study was to determine the prevalence of male infertility after bilateral mesh repair. In a prospective study, a questionnaire inquiring about involuntary childlessness, investigation for infertility and number of children was sent by mail to a group of 376 men aged 18-55 years, who had undergone bilateral mesh repair, identified in the Swedish Hernia Register (SHR). Questionnaires were also sent to 2 control groups, 1 consisting of 186 men from the SHR who had undergone bilateral repair without mesh, and 1 consisting of 383 men identified in the general population. The control group from the SHR was matched 2:1 for age and years elapsed since operation. The control group from the general population was matched 1:1 for age and marital status. The overall response rate was 525 of 945 (56%). Method of approach (anterior or posterior), type of mesh, and testicular status at the time of the repair had no significant impact on the answers to the questions. Nor did subgroup analysis of the men ≤40 years old reveal any significant differences. The results of this prospective study in men do not support the hypothesis that bilateral inguinal hernia repair with alloplastic mesh prosthesis causes male infertility at a significantly greater rate than those operated without mesh. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Does Attorney Advertising Influence Patient Perceptions of Pelvic Mesh?

    Science.gov (United States)

    Tippett, Elizabeth; King, Jesse; Lucent, Vincent; Ephraim, Sonya; Murphy, Miles; Taff, Eileen

    2018-01-01

    To measure the relative influence of attorney advertising on patient perceptions of pelvic mesh compared with a history of surgery and a first urology visit. A 52-item survey was administered to 170 female patients in 2 urology offices between 2014 and 2016. Multiple survey items were combined to form scales for benefit and risk perceptions of pelvic mesh, perceptions of the advertising, attitudes toward pelvic mesh, and knowledge of pelvic mesh and underlying medical conditions. Data were analyzed using hierarchical linear regression models. Exposure to attorney advertising was quite high; 88% reported seeing a mesh-related attorney advertisement in the last 6 months. Over half of patients reported seeing attorney advertisements more than once per week. A history of prior mesh implant surgery was the strongest predictor of benefit and risk perceptions of pelvic mesh. Exposure to attorney advertising was associated with higher risk perceptions but did not significantly affect perceptions of benefits. Past urologist visits increased perceptions of benefits but had no effect on risk perceptions. Attorney advertising appears to have some influence on risk perceptions, but personal experience and discussions with a urogynecologist or urologist also influence patient perceptions. Implications, limitations, and future research are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A Survey of Solver-Related Geometry and Meshing Issues

    Science.gov (United States)

    Masters, James; Daniel, Derick; Gudenkauf, Jared; Hine, David; Sideroff, Chris

    2016-01-01

    There is a concern in the computational fluid dynamics community that mesh generation is a significant bottleneck in the CFD workflow. This is one of several papers that will help set the stage for a moderated panel discussion addressing this issue. Although certain general "rules of thumb" and a priori mesh metrics can be used to ensure that some base level of mesh quality is achieved, inadequate consideration is often given to the type of solver or particular flow regime on which the mesh will be utilized. This paper explores how an analyst may want to think differently about a mesh based on considerations such as if a flow is compressible vs. incompressible or hypersonic vs. subsonic or if the solver is node-centered vs. cell-centered. This paper is a high-level investigation intended to provide general insight into how considering the nature of the solver or flow when performing mesh generation has the potential to increase the accuracy and/or robustness of the solution and drive the mesh generation process to a state where it is no longer a hindrance to the analysis process.

  15. Design Investigation on Applicable Mesh Structures for Medical Stent Applications

    Science.gov (United States)

    Asano, Shoji; He, Jianmei

    2017-11-01

    In recent years, utilization of medical stents is one of effective treatments for stenosis and occlusion occurring in a living body’s lumen indispensable for maintenance of human life such as superficial femoral artery (SFA) occlusion. However, there are concerns about the occurrence of fatigue fractures caused by stress concentrations, neointimal hyperplasia and the like due to the shape structure and the manufacturing method in the conventional stents, and a stent having high strength and high flexibility is required. Therefore, in this research, applicable mesh structures for medical stents based on the design concepts of high strength, high flexibility are interested to solve various problem of conventional stent. According to the shape and dimensions of SFA occlusion therapy stent and indwelling delivery catheter, shape design of the meshed stent are performed using 3-dimensional CAD software Solid Works first. Then analytical examination on storage characteristics and compression characteristics of such mesh structure applied stent models were carried out through finite element analysis software ANSYS Workbench. Meshed stent models with higher strength and higher flexibility with integral molding are investigated analytically. It was found that the storage characteristics and compression characteristics of meshed stent modles are highly dependent on the basic mesh shapes with same surface void ratio. Trade-off relationship between flexibility and storage characteristics is found exited, it is required to provide appropriate curvatures during basic mesh shape design.

  16. Finite element simulation of impact response of wire mesh screens

    Directory of Open Access Journals (Sweden)

    Wang Caizheng

    2015-01-01

    Full Text Available In this paper, the response of wire mesh screens to low velocity impact with blunt objects is investigated using finite element (FE simulation. The woven wire mesh is modelled with homogeneous shell elements with equivalent smeared mechanical properties. The mechanical behaviour of the woven wire mesh was determined experimentally with tensile tests on steel wire mesh coupons to generate the data for the smeared shell material used in the FE. The effects of impacts with a low mass (4 kg and a large mass (40 kg providing the same impact energy are studied. The joint between the wire mesh screen and the aluminium frame surrounding it is modelled using contact elements with friction between the corresponding elements. Damage to the screen of different types compromising its structural integrity, such as mesh separation and pulling out from the surrounding frame is modelled. The FE simulation is validated with results of impact tests conducted on woven steel wire screen meshes.

  17. Mesh fixation in endoscopic inguinal hernia repair: evaluation of methodology based on a systematic review of randomised clinical trials.

    Science.gov (United States)

    Lederhuber, Hans; Stiede, Franziska; Axer, Stephan; Dahlstrand, Ursula

    2017-11-01

    The issue of mesh fixation in endoscopic inguinal hernia repair is frequently debated and still no conclusive data exist on differences between methods regarding long-term outcome and postoperative complications. The quantity of trials and the simultaneous lack of high-quality evidence raise the question how future trials should be planned. PubMed, EMBASE and the Cochrane Library were searched, using the filters "randomised clinical trials" and "humans". Trials that compared one method of mesh fixation with another fixation method or with non-fixation in endoscopic inguinal hernia repair were eligible. To be included, the trial was required to have assessed at least one of the following primary outcome parameters: recurrence; surgical site infection; chronic pain; or quality-of-life. Fourteen trials assessing 2161 patients and 2562 hernia repairs were included. Only two trials were rated as low risk for bias. Eight trials evaluated recurrence or surgical site infection; none of these could show significant differences between methods of fixation. Two of 11 trials assessing chronic pain described significant differences between methods of fixation. One of two trials evaluating quality-of-life showed significant differences between fixation methods in certain functions. High-quality evidence for differences between the assessed mesh fixation techniques is still lacking. From a socioeconomic and ethical point of view, it is necessary that future trials will be properly designed. As small- and medium-sized single-centre trials have proven unable to find answers, register studies or multi-centre studies with an evident focus on methodology and study design are needed in order to answer questions about mesh fixation in inguinal hernia repair.

  18. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients.

    Science.gov (United States)

    Kdous, Moez; Zhioua, Fethi

    2014-12-01

    To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ⩾2 according to the Baden-Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh®, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. The patients' characteristics and surgical variables were recorded prospectively. The anatomical outcome, as measured by a physical examination and postoperative stratification of prolapse, and functional outcome, as assessed by a questionnaire derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and the Pelvic Organ Prolapse-Urinary Incontinence-Sexual Questionnaire, were considered as the primary outcome measures. Peri- and postoperative complications constituted the secondary outcome measures. At 36 months after surgery the anatomical success rate (stage 0 or 1) was 93%. On a functional level, all the scores of quality of life and sexuality were improved. The overall satisfaction score (visual analogue scale) was 71.4%. There were no perioperative adverse events. Mesh erosion was reported in 7.6% and mesh retraction in 5.7% of the patients. If the guidelines and precautions are followed, vaginal prosthetic surgery for genitourinary prolapse has shown long-term benefits. It provides excellent results both anatomically and functionally. However, complications are not negligible and some are specific to prosthetic surgery.

  19. Polyhedral meshing in numerical analysis of conjugate heat transfer

    Science.gov (United States)

    Sosnowski, Marcin; Krzywanski, Jaroslaw; Grabowska, Karolina; Gnatowska, Renata

    2018-06-01

    Computational methods have been widely applied in conjugate heat transfer analysis. The very first and crucial step in such research is the meshing process which consists in dividing the analysed geometry into numerous small control volumes (cells). In Computational Fluid Dynamics (CFD) applications it is desirable to use the hexahedral cells as the resulting mesh is characterized by low numerical diffusion. Unfortunately generating such mesh can be a very time-consuming task and in case of complicated geometry - it may not be possible to generate cells of good quality. Therefore tetrahedral cells have been implemented into commercial pre-processors. Their advantage is the ease of its generation even in case of very complex geometry. On the other hand tetrahedrons cannot be stretched excessively without decreasing the mesh quality factor, so significantly larger number of cells has to be used in comparison to hexahedral mesh in order to achieve a reasonable accuracy. Moreover the numerical diffusion of tetrahedral elements is significantly higher. Therefore the polyhedral cells are proposed within the paper in order to combine the advantages of hexahedrons (low numerical diffusion resulting in accurate solution) and tetrahedrons (rapid semi-automatic generation) as well as to overcome the disadvantages of both the above mentioned mesh types. The major benefit of polyhedral mesh is that each individual cell has many neighbours, so gradients can be well approximated. Polyhedrons are also less sensitive to stretching than tetrahedrons which results in better mesh quality leading to improved numerical stability of the model. In addition, numerical diffusion is reduced due to mass exchange over numerous faces. This leads to a more accurate solution achieved with a lower cell count. Therefore detailed comparison of numerical modelling results concerning conjugate heat transfer using tetrahedral and polyhedral meshes is presented in the paper.

  20. Challenging the Myth: Transvaginal Mesh is Not Associated with Carcinogenesis.

    Science.gov (United States)

    Chughtai, Bilal; Sedrakyan, Art; Mao, Jialin; Thomas, Dominique; Eilber, Karyn S; Clemens, J Quentin; Anger, Jennifer T

    2017-10-01

    We sought to determine if there was a potential link between synthetic polypropylene mesh implantation for transvaginal pelvic organ prolapse and stress urinary incontinence, and carcinogenesis using statewide administrative data. Women who underwent transvaginal surgery for pelvic organ prolapse or stress urinary incontinence with mesh between January 2008 and December 2009 in New York State were identified using ICD-9-CM procedure codes and CPT-4 codes. Patients in the mesh cohort were individually matched to 2 control cohorts based on comorbidities and procedure date. Carcinogenesis was determined before and after matching at 1, 2 and 3 years, and during the entire followup time. A total of 2,229 patients who underwent mesh based pelvic organ prolapse surgery and 10,401 who underwent sling surgery for stress urinary incontinence between January 2008 and December 2009 were included in the study. Mean followup was 6 years (range 5 to 7). Exact matching between the mesh and control cohorts resulted in 1,870 pairs for pelvic organ prolapse mesh and cholecystectomy (1:2), 1,278 pairs for pelvic organ prolapse mesh and hysterectomy (1:1), 7,986 pairs for sling and cholecystectomy (1:1) and 3,810 pairs for sling and hysterectomy (1:1). Transvaginal mesh implantation was not associated with an increased risk of a cancer diagnosis (pelvic/local cancers or any cancer) at 1 year and during the entire followup of up to 7 years. Transvaginal surgery with implantation of mesh was not associated with the development of malignancy at a mean followup of 6 years. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. r-Adaptive mesh generation for shell finite element analysis

    International Nuclear Information System (INIS)

    Cho, Maenghyo; Jun, Seongki

    2004-01-01

    An r-adaptive method or moving grid technique relocates a grid so that it becomes concentrated in the desired region. This concentration improves the accuracy and efficiency of finite element solutions. We apply the r-adaptive method to computational mesh of shell surfaces, which is initially regular and uniform. The r-adaptive method, given by Liao and Anderson [Appl. Anal. 44 (1992) 285], aggregate the grid in the region with a relatively high weight function without any grid-tangling. The stress error estimator is calculated in the initial uniform mesh for a weight function. However, since the r-adaptive method is a method that moves the grid, shell surface geometry error such as curvature error and mesh distortion error will increase. Therefore, to represent the exact geometry of a shell surface and to prevent surface geometric errors, we use the Naghdi's shell theory and express the shell surface by a B-spline patch. In addition, using a nine-node element, which is relatively less sensitive to mesh distortion, we try to diminish mesh distortion error in the application of an r-adaptive method. In the numerical examples, it is shown that the values of the error estimator for a cylinder, hemisphere, and torus in the overall domain can be reduced effectively by using the mesh generated by the r-adaptive method. Also, the reductions of the estimated relative errors are demonstrated in the numerical examples. In particular, a new functional is proposed to construct an adjusted mesh configuration by considering a mesh distortion measure as well as the stress error function. The proposed weight function provides a reliable mesh adaptation method after a parameter value in the weight function is properly chosen

  2. Surgical management of pelvic organ prolapse in women.

    Science.gov (United States)

    Maher, Christopher; Feiner, Benjamin; Baessler, Kaven; Schmid, Corina

    2013-04-30

    Pelvic organ prolapse may occur in up to 50% of parous women. A variety of urinary, bowel and sexual symptoms may be associated with the prolapse. To determine the effects of the many different surgeries used in the management of pelvic organ prolapse. We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In Process and handsearching of journals and conference proceedings, healthcare-related bibliographic databases, handsearched conference proceedings (searched 20 August 2012), and reference lists of relevant articles. We also contacted researchers in the field. Randomised or quasi-randomised controlled trials that included surgical operations for pelvic organ prolapse. Trials were assessed and data extracted independently by two review authors. Six investigators were contacted for additional information with five responding. Fifty-six randomised controlled trials were identified evaluating 5954 women. For upper vaginal prolapse (uterine or vault) abdominal sacral colpopexy was associated with a lower rate of recurrent vault prolapse on examination and painful intercourse than with vaginal sacrospinous colpopexy. These benefits must be balanced against a longer operating time, longer time to return to activities of daily living and increased cost of the abdominal approach. In single studies the sacral colpopexy had a higher success rate on examination and lower reoperation rate than high vaginal uterosacral suspension and transvaginal polypropylene mesh.Twenty-one trials compared a variety of surgical procedures for anterior compartment prolapse (cystocele). Ten compared native tissue repair with graft (absorbable and permanent mesh, biological grafts) repair for anterior compartment prolapse. Native tissue anterior repair was associated with more recurrent anterior compartment prolapse than when supplemented with a polyglactin

  3. Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

    Science.gov (United States)

    Ow, Lin Li; Lim, Yik N; Dwyer, Peter L; Karmakar, Debjyoti; Murray, Christine; Thomas, Elizabeth; Rosamilia, Anna

    2016-09-01

    The objective of this study was to assess outcomes in native tissue (NT) and transvaginal mesh (TVM) repair in women with recurrent prolapse. A retrospective two-group observational study of 237 women who underwent prolapse repair after failed NT repair in two tertiary hospitals. A primary outcome of "success" was defined using a composite outcome of no vaginal bulge symptoms, no anatomical recurrence in the same compartment beyond the hymen (0 cm on POPQ) and no surgical re-treatment for prolapse in the same compartment. Secondary outcomes assessed included re-operation for prolapse in the same compartment, dyspareunia and mesh-related complications. Of a total of 336 repairs, 196 were performed in the anterior compartment and 140 in the posterior compartment. Compared with the TVM groups, women undergoing repeat NT repair were more likely to experience anatomical recurrence (anterior 40.9 % vs 25 %, p = 0.02, posterior 25.3 % vs 7.5 %, p = 0.01), report vaginal bulge (anterior 34.1 % vs 12 %, p mesh exposure were 9.3 % anteriorly and 15.1 % posteriorly. Although the number of women requiring a prolapse re-operation is lower in the TVM group, the overall re-operation rate was not significantly different when procedures to correct mesh complications were included. Although the success rate is better with the use of TVM for recurrent prolapse, the total re-operation rates are similar when mesh complication-related surgeries are included.

  4. Prevention of parastomal hernias with 3D funnel meshes in intraperitoneal onlay position by placement during initial stoma formation.

    Science.gov (United States)

    Köhler, G; Hofmann, A; Lechner, M; Mayer, F; Wundsam, H; Emmanuel, K; Fortelny, R H

    2016-02-01

    In patients with terminal ostomies, parastomal hernias (PSHs) occur on a frequent basis. They are commonly associated with various degrees of complaints and occasionally lead to life-threatening complications. Various strategies and measures have been tested and evaluated, but to date there is a lack of published evidence with regard to the best surgical technique for the prevention of PSH development. We conducted a retrospective analysis of prospectively collected data of eighty patients, who underwent elective permanent ostomy formation between 2009 and 2014 by means of prophylactic implantation of a three-dimensional (3D) funnel mesh in intraperitoneal onlay (IPOM) position. PSH developed in three patients (3.75%). No mesh-related complications were encountered and none of the implants had to be removed. Ostomy-related complications had to be noted in seven (8.75%) cases. No manifestation of ostomy prolapse occurred. Follow-up time was a median 21 (range 3-47) months. The prophylactical implantation of a specially shaped, 3D mesh implant in IPOM technique during initial formation of a terminal enterostomy is safe, highly efficient and comparatively easy to perform. As opposed to what can be achieved with flat or keyhole meshes, the inner boundary areas of the ostomy itself can be well covered and protected from the surging viscera with the 3D implants. At the same time, the vertical, tunnel-shaped part of the mesh provides sufficient protection from an ostomy prolapse. Further studies will be needed to compare the efficacy of various known approaches to PSH prevention.

  5. Autoclaved Sand-Lime Products with a Polypropylene Mesh

    Science.gov (United States)

    Kostrzewa, Paulina; Stępień, Anna

    2017-10-01

    The paper presents the results of the research on modifications of silicate bricks with a polypropylene mesh and their influence on physical, mechanical and microstructural properties of such bricks. The main goal of the paper was to determine effects of the polypropylene mesh on sand-lime product parameters. The analysis has focused on compressive strength, water absorption, bulk density and structural features of the material. The obtained product is characterized by improved basic performance characteristics compared to traditional silicate products. Using the polypropylene mesh increased compressive strength by 25% while decreasing the product density. The modified products retain their form and do not disintegrate after losing their bearing capacity.

  6. Discrete Surface Evolution and Mesh Deformation for Aircraft Icing Applications

    Science.gov (United States)

    Thompson, David; Tong, Xiaoling; Arnoldus, Qiuhan; Collins, Eric; McLaurin, David; Luke, Edward; Bidwell, Colin S.

    2013-01-01

    Robust, automated mesh generation for problems with deforming geometries, such as ice accreting on aerodynamic surfaces, remains a challenging problem. Here we describe a technique to deform a discrete surface as it evolves due to the accretion of ice. The surface evolution algorithm is based on a smoothed, face-offsetting approach. We also describe a fast algebraic technique to propagate the computed surface deformations into the surrounding volume mesh while maintaining geometric mesh quality. Preliminary results presented here demonstrate the ecacy of the approach for a sphere with a prescribed accretion rate, a rime ice accretion, and a more complex glaze ice accretion.

  7. Expected Transmission Energy Route Metric for Wireless Mesh Senor Networks

    Directory of Open Access Journals (Sweden)

    YanLiang Jin

    2011-01-01

    Full Text Available Mesh is a network topology that achieves high throughput and stable intercommunication. With great potential, it is expected to be the key architecture of future networks. Wireless sensor networks are an active research area with numerous workshops and conferences arranged each year. The overall performance of a WSN highly depends on the energy consumption of the network. This paper designs a new routing metric for wireless mesh sensor networks. Results from simulation experiments reveal that the new metric algorithm improves the energy balance of the whole network and extends the lifetime of wireless mesh sensor networks (WMSNs.

  8. Procedure for the automatic mesh generation of innovative gear teeth

    Directory of Open Access Journals (Sweden)

    Radicella Andrea Chiaramonte

    2016-01-01

    Full Text Available After having described gear wheels with teeth having the two sides constituted by different involutes and their importance in engineering applications, we stress the need for an efficient procedure for the automatic mesh generation of innovative gear teeth. First, we describe the procedure for the subdivision of the tooth profile in the various possible cases, then we show the method for creating the subdivision mesh, defined by two series of curves called meridians and parallels. Finally, we describe how the above procedure for automatic mesh generation is able to solve specific cases that may arise when dealing with teeth having the two sides constituted by different involutes.

  9. Watermarking on 3D mesh based on spherical wavelet transform.

    Science.gov (United States)

    Jin, Jian-Qiu; Dai, Min-Ya; Bao, Hu-Jun; Peng, Qun-Sheng

    2004-03-01

    In this paper we propose a robust watermarking algorithm for 3D mesh. The algorithm is based on spherical wavelet transform. Our basic idea is to decompose the original mesh into a series of details at different scales by using spherical wavelet transform; the watermark is then embedded into the different levels of details. The embedding process includes: global sphere parameterization, spherical uniform sampling, spherical wavelet forward transform, embedding watermark, spherical wavelet inverse transform, and at last resampling the mesh watermarked to recover the topological connectivity of the original model. Experiments showed that our algorithm can improve the capacity of the watermark and the robustness of watermarking against attacks.

  10. Vertex Normals and Face Curvatures of Triangle Meshes

    KAUST Repository

    Sun, Xiang

    2016-08-12

    This study contributes to the discrete differential geometry of triangle meshes, in combination with discrete line congruences associated with such meshes. In particular we discuss when a congruence defined by linear interpolation of vertex normals deserves to be called a ʼnormal’ congruence. Our main results are a discussion of various definitions of normality, a detailed study of the geometry of such congruences, and a concept of curvatures and shape operators associated with the faces of a triangle mesh. These curvatures are compatible with both normal congruences and the Steiner formula.

  11. Isotropic 2D quadrangle meshing with size and orientation control

    KAUST Repository

    Pellenard, Bertrand

    2011-12-01

    We propose an approach for automatically generating isotropic 2D quadrangle meshes from arbitrary domains with a fine control over sizing and orientation of the elements. At the heart of our algorithm is an optimization procedure that, from a coarse initial tiling of the 2D domain, enforces each of the desirable mesh quality criteria (size, shape, orientation, degree, regularity) one at a time, in an order designed not to undo previous enhancements. Our experiments demonstrate how well our resulting quadrangle meshes conform to a wide range of input sizing and orientation fields.

  12. Engagement of Metal Debris into a Gear Mesh

    Science.gov (United States)

    Handschuh, Robert F.; Krantz, Timothy L.

    2010-01-01

    A series of bench top experiments was conducted to determine the effects of metallic debris being dragged through meshing gear teeth. A test rig that is typically used to conduct contact fatigue experiments was used for these tests. Several sizes of drill material, shim stock, and pieces of gear teeth were introduced and then driven through the meshing region. The level of torque required to drive the "chip" through the gear mesh was measured. From the data gathered, chip size sufficient to jam the mechanism can be determined.

  13. Use of mesh in laparoscopic paraesophageal hernia repair

    DEFF Research Database (Denmark)

    Müller-Stich, Beat P.; Kenngott, Hannes G.; Gondan, Matthias

    2015-01-01

    Introduction. Mesh augmentation seems to reduce recurrences following laparoscopic paraesophageal hernia repair (LPHR). However, there is an uncertain risk of mesh-associated complications. Risk-benefit analysis might solve the dilemma. Materials and Methods. A systematic literature search...... potential benefits of LMAH. All data regarding LMAH were used to estimate risk of mesh-associated complications. Risk-benefit analysis was performed using a Markov Monte Carlo decision-analytic model. Results. Meta-analysis of 3 RCTs and 9 OCSs including 915 patients revealed a significantly lower...

  14. Numerical convergence of discrete exterior calculus on arbitrary surface meshes

    KAUST Repository

    Mohamed, Mamdouh S.

    2018-02-13

    Discrete exterior calculus (DEC) is a structure-preserving numerical framework for partial differential equations solution, particularly suitable for simplicial meshes. A longstanding and widespread assumption has been that DEC requires special (Delaunay) triangulations, which complicated the mesh generation process especially for curved surfaces. This paper presents numerical evidence demonstrating that this restriction is unnecessary. Convergence experiments are carried out for various physical problems using both Delaunay and non-Delaunay triangulations. Signed diagonal definition for the key DEC operator (Hodge star) is adopted. The errors converge as expected for all considered meshes and experiments. This relieves the DEC paradigm from unnecessary triangulation limitation.

  15. Gender differences in the acquisition of surgical skills

    DEFF Research Database (Denmark)

    Ali, Amir; Subhi, Yousif; Ringsted, Charlotte

    2015-01-01

    BACKGROUND: Females are less attracted than males to surgical specialties, which may be due to differences in the acquisition of skills. The aim of this study was to systematically review studies that investigate gender differences in the acquisition of surgical skills. METHODS: We performed...... a comprehensive database search using relevant search phrases and MeSH terms. We included studies that investigated the role of gender in the acquisition of surgical skills. RESULTS: Our search yielded 247 studies, 18 of which were found to be eligible and were therefore included. These studies included a total...... of 2,106 study participants. The studies were qualitatively synthesized in five categories (studies on medical students, studies on both medical students and residents, studies on residents, studies on gender differences in needed physical strength, and studies on other gender-related training...

  16. Fair packet scheduling in Wireless Mesh Networks

    KAUST Repository

    Nawab, Faisal

    2014-02-01

    In this paper we study the interactions of TCP and IEEE 802.11 MAC in Wireless Mesh Networks (WMNs). We use a Markov chain to capture the behavior of TCP sessions, particularly the impact on network throughput due to the effect of queue utilization and packet relaying. A closed form solution is derived to numerically determine the throughput. Based on the developed model, we propose a distributed MAC protocol called Timestamp-ordered MAC (TMAC), aiming to alleviate the unfairness problem in WMNs. TMAC extends CSMA/CA by scheduling data packets based on their age. Prior to transmitting a data packet, a transmitter broadcasts a request control message appended with a timestamp to a selected list of neighbors. It can proceed with the transmission only if it receives a sufficient number of grant control messages from these neighbors. A grant message indicates that the associated data packet has the lowest timestamp of all the packets pending transmission at the local transmit queue. We demonstrate that a loose ordering of timestamps among neighboring nodes is sufficient for enforcing local fairness, subsequently leading to flow rate fairness in a multi-hop WMN. We show that TMAC can be implemented using the control frames in IEEE 802.11, and thus can be easily integrated in existing 802.11-based WMNs. Our simulation results show that TMAC achieves excellent resource allocation fairness while maintaining over 90% of maximum link capacity across a large number of topologies.

  17. Surgical management of the radiated chest wall

    International Nuclear Information System (INIS)

    Arnold, P.G.; Pairolero, P.C.

    1986-01-01

    Fifty consecutive patients with radiation-related problems of the chest wall were treated between 1976 and 1984. There were 40 women and 10 men with an average age of 54 years (range 26 to 78 years). Twenty-three patients had radiation ulcers alone, 20 had recurrent cancer, and 7 had infected median sternotomy wounds. Thirty-six had skeletal resections and 44 had soft-tissue resections. The skeleton was reconstructed with Prolene mesh in 12 patients and with autogenous rib in 3. Sixty-three muscles were transposed in 43 patients. Twelve omental transpositions were performed (8 for primary treatment and 4 for salvage of a failed muscle flap). Hospitalization averaged 20.2 days. There was one operative death (at 29 days). Partial flap necrosis occurred in 10 patients. Mesh was removed in three patients. There were 14 late deaths, most from recurrent tumor. The remaining patients had well-healed wounds and a generally improved quality of life. We conclude that aggressive resection and reliable reconstruction are critical considerations in the surgical management of this perplexing clinical problem

  18. Toward the Development of Virtual Surgical Tools to Aid Orthopaedic FE Analyses

    Directory of Open Access Journals (Sweden)

    Srinivas C. Tadepalli

    2010-01-01

    Full Text Available Computational models of joint anatomy and function provide a means for biomechanists, physicians, and physical therapists to understand the effects of repetitive motion, acute injury, and degenerative diseases. Finite element models, for example, may be used to predict the outcome of a surgical intervention or to improve the design of prosthetic implants. Countless models have been developed over the years to address a myriad of orthopaedic procedures. Unfortunately, few studies have incorporated patient-specific models. Historically, baseline anatomic models have been used due to the demands associated with model development. Moreover, surgical simulations impose additional modeling challenges. Current meshing practices do not readily accommodate the inclusion of implants. Our goal is to develop a suite of tools (virtual instruments and guides which enable surgical procedures to be readily simulated and to facilitate the development of all-hexahedral finite element mesh definitions.

  19. Reconstruction of Midface and Orbital Wall Defects After Maxillectomy and Orbital Content Preservation With Titanium Mesh and Fascia Lata: 3-Year Follow-Up.

    Science.gov (United States)

    Motiee-Langroudi, Maziar; Harirchi, Iraj; Amali, Amin; Jafari, Mehrdad

    2015-12-01

    To describe the authors' experience in the reconstruction of patients after total maxillectomy with preservation of orbital contents for maxillary tumors using titanium mesh and autogenous fascia lata, where no setting for free flap reconstruction is available. Twelve consecutive patients with paranasal sinus tumors underwent total maxillectomy without orbital exenterations and primary reconstruction. The defects were reconstructed by titanium mesh in combination with autogenous fascia lata in the orbital floor performed by 1 surgical team. Titanium mesh (0.2 mm thick) was contoured and fixed to reconstruct the orbital floor and obtain midface projection. Fascia lata was used to cover the titanium mesh along the orbital floor to prevent fat entrapment in the mesh holes. The most common pathology was squamous cell carcinoma (50%). Patients' mean age was 45.66 years (33 to 74 yr). The mean follow-up period was 35.2 months (30 to 49 months). During follow-up, no infection or foreign body reaction was encountered. Extrusion of titanium mesh occurred in 4 patients who underwent postoperative radiotherapy. Two cases of mild diplopia at extreme gaze occurred early during the postoperative period that resolved after a few months. Placing fascia lata between the titanium mesh surface of the orbital implant and the orbital contents was successful in preventing long-term diplopia or dystopia. Nevertheless, exposure of the titanium implant through the skin surface represented a complication of this technique in 25% of patients. Further studies are required with head-to-head comparisons of artificial materials and free flaps for reconstruction of maxillectomy defects. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. A 52-month follow-up on the transvaginal mesh surgery in vaginal cuff eversion.

    Science.gov (United States)

    Lo, Tsia-Shu; Yusoff, Faridah Mohd; Kao, Chuan-Chi; Jaili, Sukanda; Uy Patrimonio, Ma Clarissa

    2017-06-01

    Transvaginal mesh anterior-posterior (TVM-AP) provides better cure rates in the surgical treatment of vaginal cuff eversion than anterior transvaginal mesh combined with sacrospinous ligament fixation (TVM-A). We determine the outcomes after TVM-A and TVM-AP surgeries in advanced vaginal cuff prolapse. The charts of 796 women who underwent pelvic organ prolapse (POP) surgery from July 2006 to January 2012 in Chang Gung Memorial Hospitals were reviewed. We included women who presented with advanced cuff eversion and treated with TVM surgery. Data were analysed after three years post-surgery. Descriptive statistics were used for demographic and perioperative data. The paired-samples t test was used for comparison of preoperative and postoperative continuous data. The outcomes measured were objective cure (POP-Q stage ≤ 1) and subjective cure (negative response to question 2 and 3 on POPDI-6). A total of 97 patients was analysed. 61 patients had TVM-A and 36 patients had TVM-AP insertion. Mean follow-up was 52 months. The objective cure rate for TVM-AP was significantly higher than TVM-A, 94.4% versus 80.3%. TVM-AP also showed a higher subjective cure rate (91.7%) though there was no significant difference from TVM-A (p = 0.260). The mesh extrusion rate was low at 3.1% with no major complications seen. In TVM-A the blood loss was lesser and the operation time was shorter. TVM-AP showed better objective cure rate than TVM-A at 52 months. However, TVM-A is less invasive in comparison with an acceptably good cure rates. Copyright © 2017. Published by Elsevier B.V.

  1. Kinetic mesh-free method for flutter prediction in turbomachines

    Indian Academy of Sciences (India)

    Mesh-free kinetic upwind scheme; unsteady flows; modified CIR splitting ... scheme for solving the inviscid compressible Euler equations of gas ..... typically carried out for about five cycles in which the periodic behaviour of the flow is captured.

  2. Inductive Cross Shaped Metal Meshes in Silicon Substrate

    National Research Council Canada - National Science Library

    Sternberg, O; Moller, K. D; Grebel, H; Stewart, K. P; Henry, R. M

    2002-01-01

    .... The Micro-Stripes program was used for the calculation of resonance wavelength and width of resonance of cross shaped metal meshes and best- fit formulas were developed for the presentation of the data...

  3. Numerical convergence of discrete exterior calculus on arbitrary surface meshes

    KAUST Repository

    Mohamed, Mamdouh S.; Hirani, Anil N.; Samtaney, Ravi

    2018-01-01

    Discrete exterior calculus (DEC) is a structure-preserving numerical framework for partial differential equations solution, particularly suitable for simplicial meshes. A longstanding and widespread assumption has been that DEC requires special

  4. Dynamic power control for wireless backbone mesh networks: a survey

    CSIR Research Space (South Africa)

    Olwal, TO

    2010-01-01

    Full Text Available points of failures, and robust against RF interference, obstacles or power outage. This is because WMRs forming wireless backbone mesh networks (WBMNs) are built on advanced physical technologies. Such nodes perform both accessing and forwarding...

  5. Form-finding with polyhedral meshes made simple

    KAUST Repository

    Tang, Chengcheng; Sun, Xiang; Gomes, Maria Alexandra; Wallner, Johannes; Pottmann, Helmut

    2014-01-01

    We solve the form-finding problem for polyhedral meshes in a way which combines form, function and fabrication; taking care of user-specified constraints like boundary interpolation, planarity of faces, statics, panel size and shape, enclosed volume, and last, but not least, cost. Our main application is the interactive modeling of meshes for architectural and industrial design. Our approach can be described as guided exploration of the constraint space whose algebraic structure is simplified by introducing auxiliary variables and ensuring that constraints are at most quadratic. Computationally, we perform a projection onto the constraint space which is biased towards low values of an energy which expresses desirable "soft" properties like fairness. We have created a tool which elegantly handles difficult tasks, such as taking boundary-alignment of polyhedral meshes into account, planarization, fairing under planarity side conditions, handling hybrid meshes, and extending the treatment of static equilibrium to shapes which possess overhanging parts.

  6. Ordering schemes for parallel processing of certain mesh problems

    International Nuclear Information System (INIS)

    O'Leary, D.

    1984-01-01

    In this work, some ordering schemes for mesh points are presented which enable algorithms such as the Gauss-Seidel or SOR iteration to be performed efficiently for the nine-point operator finite difference method on computers consisting of a two-dimensional grid of processors. Convergence results are presented for the discretization of u /SUB xx/ + u /SUB yy/ on a uniform mesh over a square, showing that the spectral radius of the iteration for these orderings is no worse than that for the standard row by row ordering of mesh points. Further applications of these mesh point orderings to network problems, more general finite difference operators, and picture processing problems are noted

  7. Metal Mesh Filters for Terahertz Receivers, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — The technical objective of this SBIR program is to develop and demonstrate metal mesh filters for use in NASA's low noise receivers for terahertz astronomy and...

  8. Form-finding with polyhedral meshes made simple

    KAUST Repository

    Tang, Chengcheng

    2014-07-27

    We solve the form-finding problem for polyhedral meshes in a way which combines form, function and fabrication; taking care of user-specified constraints like boundary interpolation, planarity of faces, statics, panel size and shape, enclosed volume, and last, but not least, cost. Our main application is the interactive modeling of meshes for architectural and industrial design. Our approach can be described as guided exploration of the constraint space whose algebraic structure is simplified by introducing auxiliary variables and ensuring that constraints are at most quadratic. Computationally, we perform a projection onto the constraint space which is biased towards low values of an energy which expresses desirable "soft" properties like fairness. We have created a tool which elegantly handles difficult tasks, such as taking boundary-alignment of polyhedral meshes into account, planarization, fairing under planarity side conditions, handling hybrid meshes, and extending the treatment of static equilibrium to shapes which possess overhanging parts.

  9. Comparative Study of Different Gill Net Mesh Sizes in the ...

    African Journals Online (AJOL)

    Bioline

    component weighting) in the catch, which were favoured by the bigger mesh sizes (70mm). ... METHODS ... fishes from each ice chest were identified using the ..... feeding habits), and population (abundance) (RPI ... biomass per unit effort.

  10. Application-specific mesh-based heterogeneous FPGA architectures

    CERN Document Server

    Parvez, Husain

    2011-01-01

    This volume presents a new exploration environment for mesh-based, heterogeneous FPGA architectures. Readers will find a description of state-of-the-art techniques for reducing area requirements, which both increase performance and enable power reduction.

  11. Trajectory Optimization Based on Multi-Interval Mesh Refinement Method

    Directory of Open Access Journals (Sweden)

    Ningbo Li

    2017-01-01

    Full Text Available In order to improve the optimization accuracy and convergence rate for trajectory optimization of the air-to-air missile, a multi-interval mesh refinement Radau pseudospectral method was introduced. This method made the mesh endpoints converge to the practical nonsmooth points and decreased the overall collocation points to improve convergence rate and computational efficiency. The trajectory was divided into four phases according to the working time of engine and handover of midcourse and terminal guidance, and then the optimization model was built. The multi-interval mesh refinement Radau pseudospectral method with different collocation points in each mesh interval was used to solve the trajectory optimization model. Moreover, this method was compared with traditional h method. Simulation results show that this method can decrease the dimensionality of nonlinear programming (NLP problem and therefore improve the efficiency of pseudospectral methods for solving trajectory optimization problems.

  12. Constructing C1 Continuous Surface on Irregular Quad Meshes

    Institute of Scientific and Technical Information of China (English)

    HE Jun; GUO Qiang

    2013-01-01

    A new method is proposed for surface construction on irregular quad meshes as extensions to uniform B-spline surfaces. Given a number of control points, which form a regular or irregular quad mesh, a weight function is constructed for each control point. The weight function is defined on a local domain and is C1 continuous. Then the whole surface is constructed by the weighted combination of all the control points. The property of the new method is that the surface is defined by piecewise C1 bi-cubic rational parametric polynomial with each quad face. It is an extension to uniform B-spline surfaces in the sense that its definition is an analogy of the B-spline surface, and it produces a uniform bi-cubic B-spline surface if the control mesh is a regular quad mesh. Examples produced by the new method are also included.

  13. Isotropic 2D quadrangle meshing with size and orientation control

    KAUST Repository

    Pellenard, Bertrand; Alliez, Pierre; Morvan, Jean-Marie

    2011-01-01

    We propose an approach for automatically generating isotropic 2D quadrangle meshes from arbitrary domains with a fine control over sizing and orientation of the elements. At the heart of our algorithm is an optimization procedure that, from a coarse

  14. The use of mesh implants in vaginal prolapse surgery: Position ...

    African Journals Online (AJOL)

    sponsored training have also played a role in the adoption of these new techniques. .... surface area and weight of type 1 polypropylene mesh used in different kits, make ... such as bladder and rectal injury, and further recurrence. Realistic.

  15. Coarse-mesh rebalancing acceleration for eigenvalue problems

    International Nuclear Information System (INIS)

    Asaoka, T.; Nakahara, Y.; Miyasaka, S.

    1974-01-01

    The coarse-mesh rebalance method is adopted for Monte Carlo schemes for aiming at accelerating the convergence of a source iteration process. At every completion of the Monte Carlo game for one batch of neutron histories, the scaling factor for the neutron flux is calculated to achieve the neutron balance in each coarse-mesh zone into which the total system is divided. This rebalance factor is multiplied to the weight of each fission source neutron in the coarse-mesh zone for playing the next Monte Carlo game. The numerical examples have shown that the coarse-mesh rebalance Monte Carlo calculation gives a good estimate of the eigenvalue already after several batches with a negligible extra computer time compared to the standard Monte Carlo. 5 references. (U.S.)

  16. Design and Implementation of the MESH Services Platform

    NARCIS (Netherlands)

    Batteram, Harold J.; Bakker, John-Luc; Verhoosel, Jack P.C.; Diakov, N.K.

    1999-01-01

    Industry acceptance of TINA (Telecommunications Information Networking Architecture) will depend heavily on both the evaluation of working systems that implement this architecture, and on the experiences obtained during the design and implementation of these systems. During the MESH' (Multimedia

  17. Interoperable mesh and geometry tools for advanced petascale simulations

    International Nuclear Information System (INIS)

    Diachin, L; Bauer, A; Fix, B; Kraftcheck, J; Jansen, K; Luo, X; Miller, M; Ollivier-Gooch, C; Shephard, M S; Tautges, T; Trease, H

    2007-01-01

    SciDAC applications have a demonstrated need for advanced software tools to manage the complexities associated with sophisticated geometry, mesh, and field manipulation tasks, particularly as computer architectures move toward the petascale. The Center for Interoperable Technologies for Advanced Petascale Simulations (ITAPS) will deliver interoperable and interchangeable mesh, geometry, and field manipulation services that are of direct use to SciDAC applications. The premise of our technology development goal is to provide such services as libraries that can be used with minimal intrusion into application codes. To develop these technologies, we focus on defining a common data model and data-structure neutral interfaces that unify a number of different services such as mesh generation and improvement, front tracking, adaptive mesh refinement, shape optimization, and solution transfer operations. We highlight the use of several ITAPS services in SciDAC applications

  18. Kinetic mesh-free method for flutter prediction in turbomachines

    Indian Academy of Sciences (India)

    -based mesh-free method for unsteady flows. ... Council for Scientific and Industrial Research, National Aerospace Laboratories, Computational and Theoretical Fluid Dynamics Division, Bangalore 560 017, India; Engineering Mechanics Unit, ...

  19. Are patient specific meshes required for EIT head imaging?

    Science.gov (United States)

    Jehl, Markus; Aristovich, Kirill; Faulkner, Mayo; Holder, David

    2016-06-01

    Head imaging with electrical impedance tomography (EIT) is usually done with time-differential measurements, to reduce time-invariant modelling errors. Previous research suggested that more accurate head models improved image quality, but no thorough analysis has been done on the required accuracy. We propose a novel pipeline for creation of precise head meshes from magnetic resonance imaging and computed tomography scans, which was applied to four different heads. Voltages were simulated on all four heads for perturbations of different magnitude, haemorrhage and ischaemia, in five different positions and for three levels of instrumentation noise. Statistical analysis showed that reconstructions on the correct mesh were on average 25% better than on the other meshes. However, the stroke detection rates were not improved. We conclude that a generic head mesh is sufficient for monitoring patients for secondary strokes following head trauma.

  20. Finite element meshing approached as a global minimization process

    Energy Technology Data Exchange (ETDEWEB)

    WITKOWSKI,WALTER R.; JUNG,JOSEPH; DOHRMANN,CLARK R.; LEUNG,VITUS J.

    2000-03-01

    The ability to generate a suitable finite element mesh in an automatic fashion is becoming the key to being able to automate the entire engineering analysis process. However, placing an all-hexahedron mesh in a general three-dimensional body continues to be an elusive goal. The approach investigated in this research is fundamentally different from any other that is known of by the authors. A physical analogy viewpoint is used to formulate the actual meshing problem which constructs a global mathematical description of the problem. The analogy used was that of minimizing the electrical potential of a system charged particles within a charged domain. The particles in the presented analogy represent duals to mesh elements (i.e., quads or hexes). Particle movement is governed by a mathematical functional which accounts for inter-particles repulsive, attractive and alignment forces. This functional is minimized to find the optimal location and orientation of each particle. After the particles are connected a mesh can be easily resolved. The mathematical description for this problem is as easy to formulate in three-dimensions as it is in two- or one-dimensions. The meshing algorithm was developed within CoMeT. It can solve the two-dimensional meshing problem for convex and concave geometries in a purely automated fashion. Investigation of the robustness of the technique has shown a success rate of approximately 99% for the two-dimensional geometries tested. Run times to mesh a 100 element complex geometry were typically in the 10 minute range. Efficiency of the technique is still an issue that needs to be addressed. Performance is an issue that is critical for most engineers generating meshes. It was not for this project. The primary focus of this work was to investigate and evaluate a meshing algorithm/philosophy with efficiency issues being secondary. The algorithm was also extended to mesh three-dimensional geometries. Unfortunately, only simple geometries were tested

  1. AUTOMATIC MESH GENERATION OF 3—D GEOMETRIC MODELS

    Institute of Scientific and Technical Information of China (English)

    刘剑飞

    2003-01-01

    In this paper the presentation of the ball-packing method is reviewed, and a schemeto generate mesh for complex 3-D geometric models is given, which consists of 4 steps: (1) createnodes in 3-D models by ball-packing method, (2) connect nodes to generate mesh by 3-D Delaunaytriangulation, (3) retrieve the boundary of the model after Delaunay triangulation, (4) improve themesh.

  2. Feedforward Control of Gear Mesh Vibration Using Piezoelectric Actuators

    Directory of Open Access Journals (Sweden)

    Gerald T. Montague

    1994-01-01

    Full Text Available This article presents a novel means for suppressing gear mesh related vibrations. The key components in this approach are piezoelectric actuators and a high-frequency, analog feed forward controller. Test results are presented and show up to a 70% reduction in gear mesh acceleration and vibration control up to 4500 Hz. The principle of the approach is explained by an analysis of a harmonically excited, general linear vibratory system.

  3. Distributed Cross-layer Monitoring in Wireless Mesh Networks

    OpenAIRE

    Panmin, Ye; Yong,

    2009-01-01

    Wireless mesh networks has rapid development over the last few years. However, due to properties such as distributed infrastructure and interference, which strongly affect the performance of wireless mesh networks, developing technology has to face the challenge of architecture and protocol design issues. Traditional layered protocols do not function efficiently in multi-hop wireless environments. To get deeper understanding on interaction of the layered protocols and optimize the performance...

  4. Mesh Generation via Local Bisection Refinement of Triangulated Grids

    Science.gov (United States)

    2015-06-01

    Science and Technology Organisation DSTO–TR–3095 ABSTRACT This report provides a comprehensive implementation of an unstructured mesh generation method...and Technology Organisation 506 Lorimer St, Fishermans Bend, Victoria 3207, Australia Telephone: 1300 333 362 Facsimile: (03) 9626 7999 c© Commonwealth...their behaviour is critically linked to Maubach’s method and the data structures N and T . The top- level mesh refinement algorithm is also presented

  5. Two-dimensional isostatic meshes in the finite element method

    OpenAIRE

    Martínez Marín, Rubén; Samartín, Avelino

    2002-01-01

    In a Finite Element (FE) analysis of elastic solids several items are usually considered, namely, type and shape of the elements, number of nodes per element, node positions, FE mesh, total number of degrees of freedom (dot) among others. In this paper a method to improve a given FE mesh used for a particular analysis is described. For the improvement criterion different objective functions have been chosen (Total potential energy and Average quadratic error) and the number of nodes and dof's...

  6. A general boundary capability embedded in an orthogonal mesh

    International Nuclear Information System (INIS)

    Hewett, D.W.; Yu-Jiuan Chen

    1995-01-01

    The authors describe how they hold onto orthogonal mesh discretization when dealing with curved boundaries. Special difference operators were constructed to approximate numerical zones split by the domain boundary; the operators are particularly simple for this rectangular mesh. The authors demonstrated that this simple numerical approach, termed Dynamic Alternating Direction Implicit, turned out to be considerably more efficient than more complex grid-adaptive algorithms that were tried previously

  7. Vaginal Approaches Using Synthetic Mesh to Treat Pelvic Organ Prolapse

    OpenAIRE

    Moon, Jei Won; Chae, Hee Dong

    2016-01-01

    Pelvic organ prolapse (POP) is a very common condition in elderly women. In women with POP, a sacrocolpopexy or a vaginal hysterectomy with anterior and posterior colporrhaphy has long been considered as the gold standard of treatment. However, in recent decades, the tendency to use a vaginal approach with mesh for POP surgery has been increasing. A vaginal approach using mesh has many advantages, such as its being less invasive than an abdominal approach and easier to do than a laparoscopic ...

  8. Mesh joinery: a method for building fabricable structures

    OpenAIRE

    Cignoni, Paolo; Pietroni, Nico; Malomo, Luigi; Scopigno, Roberto

    2015-01-01

    Mesh joinery is an innovative method to produce illustrative shape approximations suitable for fabrication. Mesh joinery is capable of producing complex fabricable structures in an efficient and visually pleasing manner. We represent an input geometry as a set of planar pieces arranged to compose a rigid structure by exploiting an efficient slit mechanism. Since slices are planar, a standard 2D cutting system is sufficient to fabricate them.

  9. Incisional hernia prevention using a cyanoacrilate-fixed retrofascial mesh.

    Science.gov (United States)

    Hoyuela, Carlos; Juvany, Montserrat; Trias, Miquel; Ardid, Jordi; Martrat, Antoni

    2018-01-01

    The rate of incisional hernia in high-risk patients (obesity, cancer, etc.) is high, even in laparoscopic surgery. The aim of this study is to evaluate the safety of the use of cyanoacrylate fixed prophylactic meshes in the assistance incision in overweight or obese patients undergoing laparoscopic colorectal surgery. A prospective, non-randomized cohort study of patients undergoing elective laparoscopic resection for colorectal cancer between January 2013 and March 2016 was performed. Those with a body mass index greater than 25kg / m 2 were evaluated to implant a prophylactic meshes fixed with cyanoacrylate (Histoacryl®) as reinforcement of the assistance incision. 52 patients were analyzed (mean body mass index: 28.4±2kg / m 2 ). Prophylactic meshes was implanted in 15 patients. The time to put the mesh in place was always less than 5minutes. There was no significant difference in wound infection rate (12% vs. 10%). No mesh had to be explanted. Although the mean follow-up was shorter (14.1±4 vs. 22.3±9 months), there were no incisional hernia in the mesh group. On the other hand, in the non-mesh group, 1 acute evisceration (2.7%) and 4 incisional hernia of the assistance incision were observed (10.8%). There were no significant differences between groups regarding trocar incisional hernia (6.6 vs. 5.4%). The implantation of a reinforcement prophylactic mesh in overweight or obese patients undergoing laparoscopic colorectal surgery is safe and seems to reduce the short-term rate of incisional hernia. Fixation with cyanoacrylate is a rapid method that facilitates the procedure without additional complications. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse.

    Science.gov (United States)

    Pushkar, Dmitry Y; Vasilchenko, Mikhail I; Kasyan, George R

    2013-10-01

    Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy.

  11. An Implementation and Parallelization of the Scale Space Meshing Algorithm

    Directory of Open Access Journals (Sweden)

    Julie Digne

    2015-11-01

    Full Text Available Creating an interpolating mesh from an unorganized set of oriented points is a difficult problemwhich is often overlooked. Most methods focus indeed on building a watertight smoothed meshby defining some function whose zero level set is the surface of the object. However in some casesit is crucial to build a mesh that interpolates the points and does not fill the acquisition holes:either because the data are sparse and trying to fill the holes would create spurious artifactsor because the goal is to explore visually the data exactly as they were acquired without anysmoothing process. In this paper we detail a parallel implementation of the Scale-Space Meshingalgorithm, which builds on the scale-space framework for reconstructing a high precision meshfrom an input oriented point set. This algorithm first smoothes the point set, producing asingularity free shape. It then uses a standard mesh reconstruction technique, the Ball PivotingAlgorithm, to build a mesh from the smoothed point set. The final step consists in back-projecting the mesh built on the smoothed positions onto the original point set. The result ofthis process is an interpolating, hole-preserving surface mesh reconstruction.

  12. Thermal Analysis of Concrete Storage Cask with Bird Screen Meshes

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ju-Chan; Bang, K.S.; Yu, S.H.; Cho, S.S.; Choi, W.S. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    In this study, a thermal analysis of the cask with bird screen meshes has been performed using a porous media model. The overpack consists of a structural material, a concrete shielding, and a ventilation system. Heat is removed from the cask to the environment by a passive means only. Air inlet and outlet ducts are installed at the bottom and top of the cask for a ventilation system. Bird screen meshes are installed at the air inlet and outlet ducts to inhibit intrusion of debris from the external environment. The presence of this screens introduce an additional resistance to air flow through the ducts. Five types of meshes for bird screen were considered in this study. The bird screen meshes at the inlet and outlet vents reduce the open area for flow by about 44 - 79 %. Flow resistance coefficients for porous media model were deduced from the fluid flow analysis of bird screen meshes. Thermal analyses for the concrete cask have been carried out using a porous media model. The analysis results agreed well with the test results. Therefore, it was shown that the porous media model for the screen mesh was established to estimate the cask temperatures.

  13. Adaptive mesh refinement for shocks and material interfaces

    Energy Technology Data Exchange (ETDEWEB)

    Dai, William Wenlong [Los Alamos National Laboratory

    2010-01-01

    There are three kinds of adaptive mesh refinement (AMR) in structured meshes. Block-based AMR sometimes over refines meshes. Cell-based AMR treats cells cell by cell and thus loses the advantage of the nature of structured meshes. Patch-based AMR is intended to combine advantages of block- and cell-based AMR, i.e., the nature of structured meshes and sharp regions of refinement. But, patch-based AMR has its own difficulties. For example, patch-based AMR typically cannot preserve symmetries of physics problems. In this paper, we will present an approach for a patch-based AMR for hydrodynamics simulations. The approach consists of clustering, symmetry preserving, mesh continuity, flux correction, communications, management of patches, and load balance. The special features of this patch-based AMR include symmetry preserving, efficiency of refinement across shock fronts and material interfaces, special implementation of flux correction, and patch management in parallel computing environments. To demonstrate the capability of the AMR framework, we will show both two- and three-dimensional hydrodynamics simulations with many levels of refinement.

  14. 3D Mesh Compression and Transmission for Mobile Robotic Applications

    Directory of Open Access Journals (Sweden)

    Bailin Yang

    2016-01-01

    Full Text Available Mobile robots are useful for environment exploration and rescue operations. In such applications, it is crucial to accurately analyse and represent an environment, providing appropriate inputs for motion planning in order to support robot navigation and operations. 2D mapping methods are simple but cannot handle multilevel or multistory environments. To address this problem, 3D mapping methods generate structural 3D representations of the robot operating environment and its objects by 3D mesh reconstruction. However, they face the challenge of efficiently transmitting those 3D representations to system modules for 3D mapping, motion planning, and robot operation visualization. This paper proposes a quality-driven mesh compression and transmission method to address this. Our method is efficient, as it compresses a mesh by quantizing its transformed vertices without the need to spend time constructing an a-priori structure over the mesh. A visual distortion function is developed to govern the level of quantization, allowing mesh transmission to be controlled under different network conditions or time constraints. Our experiments demonstrate how the visual quality of a mesh can be manipulated by the visual distortion function.

  15. Enriching Triangle Mesh Animations with Physically Based Simulation.

    Science.gov (United States)

    Li, Yijing; Xu, Hongyi; Barbic, Jernej

    2017-10-01

    We present a system to combine arbitrary triangle mesh animations with physically based Finite Element Method (FEM) simulation, enabling control over the combination both in space and time. The input is a triangle mesh animation obtained using any method, such as keyframed animation, character rigging, 3D scanning, or geometric shape modeling. The input may be non-physical, crude or even incomplete. The user provides weights, specified using a minimal user interface, for how much physically based simulation should be allowed to modify the animation in any region of the model, and in time. Our system then computes a physically-based animation that is constrained to the input animation to the amount prescribed by these weights. This permits smoothly turning physics on and off over space and time, making it possible for the output to strictly follow the input, to evolve purely based on physically based simulation, and anything in between. Achieving such results requires a careful combination of several system components. We propose and analyze these components, including proper automatic creation of simulation meshes (even for non-manifold and self-colliding undeformed triangle meshes), converting triangle mesh animations into animations of the simulation mesh, and resolving collisions and self-collisions while following the input.

  16. Parallel adaptation of general three-dimensional hybrid meshes

    International Nuclear Information System (INIS)

    Kavouklis, Christos; Kallinderis, Yannis

    2010-01-01

    A new parallel dynamic mesh adaptation and load balancing algorithm for general hybrid grids has been developed. The meshes considered in this work are composed of four kinds of elements; tetrahedra, prisms, hexahedra and pyramids, which poses a challenge to parallel mesh adaptation. Additional complexity imposed by the presence of multiple types of elements affects especially data migration, updates of local data structures and interpartition data structures. Efficient partition of hybrid meshes has been accomplished by transforming them to suitable graphs and using serial graph partitioning algorithms. Communication among processors is based on the faces of the interpartition boundary and the termination detection algorithm of Dijkstra is employed to ensure proper flagging of edges for refinement. An inexpensive dynamic load balancing strategy is introduced to redistribute work load among processors after adaptation. In particular, only the initial coarse mesh, with proper weighting, is balanced which yields savings in computation time and relatively simple implementation of mesh quality preservation rules, while facilitating coarsening of refined elements. Special algorithms are employed for (i) data migration and dynamic updates of the local data structures, (ii) determination of the resulting interpartition boundary and (iii) identification of the communication pattern of processors. Several representative applications are included to evaluate the method.

  17. Thermal Analysis of Concrete Storage Cask with Bird Screen Meshes

    International Nuclear Information System (INIS)

    Lee, Ju-Chan; Bang, K.S.; Yu, S.H.; Cho, S.S.; Choi, W.S.

    2016-01-01

    In this study, a thermal analysis of the cask with bird screen meshes has been performed using a porous media model. The overpack consists of a structural material, a concrete shielding, and a ventilation system. Heat is removed from the cask to the environment by a passive means only. Air inlet and outlet ducts are installed at the bottom and top of the cask for a ventilation system. Bird screen meshes are installed at the air inlet and outlet ducts to inhibit intrusion of debris from the external environment. The presence of this screens introduce an additional resistance to air flow through the ducts. Five types of meshes for bird screen were considered in this study. The bird screen meshes at the inlet and outlet vents reduce the open area for flow by about 44 - 79 %. Flow resistance coefficients for porous media model were deduced from the fluid flow analysis of bird screen meshes. Thermal analyses for the concrete cask have been carried out using a porous media model. The analysis results agreed well with the test results. Therefore, it was shown that the porous media model for the screen mesh was established to estimate the cask temperatures

  18. The quasidiffusion method for transport problems on unstructured meshes

    Science.gov (United States)

    Wieselquist, William A.

    2009-06-01

    In this work, we develop a quasidiffusion (QD) method for solving radiation transport problems on unstructured quadrilateral meshes in 2D Cartesian geometry, for example hanging-node meshes from adaptive mesh refinement (AMR) applications or skewed quadrilateral meshes from radiation hydrodynamics with Lagrangian meshing. The main result of the work is a new low-order quasidiffusion (LOQD) discretization on arbitrary quadrilaterals and a strategy for the efficient iterative solution which uses Krylov methods and incomplete LU factorization (ILU) preconditioning. The LOQD equations are a non-symmetric set of first-order PDEs that in second-order form resembles convection- diffusion with a diffusion tensor, with the difference that the LOQD equations contain extra cross-derivative terms. Our finite volume (FV) discretization of the LOQD equations is compared with three LOQD discretizations from literature. We then present a conservative, short characteristics discretization based on subcell balances (SCSB) that uses polynomial exponential moments to achieve robust behavior in various limits (e.g. small cells and voids) and is second- order accurate in space. A linear representation of the isotropic component of the scattering source based on face-average and cell-average scalar fluxes is also proposed and shown to be effective in some problems. In numerical tests, our QD method with linear scattering source representation shows some advantages compared to other transport methods. We conclude with avenues for future research and note that this QD method may easily be extended to arbitrary meshes in 3D Cartesian geometry.

  19. An optimization-based framework for anisotropic simplex mesh adaptation

    Science.gov (United States)

    Yano, Masayuki; Darmofal, David L.

    2012-09-01

    We present a general framework for anisotropic h-adaptation of simplex meshes. Given a discretization and any element-wise, localizable error estimate, our adaptive method iterates toward a mesh that minimizes error for a given degrees of freedom. Utilizing mesh-metric duality, we consider a continuous optimization problem of the Riemannian metric tensor field that provides an anisotropic description of element sizes. First, our method performs a series of local solves to survey the behavior of the local error function. This information is then synthesized using an affine-invariant tensor manipulation framework to reconstruct an approximate gradient of the error function with respect to the metric tensor field. Finally, we perform gradient descent in the metric space to drive the mesh toward optimality. The method is first demonstrated to produce optimal anisotropic meshes minimizing the L2 projection error for a pair of canonical problems containing a singularity and a singular perturbation. The effectiveness of the framework is then demonstrated in the context of output-based adaptation for the advection-diffusion equation using a high-order discontinuous Galerkin discretization and the dual-weighted residual (DWR) error estimate. The method presented provides a unified framework for optimizing both the element size and anisotropy distribution using an a posteriori error estimate and enables efficient adaptation of anisotropic simplex meshes for high-order discretizations.

  20. Repair of giant postlaminectomy pseudomeningocele with fast-resorbing polymer mesh: technical report of 2 cases.

    Science.gov (United States)

    Alvarez, Carlos M; Urakov, Timur M; Vanni, Steven

    2018-03-01

    Pseudomeningocele is a rare but well-known complication of lumbar spine surgery, which arises in 0.068%-0.1% of individuals in large series of patients undergoing laminectomy and in up to 2% of patients with postlaminectomy symptoms. In symptomatic pseudomeningoceles, surgical reexploration and repair of the dural defect are typically necessary. Whereas the goals of pseudomeningocele repair, which are extirpation of the pseudomeningocele cavity and elimination of extradural dead space, can typically be achieved by primary closure performed using nonabsorbable sutures, giant pseudomeningoceles (> 8 cm) can require more elaborate repair in which fibrin glues, dural substitute, myofascial flaps, or all of the above are used. The authors present 2 cases of postsurgical symptomatic giant pseudomeningoceles that were repaired using a fast-resorbing polymer mesh-supported reconstruction technique, which is described here for the first time.

  1. Combined in vivo and ex vivo analysis of mesh mechanics in a porcine hernia model.

    Science.gov (United States)

    Kahan, Lindsey G; Lake, Spencer P; McAllister, Jared M; Tan, Wen Hui; Yu, Jennifer; Thompson, Dominic; Brunt, L Michael; Blatnik, Jeffrey A

    2018-02-01

    Hernia meshes exhibit variability in mechanical properties, and their mechanical match to tissue has not been comprehensively studied. We used an innovative imaging model of in vivo strain tracking and ex vivo mechanical analysis to assess effects of mesh properties on repaired abdominal walls in a porcine model. We hypothesized that meshes with dissimilar mechanical properties compared to native tissue would alter abdominal wall mechanics more than better-matched meshes. Seven mini-pigs underwent ventral hernia creation and subsequent open repair with one of two heavyweight polypropylene meshes. Following mesh implantation with attached radio-opaque beads, fluoroscopic images were taken at insufflation pressures from 5 to 30 mmHg on postoperative days 0, 7, and 28. At 28 days, animals were euthanized and ex vivo mechanical testing performed on full-thickness samples across repaired abdominal walls. Testing was conducted on 13 mini-pig controls, and on meshes separately. Stiffness and anisotropy (the ratio of stiffness in the transverse versus craniocaudal directions) were assessed. 3D reconstructions of repaired abdominal walls showed stretch patterns. As pressure increased, both meshes expanded, with no differences between groups. Over time, meshes contracted 17.65% (Mesh A) and 0.12% (Mesh B; p = 0.06). Mesh mechanics showed that Mesh A deviated from anisotropic native tissue more than Mesh B. Compared to native tissue, Mesh A was stiffer both transversely and craniocaudally. Explanted repaired abdominal walls of both treatment groups were stiffer than native tissue. Repaired tissue became less anisotropic over time, as mesh properties prevailed over native abdominal wall properties. This technique assessed 3D stretch at the mesh level in vivo in a porcine model. While the abdominal wall expanded, mesh-ingrown areas contracted, potentially indicating stresses at mesh edges. Ex vivo mechanics demonstrate that repaired tissue adopts mesh properties, suggesting

  2. A Rare Complication of Composite Dual Mesh: Migration and Enterocutaneous Fistula Formation

    Directory of Open Access Journals (Sweden)

    Ozgur Bostanci

    2015-01-01

    Full Text Available Introduction. Mesh is commonly employed for abdominal hernia repair because it ensures a low recurrence rate. However, enterocutaneous fistula due to mesh migration can occur as a very rare, late complication, for which diagnosis is very difficult. Presentation of Case. Here we report the case of an enterocutaneous fistula due to late mesh migration in a mentally retarded, diabetic, 35-year-old male after umbilical hernia repair with composite dual mesh in 2010. Discussion. Mesh is a foreign substance, because of that some of the complications including hematoma, seroma, foreign body reaction, organ damage, infection, mesh rejection, and fistula formation may occur after implantation of the mesh. In the literature, most cases of mesh-associated enterocutaneous fistula due to migration involved polypropylene meshes. Conclusion. This case serves as a reminder of migration of composite dual meshes.

  3. Anisotropic mesh adaptation for marine ice-sheet modelling

    Science.gov (United States)

    Gillet-Chaulet, Fabien; Tavard, Laure; Merino, Nacho; Peyaud, Vincent; Brondex, Julien; Durand, Gael; Gagliardini, Olivier

    2017-04-01

    Improving forecasts of ice-sheets contribution to sea-level rise requires, amongst others, to correctly model the dynamics of the grounding line (GL), i.e. the line where the ice detaches from its underlying bed and goes afloat on the ocean. Many numerical studies, including the intercomparison exercises MISMIP and MISMIP3D, have shown that grid refinement in the GL vicinity is a key component to obtain reliable results. Improving model accuracy while maintaining the computational cost affordable has then been an important target for the development of marine icesheet models. Adaptive mesh refinement (AMR) is a method where the accuracy of the solution is controlled by spatially adapting the mesh size. It has become popular in models using the finite element method as they naturally deal with unstructured meshes, but block-structured AMR has also been successfully applied to model GL dynamics. The main difficulty with AMR is to find efficient and reliable estimators of the numerical error to control the mesh size. Here, we use the estimator proposed by Frey and Alauzet (2015). Based on the interpolation error, it has been found effective in practice to control the numerical error, and has some flexibility, such as its ability to combine metrics for different variables, that makes it attractive. Routines to compute the anisotropic metric defining the mesh size have been implemented in the finite element ice flow model Elmer/Ice (Gagliardini et al., 2013). The mesh adaptation is performed using the freely available library MMG (Dapogny et al., 2014) called from Elmer/Ice. Using a setup based on the inter-comparison exercise MISMIP+ (Asay-Davis et al., 2016), we study the accuracy of the solution when the mesh is adapted using various variables (ice thickness, velocity, basal drag, …). We show that combining these variables allows to reduce the number of mesh nodes by more than one order of magnitude, for the same numerical accuracy, when compared to uniform mesh

  4. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  5. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  6. A virtual surgical training system that simulates cutting of soft tissue using a modified pre-computed elastic model.

    Science.gov (United States)

    Toe, Kyaw Kyar; Huang, Weimin; Yang, Tao; Duan, Yuping; Zhou, Jiayin; Su, Yi; Teo, Soo-Kng; Kumar, Selvaraj Senthil; Lim, Calvin Chi-Wan; Chui, Chee Kong; Chang, Stephen

    2015-08-01

    This work presents a surgical training system that incorporates cutting operation of soft tissue simulated based on a modified pre-computed linear elastic model in the Simulation Open Framework Architecture (SOFA) environment. A precomputed linear elastic model used for the simulation of soft tissue deformation involves computing the compliance matrix a priori based on the topological information of the mesh. While this process may require a few minutes to several hours, based on the number of vertices in the mesh, it needs only to be computed once and allows real-time computation of the subsequent soft tissue deformation. However, as the compliance matrix is based on the initial topology of the mesh, it does not allow any topological changes during simulation, such as cutting or tearing of the mesh. This work proposes a way to modify the pre-computed data by correcting the topological connectivity in the compliance matrix, without re-computing the compliance matrix which is computationally expensive.

  7. 3D face analysis by using Mesh-LBP feature

    Science.gov (United States)

    Wang, Haoyu; Yang, Fumeng; Zhang, Yuming; Wu, Congzhong

    2017-11-01

    Objective: Face Recognition is one of the widely application of image processing. Corresponding two-dimensional limitations, such as the pose and illumination changes, to a certain extent restricted its accurate rate and further development. How to overcome the pose and illumination changes and the effects of self-occlusion is the research hotspot and difficulty, also attracting more and more domestic and foreign experts and scholars to study it. 3D face recognition fusing shape and texture descriptors has become a very promising research direction. Method: Our paper presents a 3D point cloud based on mesh local binary pattern grid (Mesh-LBP), then feature extraction for 3D face recognition by fusing shape and texture descriptors. 3D Mesh-LBP not only retains the integrity of the 3D geometry, is also reduces the need for recognition process of normalization steps, because the triangle Mesh-LBP descriptor is calculated on 3D grid. On the other hand, in view of multi-modal consistency in face recognition advantage, construction of LBP can fusing shape and texture information on Triangular Mesh. In this paper, some of the operators used to extract Mesh-LBP, Such as the normal vectors of the triangle each face and vertex, the gaussian curvature, the mean curvature, laplace operator and so on. Conclusion: First, Kinect devices obtain 3D point cloud face, after the pretreatment and normalization, then transform it into triangular grid, grid local binary pattern feature extraction from face key significant parts of face. For each local face, calculate its Mesh-LBP feature with Gaussian curvature, mean curvature laplace operator and so on. Experiments on the our research database, change the method is robust and high recognition accuracy.

  8. Using virtual ridge augmentation and 3D printing to fabricate a titanium mesh positioning device: A novel technique letter.

    Science.gov (United States)

    Al-Ardah, Aladdin; Alqahtani, Nasser; AlHelal, Abdulaziz; Goodacre, Brian; Swamidass, Rajesh; Garbacea, Antoanela; Lozada, Jaime

    2018-05-02

    This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.

  9. Efficacy of an absorbable mesh in keeping the small bowel out of the human pelvis following surgery

    International Nuclear Information System (INIS)

    Devereux, D.F.; Chandler, J.J.; Eisenstat, T.; Zinkin, L.

    1988-01-01

    Patients with pelvic malignancies frequently require postoperative radiation therapy either as adjunctive or palliative treatment. Tumoricidal doses, however, are frequently associated with small-bowel damage. Animal experiments demonstrated tolerance to high-dose radiation therapy and protection from radiation enteritis by use of an absorbable polymer polyglycolic acid (PGA) that is used as an intestinal sling to elevate the small bowel away from the operated site. Sixty patients (42 with rectal carcinomas and 18 with gynecologic malignancies) underwent surgical treatment that included the intestinal sling procedure. Postoperative radiation was begun within three weeks following surgery and patients received a mean approximating 5500 rads in fractionated doses. A mean follow-up time of 28 months has not revealed a single case of radiation enteritis (by either contrast studies or physiologic studies) or PGA mesh-related complications. The authors believe that this surgical technique should be employed in patients who may require postoperative radiation treatment for pelvic malignancy

  10. Prospective, Randomized Study on the Use of a Prosthetic Mesh for Prevention of Parastomal Hernia of Permanent Colostomy.

    Science.gov (United States)

    Vierimaa, Mika; Klintrup, Kai; Biancari, Fausto; Victorzon, Mikael; Carpelan-Holmström, Monika; Kössi, Jyrki; Kellokumpu, Ilmo; Rauvala, Erkki; Ohtonen, Pasi; Mäkelä, Jyrki; Rautio, Tero

    2015-10-01

    Prophylactic placement of a mesh has been suggested to prevent parastomal hernia, but evidence to support this approach is scarce. The aim of this study was to evaluate whether laparoscopic placement of a prophylactic, dual-component, intraperitoneal onlay mesh around a colostomy is safe and prevents parastomal hernia formation after laparoscopic abdominoperineal resection. This is a prospective, multicenter, randomized controlled clinical trial. This study was conducted at 2 university and 3 central Finnish hospitals. From 2010 to 2013, 83 patients undergoing laparoscopic abdominoperineal resection for rectal cancer were recruited. After withdrawals and exclusions, the outcome of 70 patients, 35 patients in each study group, could be examined. In the intervention group, an end colostomy was created with placement of a intraperitoneal, dual-component onlay mesh and compared with a group with a traditional stoma. The main outcome measures were the incidence of clinically and radiologically detected parastomal hernias and their extent 12 months after surgery. Stoma-related morbidity and the need for surgical repair of parastomal hernia were secondary outcome measures. Parastomal hernia was observed by clinical inspection in 5 intervention patients (14.3%) and in 12 control patients (32.3%; p = 0.049). Surgical repair of parastomal hernia was performed in 1 control patient (3.2%) and in none of the patients in the intervention group. CT detected parastomal hernia in 18 intervention patients (51.4%) and in 17 control patients (53.1%; p = 1.00). The extent of hernias was similar according to European Hernia Society classification (p = 0.41). Colostomy-related morbidity (32.3% vs 14.3%; p = 0.140) did not differ between the study groups. The study was limited by its small size and short follow-up time. Prophylactic laparoscopic placement of intraperitoneal onlay mesh does not significantly reduce the overall risk of radiologically detected parastomal hernia after

  11. One-year outcome of concurrent anterior and posterior transvaginal mesh surgery for treatment of advanced urogenital prolapse: case series.

    Science.gov (United States)

    Lo, Tsia-Shu

    2010-01-01

    To estimate the safety and efficacy of performing concurrent anterior and posterior transvaginal mesh surgery using a commercially available kit (Gynecare PROLIFT Pelvic Floor Repair System; Ethicon, Inc., Somerville, NJ) for treatment of advanced urogenital prolapse (stage III or higher, Pelvic Organ Prolapse Quantification [POP-Q] system staging). Case control series study (Canadian Task Force classification II-2). Medical school-affiliated hospital. Forty-three patients with severe prolapse, POP-Q stage III (n=23) or IV (n=20), underwent surgery and were followed up for more than 1 year. In patients with any prolapse greater than stage I, surgery were considered to have functional failure. The Surgical Satisfaction Questionnaire was used for subjective evaluation at 1 year postoperatively. Extensive pelvic reconstructive procedures were primarily performed using a combination of the PROLIFT anterior and posterior pelvic systems (i.e., similar to sparing the intermediate section of the PROLIFT total pelvic system). The concurrent pelvic surgery included sequential vaginal total hysterectomy, perineorrhaphy, and suburethra sling, if indicated. Additional subjective and objective evaluations included POP-Q staging, urodynamic assessment, and preoperative and 12-month postoperative questionnaires. Objective and subjective data were available for 42 patients. The subjective cure rate and objective success rate for prolapse at 12-month follow-up was 95.2% and 97.6%, respectively. Mean follow-up was 15.7 months, operation time was 79.2 minutes, operative blood loss was 109.1 mL, and postoperative hospital stay was 4.1 days. Intraoperative and postoperative complications were minor. All patients voided spontaneously before discharge. One mesh extrusion, no wound defective healing, and no rejection were observed. Two patients developed asymptomatic recurrent rectocele (stage II, POP-Q staging) that required no surgical intervention. Urodynamic parameters related to

  12. Vaginal native tissue repair versus transvaginal mesh repair for apical prolapse: how utilizing different methods of analysis affects the estimated trade-off between reoperation for mesh exposure/erosion and reoperation for recurrent prolapse.

    Science.gov (United States)

    Dieter, Alexis A; Willis-Gray, Marcella G; Weidner, Alison C; Visco, Anthony G; Myers, Evan R

    2015-05-01

    Informed decision-making about optimal surgical repair of apical prolapse with vaginal native tissue (NT) versus transvaginal mesh (TVM) requires understanding the balance between the potential "harm" of mesh-related complications and the potential "benefit" of reducing prolapse recurrence. Synthesis of data from observational studies is required and the current literature shows that the average follow-up for NT repair is significantly longer than for TVM repair. We examined this harm/benefit balance. We hypothesized that using different methods of analysis to incorporate follow-up time would affect the balance of outcomes. We used a Markov state transition model to estimate the cumulative 24-month probabilities of reoperation for mesh exposure/erosion or for recurrent prolapse after either NT or TVM repair. We used four different analytic approaches to estimate probability distributions ranging from simple pooled proportions to a random effects meta-analysis using study-specific events per patient-time. As variability in follow-up time was accounted for better, the balance of outcomes became more uncertain. For TVM repair, the incremental ratio of number of operations for mesh exposure/erosion per single reoperation for recurrent prolapse prevented increased progressively from 1.4 to over 100 with more rigorous analysis methods. The most rigorous analysis showed a 70% probability that TVM would result in more operations for recurrent prolapse repair than NT. Based on the best available evidence, there is considerable uncertainty about the harm/benefit trade-off between NT and TVM for apical prolapse repair. Future studies should incorporate time-to-event analyses, with greater standardization of reporting, in order to better inform decision-making.

  13. Facial reconstruction using polypropylene mesh after resection of maxillary ossifying fibroma

    Directory of Open Access Journals (Sweden)

    R. Soesanto

    2012-09-01

    Full Text Available Background: Ossifying fibroma is a variant of fibrous dysplasia and catagorized as osteofibrosis lesion. It commonly affects long bones but occasionally involves jaws. Mandible affected more common than maxilla. The treatment of ossifying fibroma include excision and resection. Excision of lesion and resection of maxilla could cause facial defect which cannot be reconstructed with bone graft. Purpose: The aim of this case report is to report the potential use of polypropylene mesh in facial reconstruction after hemimaxillectomy in patients diagnosed with ossifying fibroma of the maxilla. Case: A 17-years-old female patient came to Oral and Maxillofacial Surgery clinic, Dental Hospital, Faculty of Dentistry, Airlangga University, with chief complaint of swelling in the upper left cheek of 2 years duration which was not related to any history of toothache. Patient also complained of the itchiness and pain on the swelling area occasionally as well as salty discharge from the mass. The FNA was done and the citology result indicated a benign mesenchimal tumor. Incisonal biopsy was subsequently performed and the histopathology report confirmed the diagnosis of cementifying fibroma. Case management: Left hemimaxillectomy was done, and post surgical defect in the facial and buccal aspect was immediately reconstructed using three layers of polypropylene mesh. On follow-up, eleven months post-operatively, the patient was well and there was no facial deformity or asymmetry. Conclusion: Polypropylene mesh is a potential material for facial reconstruction as it can reduce the risk of facial deformity after hemimaxillectomy of patients with tumor of the maxilla.Latar belakang: Ossifying fibroma merupakan varian dari fibrous dysplasia dan termasuk di dalam kategori lesi osteofibrosis. Umumnya mengenai tulang panjang tetapi dapat juga mengenai rahang dan lebih banyak menyerang tulang mandibula dibanding maksila. Perawatan ossifying fibroma dilakukan dengan

  14. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  15. Mesh Network Architecture for Enabling Inter-Spacecraft Communication

    Science.gov (United States)

    Becker, Christopher; Merrill, Garrick

    2017-01-01

    To enable communication between spacecraft operating in a formation or small constellation, a mesh network architecture was developed and tested using a time division multiple access (TDMA) communication scheme. The network is designed to allow for the exchange of telemetry and other data between spacecraft to enable collaboration between small spacecraft. The system uses a peer-to-peer topology with no central router, so that it does not have a single point of failure. The mesh network is dynamically configurable to allow for addition and subtraction of new spacecraft into the communication network. Flight testing was performed using an unmanned aerial system (UAS) formation acting as a spacecraft analogue and providing a stressing environment to prove mesh network performance. The mesh network was primarily devised to provide low latency, high frequency communication but is flexible and can also be configured to provide higher bandwidth for applications desiring high data throughput. The network includes a relay functionality that extends the maximum range between spacecraft in the network by relaying data from node to node. The mesh network control is implemented completely in software making it hardware agnostic, thereby allowing it to function with a wide variety of existing radios and computing platforms..

  16. Parallel Block Structured Adaptive Mesh Refinement on Graphics Processing Units

    Energy Technology Data Exchange (ETDEWEB)

    Beckingsale, D. A. [Atomic Weapons Establishment (AWE), Aldermaston (United Kingdom); Gaudin, W. P. [Atomic Weapons Establishment (AWE), Aldermaston (United Kingdom); Hornung, R. D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gunney, B. T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gamblin, T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Herdman, J. A. [Atomic Weapons Establishment (AWE), Aldermaston (United Kingdom); Jarvis, S. A. [Atomic Weapons Establishment (AWE), Aldermaston (United Kingdom)

    2014-11-17

    Block-structured adaptive mesh refinement is a technique that can be used when solving partial differential equations to reduce the number of zones necessary to achieve the required accuracy in areas of interest. These areas (shock fronts, material interfaces, etc.) are recursively covered with finer mesh patches that are grouped into a hierarchy of refinement levels. Despite the potential for large savings in computational requirements and memory usage without a corresponding reduction in accuracy, AMR adds overhead in managing the mesh hierarchy, adding complex communication and data movement requirements to a simulation. In this paper, we describe the design and implementation of a native GPU-based AMR library, including: the classes used to manage data on a mesh patch, the routines used for transferring data between GPUs on different nodes, and the data-parallel operators developed to coarsen and refine mesh data. We validate the performance and accuracy of our implementation using three test problems and two architectures: an eight-node cluster, and over four thousand nodes of Oak Ridge National Laboratory’s Titan supercomputer. Our GPU-based AMR hydrodynamics code performs up to 4.87× faster than the CPU-based implementation, and has been scaled to over four thousand GPUs using a combination of MPI and CUDA.

  17. Influence of reinforcement mesh configuration for improvement of concrete durability

    Science.gov (United States)

    Pan, Chong-gen; Jin, Wei-liang; Mao, Jiang-hong; Zhang, Hua; Sun, Li-hao; Wei, Dong

    2017-10-01

    Steel bar in concrete structures under harsh environmental conditions, such as chlorine corrosion, seriously affects its service life. Bidirectional electromigration rehabilitation (BIEM) is a new method of repair technology for reinforced concrete structures in such chloride corrosion environments. By applying the BIEM, chloride ions can be removed from the concrete and the migrating corrosion inhibit can be moved to the steel surface. In conventional engineering, the concrete structure is often configured with a multi-layer steel mesh. However, the effect of the BIEM in such structures has not yet been investigated. In this paper, the relevant simulation test is carried out to study the migration law of chloride ions and the migrating corrosion inhibitor in a concrete specimen with complex steel mesh under different energizing modes. The results show that the efficiency of the BIEM increases 50% in both the monolayer steel mesh and the double-layer steel mesh. By using the single-sided BIEM, 87% of the chloride ions are removed from the steel surface. The different step modes can affect the chloride ion removal. The chloride ions within the range of the reinforcement protective cover are easier to be removed than those in the concrete between the two layers of steel mesh. However, the amount of migrating corrosion inhibitor is larger in the latter circumstances.

  18. A SURVEY on WIRELESS MESH NETWORKS, ROUTING METRICS and PROTOCOLS

    Directory of Open Access Journals (Sweden)

    Safak DURUKAN ODABASI

    2013-01-01

    Full Text Available Today, Internet has become an indispensable part of our daily lives. It has a growing user community in many fields from banking transactions to online entertainment. It will be very efficient for users, as the next generation internet access becomes wireless like frequently used services such as cellular phones. But for providing this, a new network is needed to be designed or an existing network must be improved as well as making changes on infrastructure. At this point, mesh network infrastructure arises and offers more sophisticated internet access with less need. The most important advantage of mesh networks is the capability of working without infrastructure. Mesh networks are an additional access technology more than being a renewed one in the next generation wireless networks called 4G. In this study, wireless mesh networks and example applications are mentioned. Base architecture and design factors are emphasized, current routing protocols that are used on wireless mesh networks and routing metrics on which these protocols are based, are explained. Finally, the performance effects of these protocols and metrics on different network topologies are referred.

  19. Kinetic solvers with adaptive mesh in phase space

    Science.gov (United States)

    Arslanbekov, Robert R.; Kolobov, Vladimir I.; Frolova, Anna A.

    2013-12-01

    An adaptive mesh in phase space (AMPS) methodology has been developed for solving multidimensional kinetic equations by the discrete velocity method. A Cartesian mesh for both configuration (r) and velocity (v) spaces is produced using a “tree of trees” (ToT) data structure. The r mesh is automatically generated around embedded boundaries, and is dynamically adapted to local solution properties. The v mesh is created on-the-fly in each r cell. Mappings between neighboring v-space trees is implemented for the advection operator in r space. We have developed algorithms for solving the full Boltzmann and linear Boltzmann equations with AMPS. Several recent innovations were used to calculate the discrete Boltzmann collision integral with dynamically adaptive v mesh: the importance sampling, multipoint projection, and variance reduction methods. We have developed an efficient algorithm for calculating the linear Boltzmann collision integral for elastic and inelastic collisions of hot light particles in a Lorentz gas. Our AMPS technique has been demonstrated for simulations of hypersonic rarefied gas flows, ion and electron kinetics in weakly ionized plasma, radiation and light-particle transport through thin films, and electron streaming in semiconductors. We have shown that AMPS allows minimizing the number of cells in phase space to reduce the computational cost and memory usage for solving challenging kinetic problems.

  20. Approximation of scalar and vector transport problems on polyhedral meshes

    International Nuclear Information System (INIS)

    Cantin, Pierre

    2016-01-01

    This thesis analyzes, at the continuous and at the discrete level on polyhedral meshes, the scalar and the vector transport problems in three-dimensional domains. These problems are composed of a diffusive term, an advective term, and a reactive term. In the context of Friedrichs systems, the continuous problems are analyzed in Lebesgue graph spaces. The classical positivity assumption on the Friedrichs tensor is generalized so as to consider the case of practical interest where this tensor takes null or slightly negative values. A new scheme converging at the order 3/2 is devised for the scalar advection-reaction problem using scalar degrees of freedom attached to mesh vertices. Two new schemes considering as well scalar degrees of freedom attached to mesh vertices are devised for the scalar transport problem and are robust with respect to the dominant regime. The first scheme converges at the order 1/2 when advection effects are dominant and at the order 1 when diffusion effects are dominant. The second scheme improves the accuracy by converging at the order 3/2 when advection effects are dominant. Finally, a new scheme converging at the order 1/2 is devised for the vector advection-reaction problem considering only one scalar degree of freedom per mesh edge. The accuracy and the efficiency of all these schemes are assessed on various test cases using three-dimensional polyhedral meshes. (author)

  1. Palliative care and pediatric surgical oncology.

    Science.gov (United States)

    Inserra, Alessandro; Narciso, Alessandra; Paolantonio, Guglielmo; Messina, Raffaella; Crocoli, Alessandro

    2016-10-01

    Survival rate for childhood cancer has increased in recent years, reaching as high as 70% in developed countries compared with 54% for all cancers diagnosed in the 1980s. In the remaining 30%, progression or metastatic disease leads to death and in this framework palliative care has an outstanding role though not well settled in all its facets. In this landscape, surgery has a supportive actor role integrated with other welfare aspects from which are not severable. The definition of surgical palliation has moved from the ancient definition of noncurative surgery to a group of practices performed not to cure but to alleviate an organ dysfunction offering the best quality of life possible in all the aspects of life (pain, dysfunctions, caregivers, psychosocial, etc.). To emphasize this aspect a more modern definition has been introduced: palliative therapy in whose context is comprised not only the care assistance but also the plans of care since the onset of illness, teaching the matter to surgeons in training and share paths. Literature is very poor regarding surgical aspects specifically dedicated and all researches (PubMed, Google Scholar, and Cochrane) with various meshing terms result in a more oncologic and psychosocial effort. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient.

    Science.gov (United States)

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-03-01

    Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis

  3. Surface functionalisation of polypropylene hernia-repair meshes by RF-activated plasma polymerisation of acrylic acid and silver nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Nisticò, Roberto, E-mail: roberto.nistico@unito.it [University of Torino, Department of Chemistry and NIS Research Centre, Via P. Giuria 7, 10125 Torino (Italy); Rosellini, Andrea [University of Torino, Department of Chemistry and NIS Research Centre, Via P. Giuria 7, 10125 Torino (Italy); Rivolo, Paola [Politecnico di Torino, Dipartimento di Scienza Applicata e Tecnologia, C.so Duca degli Abruzzi 24, 10129 Torino (Italy); Faga, Maria Giulia [CNR-IMAMOTER, Strada delle Cacce 73, 10135 Torino (Italy); Lamberti, Roberta; Martorana, Selanna [Herniamesh S.r.l., Via F.lli Meliga 1/C, 10034 Chivasso (Italy); Castellino, Micaela [Center for Space Human Robotics, Istituto Italiano di Tecnologia, Corso Trento 21, 10129 Torino (Italy); Virga, Alessandro; Mandracci, Pietro [Politecnico di Torino, Dipartimento di Scienza Applicata e Tecnologia, C.so Duca degli Abruzzi 24, 10129 Torino (Italy); Malandrino, Mery; Magnacca, Giuliana [University of Torino, Department of Chemistry and NIS Research Centre, Via P. Giuria 7, 10125 Torino (Italy)

    2015-02-15

    Graphical abstract: - Highlights: • Polypropylene meshes for hernioplasty were surface functionalised via plasma-polymerisation to confer adhesive properties. • Subsequently, silver nanoparticles were loaded to add antibacterial activity. • Materials were physico-chemical characterised and adhesive properties evaluated. - Abstract: Hernia diseases are among the most common and diffuse causes of surgical interventions. Unfortunately, still nowadays there are different phenomena which can cause the hernioplasty failure, for instance post-operative prostheses displacements and proliferation of bacteria in the surgical site. In order to limit these problems, commercial polypropylene (PP) and polypropylene/Teflon (PP/PTFE) bi-material meshes were surface functionalised to confer adhesive properties (and therefore reduce undesired displacements) using polyacrylic acid synthesized by plasma polymerisation (PPAA). A broad physico-chemical and morphological characterisation was carried out and adhesion properties were investigated by means of atomic force microscopy (AFM) used in force/distance (F/D) mode. Once biomedical devices surface was functionalised by PPAA coating, metallic silver nanoparticles (AgNPs) with antimicrobial properties were synthesised and loaded onto the polymeric prostheses. The effect of the PPAA, containing carboxylic functionalities, adhesive coating towards AgNPs loading capacity was verified by means of X-ray photoelectron spectroscopy (XPS). Preliminary measurement of the Ag loaded amount and release in water were also investigated via inductively coupled plasma atomic emission spectroscopy (ICP-AES). Promising results were obtained for the functionalised biomaterials, encouraging future in vitro and in vivo tests.

  4. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  5. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  6. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  7. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  8. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  9. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  10. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  11. Social Media in Surgical Training: Opportunities and Risks.

    Science.gov (United States)

    Ovaere, Sander; Zimmerman, David D E; Brady, Richard R

    2018-05-02

    Surgeon engagement with social media is growing rapidly. Innovative applications in diverse fields of health care are increasingly available. The aim of this review is to explore the current and future applications of social media in surgical training. In addition, risks and barriers of social media engagement are analyzed, and recommendations for professional social media use amongst trainers and trainees are suggested. The published, peer-reviewed literature on social media in medicine, surgery and surgical training was reviewed. MESH terms including "social media", "education", "surgical training" and "web applications" were used. Different social media surgical applications are already widely available but limited in use in the trainee's curriculum. E-learning modalities, podcasts, live surgery platforms and microblogs are used for teaching purposes. Social media enables global research collaboratives and can play a role in patient recruitment for clinical trials. The growing importance of networking is emphasized by the increased use of LinkedIn, Facebook, Sermo and other networking platforms. Risks of social media use, such as lack of peer review and the lack of source confirmation, must be considered. Governing surgeon's and trainee's associations should consider adopting and sharing their guidelines for standards of social media use. Surgical training is changing rapidly and as such, social media presents tremendous opportunities for teaching, training, research and networking. Awareness must be raised on the risks of social media use. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

  12. Tetrahedral meshing via maximal Poisson-disk sampling

    KAUST Repository

    Guo, Jianwei

    2016-02-15

    In this paper, we propose a simple yet effective method to generate 3D-conforming tetrahedral meshes from closed 2-manifold surfaces. Our approach is inspired by recent work on maximal Poisson-disk sampling (MPS), which can generate well-distributed point sets in arbitrary domains. We first perform MPS on the boundary of the input domain, we then sample the interior of the domain, and we finally extract the tetrahedral mesh from the samples by using 3D Delaunay or regular triangulation for uniform or adaptive sampling, respectively. We also propose an efficient optimization strategy to protect the domain boundaries and to remove slivers to improve the meshing quality. We present various experimental results to illustrate the efficiency and the robustness of our proposed approach. We demonstrate that the performance and quality (e.g., minimal dihedral angle) of our approach are superior to current state-of-the-art optimization-based approaches.

  13. GOMESH, Finite Elements Structure Plot with Triangular Mesh

    International Nuclear Information System (INIS)

    Draper, J.

    1977-01-01

    1 - Nature of the physical problem solved: Graphical representation of calculations on structures with finite subdivision. 2 - Method of solution: GOMESH treats meshes with triangular basic elements. The program uses the same punched cards as those required for the input to the 'STAG' series of stress analysis codes and can prepare three basic mesh diagrams which differ in their mode of numbering. One objective of using these diagrams is to show up errors in the card deck by making them visually recognisable. Furthermore, digital tests are made within the program to check that certain requirements have been observed in the production of the lattice. The program 'GOMESH', can provide, superimposed in the graphical representation, stress and temperature values in numerical form, can represent the displacement of the mesh before and after a specified irradiation time, and give the directions and sense of the principal stresses occurring in the individual elements, in the form of arrows of varying length

  14. Mesh Nanoelectronics: Seamless Integration of Electronics with Tissues.

    Science.gov (United States)

    Dai, Xiaochuan; Hong, Guosong; Gao, Teng; Lieber, Charles M

    2018-02-20

    Nanobioelectronics represents a rapidly developing field with broad-ranging opportunities in fundamental biological sciences, biotechnology, and medicine. Despite this potential, seamless integration of electronics has been difficult due to fundamental mismatches, including size and mechanical properties, between the elements of the electronic and living biological systems. In this Account, we discuss the concept, development, key demonstrations, and future opportunities of mesh nanoelectronics as a general paradigm for seamless integration of electronics within synthetic tissues and live animals. We first describe the design and realization of hybrid synthetic tissues that are innervated in three dimensions (3D) with mesh nanoelectronics where the mesh serves as both as a tissue scaffold and as a platform of addressable electronic devices for monitoring and manipulating tissue behavior. Specific examples of tissue/nanoelectronic mesh hybrids highlighted include 3D neural tissue, cardiac patches, and vascular constructs, where the nanoelectronic devices have been used to carry out real-time 3D recording of electrophysiological and chemical signals in the tissues. This novel platform was also exploited for time-dependent 3D spatiotemporal mapping of cardiac tissue action potentials during cell culture and tissue maturation as well as in response to injection of pharmacological agents. The extension to simultaneous real-time monitoring and active control of tissue behavior is further discussed for multifunctional mesh nanoelectronics incorporating both recording and stimulation devices, providing the unique capability of bidirectional interfaces to cardiac tissue. In the case of live animals, new challenges must be addressed, including minimally invasive implantation, absence of deleterious chronic tissue response, and long-term capability for monitoring and modulating tissue activity. We discuss each of these topics in the context of implantation of mesh

  15. Study on boundary search method for DFM mesh generation

    Directory of Open Access Journals (Sweden)

    Li Ri

    2012-08-01

    Full Text Available The boundary mesh of the casting model was determined by direct calculation on the triangular facets extracted from the STL file of the 3D model. Then the inner and outer grids of the model were identified by the algorithm in which we named Inner Seed Grid Method. Finally, a program to automatically generate a 3D FDM mesh was compiled. In the paper, a method named Triangle Contraction Search Method (TCSM was put forward to ensure not losing the boundary grids; while an algorithm to search inner seed grids to identify inner/outer grids of the casting model was also brought forward. Our algorithm was simple, clear and easy to construct program. Three examples for the casting mesh generation testified the validity of the program.

  16. MESH2D Grid generator design and use

    Energy Technology Data Exchange (ETDEWEB)

    Flach, G. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-10-31

    Mesh2d is a Fortran90 program originally designed to generate two-dimensional structured grids of the form [x(i),y(i,j)] where [x,y] are grid coordinates identified by indices (i,j). x-coordinates depending only on index i implies strictly vertical x-grid lines, whereas the y-grid lines can undulate. Mesh2d also assigns an integer material type to each grid cell, mtyp(i,j), in a user-specified manner. The complete grid is specified through three separate input files defining the x(i), y(i,j), and mtyp(i,j) variations. Since the original development effort, Mesh2d has been extended to more general two-dimensional structured grids of the form [x(i,j),(i,j)].

  17. PERFORMANCE ENHANCEMENT OF A MINIATURE STIRLING CRYOCOOLER WITH A MULTI MESH REGENERATOR DESIGN

    Directory of Open Access Journals (Sweden)

    KISHOR KUMAR V. V.

    2017-06-01

    Full Text Available A parametric study has been carried out using the software REGEN 3.3 to optimize the regenerator of a miniature Stirling cryocooler operating with a warm end temperature of 300 K and cold end temperature of 80 K. Regenerator designs which produce the maximum coefficient of performance (COP of the system is considered as an optimized regenerator. The length and diameter of the regenerator were fixed from the cooler system requirements. Single mesh regenerators made of 200, 250, 300, 400 and 450 Stainless Steel wire meshes were considered and the optimum phase angle and mesh size were obtained. A maximum COP of 0.1475 was obtained for 300 mesh regenerator at 70° phase angle. Then multi mesh regenerators were considered with finer mesh on the cold end and coarser mesh on the hot end. The optimum size and length of each mesh in the multi mesh regenerator and the optimum phase angle were calculated. The maximum COP of 0.156 was obtained for 200 300-400 multi mesh regenerator at 70° phase angle. The COP and net refrigeration obtained for an optimized multi mesh regenerator was found to be significantly higher than that of a single mesh regenerator. Thus a multi mesh regenerator design with a proper combination of regenerator mesh size and length can enhance the regenerator effectiveness.

  18. Mesh fixation in laparoscopic incisional hernia repair: glue fixation provides attachment strength similar to absorbable tacks but differs substantially in different meshes.

    Science.gov (United States)

    Rieder, Erwin; Stoiber, Martin; Scheikl, Verena; Poglitsch, Marcus; Dal Borgo, Andrea; Prager, Gerhard; Schima, Heinrich

    2011-01-01

    Laparoscopic ventral hernia repair has gained popularity among minimally invasive surgeons. However, mesh fixation remains a matter of discussion. This study was designed to compare noninvasive fibrin-glue attachment with tack fixation of meshes developed primarily for intra-abdominal use. It was hypothesized that particular mesh structures would substantially influence detachment force. For initial evaluation, specimens of laminated polypropylene/polydioxanone meshes were anchored to porcine abdominal walls by either helical titanium tacks or absorbable tacks in vitro. A universal tensile-testing machine was used to measure tangential detachment forces (TF). For subsequent experiments of glue fixation, polypropylene/polydioxanone mesh and 4 additional meshes with diverse particular mesh structure, ie, polyvinylidene fluoride/polypropylene mesh, a titanium-coated polypropylene mesh, a polyester mesh bonded with a resorbable collagen, and a macroporous condensed PTFE mesh were evaluated. TF tests revealed that fibrin-glue attachment was not substantially different from that achieved with absorbable tacks (median TF 7.8 Newton [N], range 1.3 to 15.8 N), but only when certain open porous meshes (polyvinylidene fluoride/polypropylene mesh: median 6.2 N, range 3.4 to 10.3 N; titanium-coated polypropylene mesh: median 5.2 N, range 2.1 to 11.7 N) were used. Meshes coated by an anti-adhesive barrier (polypropylene/polydioxanone mesh: median 3.1 N, range 1.7 to 5.8 N; polyester mesh bonded with a resorbable collagen: median 1.3 N, range 0.5 to 1.9 N), or the condensed PTFE mesh (median 3.1 N, range 2.1 to 7.0 N) provided a significantly lower TF (p < 0.01). Fibrin glue appears to be an appealing noninvasive option for mesh fixation in laparoscopic ventral hernia repair, but only if appropriate meshes are used. Glue can also serve as an adjunct to mechanical fixation to reduce the number of invasive tacks. Copyright © 2010 American College of Surgeons. Published by Elsevier

  19. Split thickness skin graft meshing ratio indications and common practices.

    Science.gov (United States)

    Pripotnev, Stahs; Papp, Anthony

    2017-12-01

    Split thickness skin grafting is a commonly used technique in burn surgery for resurfacing wounds that are unlikely to heal without scarring. Meshing and expanding skin grafts allow for reconstruction of larger wounds with smaller donor sites. A retrospective chart review was performed of 210 patients with burns equal to or greater than 20% total body surface area admitted to Vancouver General Hospital between 1998 and 2014. Charts were reviewed to collect data on patient and burn demographics. A survey was sent to Canadian plastic surgeons registered with the CSPS to collect data on common practices in burn surgery nationwide. The patients that received 3:1 or higher meshed grafts were all flame burns, had a significantly higher average TBSA (51.89%±14.87 vs 29.13%±9.48, p=0.001), and a significantly higher full thickness burn TBSA (25.76%±21.97 vs 6.20%±9.04, p=0.001). We found no significant differences in gender, age, or burn location between the less than 2:1 and 3:1 or greater meshing ratio groups. The survey of plastic surgeons performing burn surgery in Canada revealed that 60% of responders had experience with skin grafts using meshing ratios of 3:1 or higher. Of these surgeons, 100% felt that burn size and 36% felt that burn location would influence their decision to use a 3:1 or higher meshing ratio. A larger burn size is the major influencing factor for the use of higher skin graft meshing ratios by Canadian burn surgeons. Furthermore, burn location determines the choice of donor and recipient sites in these cases. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  20. Grouper: a compact, streamable triangle mesh data structure.

    Science.gov (United States)

    Luffel, Mark; Gurung, Topraj; Lindstrom, Peter; Rossignac, Jarek

    2014-01-01

    We present Grouper: an all-in-one compact file format, random-access data structure, and streamable representation for large triangle meshes. Similarly to the recently published SQuad representation, Grouper represents the geometry and connectivity of a mesh by grouping vertices and triangles into fixed-size records, most of which store two adjacent triangles and a shared vertex. Unlike SQuad, however, Grouper interleaves geometry with connectivity and uses a new connectivity representation to ensure that vertices and triangles can be stored in a coherent order that enables memory-efficient sequential stream processing. We present a linear-time construction algorithm that allows streaming out Grouper meshes using a small memory footprint while preserving the initial ordering of vertices. As a part of this construction, we show how the problem of assigning vertices and triangles to groups reduces to a well-known NP-hard optimization problem, and present a simple yet effective heuristic solution that performs well in practice. Our array-based Grouper representation also doubles as a triangle mesh data structure that allows direct access to vertices and triangles. Storing only about two integer references per triangle--i.e., less than the three vertex references stored with each triangle in a conventional indexed mesh format--Grouper answers both incidence and adjacency queries in amortized constant time. Our compact representation enables data-parallel processing on multicore computers, instant partitioning and fast transmission for distributed processing, as well as efficient out-of-core access. We demonstrate the versatility and performance benefits of Grouper using a suite of example meshes and processing kernels.

  1. Prevention of a parastomal hernia by biological mesh reinforcement

    Directory of Open Access Journals (Sweden)

    René H Fortelny

    2015-10-01

    Full Text Available Introduction: In the field of hernia prevention the prophylactic mesh-reinforcement of stoma-sites is one of the most controversially discussed issues. The incidence of parastomal hernias in the literature reported to be up to 48.1% after end colostomy and up to 30.8 % after of loop colostomy respectively, but still remains uncertain due to diagnostic variety of clinical or radiological methods, heterogeneous patient groups and variable follow-up intervals respectively. Anyway, the published data regarding the use of synthetic or bio-prostethic meshes in the prevention of parastomal hernia at the primary operation are very scarce. Methods: A literature search of the Medline database in terms of biological prophylactic mesh implantation in stoma creation identified 6 systematic reviews, 2 randomized controlled trials (RCT, 2 case controlled studies and 1 technical report. Results: In a systematic review focusing on the prevention of parastomal hernia including only RCTs encompassing one RCT using bio-prosthetic mesh the incidence of herniation was 12.5 % compared to 53% in the control group (p<0.0001. In 1 RCT and 2 case control studies respectively, there was a significant smaller incidence of parastomal herniation as well as a similar complication rate compared to the control group respectively. Only in 1 RCT no significant difference regarding the incidence of parastomal hernia was reported with comparable complication rates. Conclusion: Thus so far 2 RCT and 2 case control studies are published with prophylactic bio prosthetic reinforcement in stoma sites. The majority revealed significant better results in terms of parastomal herniation and without any mesh related complications in comparison to the non mesh group. Further multicenter RCT are required to achieve a sufficient level of recommendation.

  2. Impact of Variable-Resolution Meshes on Regional Climate Simulations

    Science.gov (United States)

    Fowler, L. D.; Skamarock, W. C.; Bruyere, C. L.

    2014-12-01

    The Model for Prediction Across Scales (MPAS) is currently being used for seasonal-scale simulations on globally-uniform and regionally-refined meshes. Our ongoing research aims at analyzing simulations of tropical convective activity and tropical cyclone development during one hurricane season over the North Atlantic Ocean, contrasting statistics obtained with a variable-resolution mesh against those obtained with a quasi-uniform mesh. Analyses focus on the spatial distribution, frequency, and intensity of convective and grid-scale precipitations, and their relative contributions to the total precipitation as a function of the horizontal scale. Multi-month simulations initialized on May 1st 2005 using ERA-Interim re-analyses indicate that MPAS performs satisfactorily as a regional climate model for different combinations of horizontal resolutions and transitions between the coarse and refined meshes. Results highlight seamless transitions for convection, cloud microphysics, radiation, and land-surface processes between the quasi-uniform and locally- refined meshes, despite the fact that the physics parameterizations were not developed for variable resolution meshes. Our goal of analyzing the performance of MPAS is twofold. First, we want to establish that MPAS can be successfully used as a regional climate model, bypassing the need for nesting and nudging techniques at the edges of the computational domain as done in traditional regional climate modeling. Second, we want to assess the performance of our convective and cloud microphysics parameterizations as the horizontal resolution varies between the lower-resolution quasi-uniform and higher-resolution locally-refined areas of the global domain.

  3. Grouper: A Compact, Streamable Triangle Mesh Data Structure

    Energy Technology Data Exchange (ETDEWEB)

    Luffel, Mark [Georgia Inst. of Technology, Atlanta, GA (United States). Visualization and Usability Center (GVU); Gurung, Topraj [Georgia Inst. of Technology, Atlanta, GA (United States). Visualization and Usability Center (GVU); Lindstrom, Peter [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Rossignac, Jarek [Georgia Inst. of Technology, Atlanta, GA (United States). Visualization and Usability Center (GVU)

    2014-01-01

    Here, we present Grouper: an all-in-one compact file format, random-access data structure, and streamable representation for large triangle meshes. Similarly to the recently published SQuad representation, Grouper represents the geometry and connectivity of a mesh by grouping vertices and triangles into fixed-size records, most of which store two adjacent triangles and a shared vertex. Unlike SQuad, however, Grouper interleaves geometry with connectivity and uses a new connectivity representation to ensure that vertices and triangles can be stored in a coherent order that enables memory-efficient sequential stream processing. We also present a linear-time construction algorithm that allows streaming out Grouper meshes using a small memory footprint while preserving the initial ordering of vertices. In this construction, we show how the problem of assigning vertices and triangles to groups reduces to a well-known NP-hard optimization problem, and present a simple yet effective heuristic solution that performs well in practice. Our array-based Grouper representation also doubles as a triangle mesh data structure that allows direct access to vertices and triangles. Storing only about two integer references per triangle-i.e., less than the three vertex references stored with each triangle in a conventional indexed mesh format-Grouper answers both incidence and adjacency queries in amortized constant time. Our compact representation enables data-parallel processing on multicore computers, instant partitioning and fast transmission for distributed processing, as well as efficient out-of-core access. We demonstrate the versatility and performance benefits of Grouper using a suite of example meshes and processing kernels.

  4. Form-finding with polyhedral meshes made simple

    KAUST Repository

    Tang, Chengcheng; Sun, Xiang; Gomes, Alexandra; Wallner, Johannes; Pottmann, Helmut

    2015-01-01

    We solve the form-finding problem for polyhedral meshes in a way which combines form, function and fabrication; taking care of user-specified constraints like boundary interpolation, planarity of faces, statics, panel size and shape, enclosed volume, and cost. Our main application is the interactive modeling of meshes for architectural and industrial design. Our approach can be described as guided exploration of the constraint space whose algebraic structure is simplified by introducing auxiliary variables and ensuring that constraints are at most quadratic.

  5. Reactor physics verification of the MCNP6 unstructured mesh capability

    International Nuclear Information System (INIS)

    Burke, T. P.; Kiedrowski, B. C.; Martz, R. L.; Martin, W. R.

    2013-01-01

    The Monte Carlo software package MCNP6 has the ability to transport particles on unstructured meshes generated from the Computed-Aided Engineering software Abaqus. Verification is performed using benchmarks with features relevant to reactor physics - Big Ten and the C5G7 computational benchmark. Various meshing strategies are tested and results are compared to reference solutions. Computational performance results are also given. The conclusions show MCNP6 is capable of producing accurate calculations for reactor physics geometries and the computational requirements for small lattice benchmarks are reasonable on modern computing platforms. (authors)

  6. Direct ethanol fuel cells with catalysed metal mesh anodes

    International Nuclear Information System (INIS)

    Chetty, Raghuram; Scott, Keith

    2007-01-01

    Platinum based binary and ternary catalysts prepared by thermal decomposition on titanium mesh were characterised and compared in terms of the electrochemical activity for ethanol oxidation. An enhancement in the catalytic activity was observed for the binary catalyst containing tin and ruthenium in their compositions with platinum. The catalysts were tested in single direct ethanol fuel cells and the result obtained with PtRu and PtSn showed that the mesh based electrodes show competitive performance in comparison to the conventional carbon based anodes

  7. Form-finding with polyhedral meshes made simple

    KAUST Repository

    Tang, Chengcheng

    2015-08-09

    We solve the form-finding problem for polyhedral meshes in a way which combines form, function and fabrication; taking care of user-specified constraints like boundary interpolation, planarity of faces, statics, panel size and shape, enclosed volume, and cost. Our main application is the interactive modeling of meshes for architectural and industrial design. Our approach can be described as guided exploration of the constraint space whose algebraic structure is simplified by introducing auxiliary variables and ensuring that constraints are at most quadratic.

  8. ANALYSIS OF COMBINED POLYSURFACES TO MESH SURFACES MATCHING

    Directory of Open Access Journals (Sweden)

    Marek WYLEŻOŁ

    2014-06-01

    Full Text Available This article applies to an example of the process of quantitatively evaluate the fit of combined polysurface (NURBS class to a surface mesh. The fitting process of the polysurface and the evaluation of obtained results have been realized in the environment of the CATIA v5 system. Obtained quantitative evaluation are shown graphically in the form of three-dimensional graphs and histograms. As the base surface mesh was used a pelvic bone stl model (the model was created by digitizing didactic physical model.

  9. Practical implementation of tetrahedral mesh reconstruction in emission tomography

    Science.gov (United States)

    Boutchko, R.; Sitek, A.; Gullberg, G. T.

    2013-05-01

    This paper presents a practical implementation of image reconstruction on tetrahedral meshes optimized for emission computed tomography with parallel beam geometry. Tetrahedral mesh built on a point cloud is a convenient image representation method, intrinsically three-dimensional and with a multi-level resolution property. Image intensities are defined at the mesh nodes and linearly interpolated inside each tetrahedron. For the given mesh geometry, the intensities can be computed directly from tomographic projections using iterative reconstruction algorithms with a system matrix calculated using an exact analytical formula. The mesh geometry is optimized for a specific patient using a two stage process. First, a noisy image is reconstructed on a finely-spaced uniform cloud. Then, the geometry of the representation is adaptively transformed through boundary-preserving node motion and elimination. Nodes are removed in constant intensity regions, merged along the boundaries, and moved in the direction of the mean local intensity gradient in order to provide higher node density in the boundary regions. Attenuation correction and detector geometric response are included in the system matrix. Once the mesh geometry is optimized, it is used to generate the final system matrix for ML-EM reconstruction of node intensities and for visualization of the reconstructed images. In dynamic PET or SPECT imaging, the system matrix generation procedure is performed using a quasi-static sinogram, generated by summing projection data from multiple time frames. This system matrix is then used to reconstruct the individual time frame projections. Performance of the new method is evaluated by reconstructing simulated projections of the NCAT phantom and the method is then applied to dynamic SPECT phantom and patient studies and to a dynamic microPET rat study. Tetrahedral mesh-based images are compared to the standard voxel-based reconstruction for both high and low signal-to-noise ratio

  10. Practical implementation of tetrahedral mesh reconstruction in emission tomography

    International Nuclear Information System (INIS)

    Boutchko, R; Gullberg, G T; Sitek, A

    2013-01-01

    This paper presents a practical implementation of image reconstruction on tetrahedral meshes optimized for emission computed tomography with parallel beam geometry. Tetrahedral mesh built on a point cloud is a convenient image representation method, intrinsically three-dimensional and with a multi-level resolution property. Image intensities are defined at the mesh nodes and linearly interpolated inside each tetrahedron. For the given mesh geometry, the intensities can be computed directly from tomographic projections using iterative reconstruction algorithms with a system matrix calculated using an exact analytical formula. The mesh geometry is optimized for a specific patient using a two stage process. First, a noisy image is reconstructed on a finely-spaced uniform cloud. Then, the geometry of the representation is adaptively transformed through boundary-preserving node motion and elimination. Nodes are removed in constant intensity regions, merged along the boundaries, and moved in the direction of the mean local intensity gradient in order to provide higher node density in the boundary regions. Attenuation correction and detector geometric response are included in the system matrix. Once the mesh geometry is optimized, it is used to generate the final system matrix for ML-EM reconstruction of node intensities and for visualization of the reconstructed images. In dynamic PET or SPECT imaging, the system matrix generation procedure is performed using a quasi-static sinogram, generated by summing projection data from multiple time frames. This system matrix is then used to reconstruct the individual time frame projections. Performance of the new method is evaluated by reconstructing simulated projections of the NCAT phantom and the method is then applied to dynamic SPECT phantom and patient studies and to a dynamic microPET rat study. Tetrahedral mesh-based images are compared to the standard voxel-based reconstruction for both high and low signal-to-noise ratio

  11. TimeMesh – A Serious Game for European Citizenship

    Directory of Open Access Journals (Sweden)

    Ricardo Baptista

    2013-03-01

    Full Text Available Serious games are games where the entertainment aspect is not the most relevant motivation or objective. TimeMesh is an online, multi-language, multiplayer, collaborative and social game platform for sharing and acquiring knowledge of the history of European regions. As such it is a serious game with educational characteristics. This article evaluates the use of TimeMesh with students of 13 and 14 years-old. It shows that this game is already a significant learning tool about European citizenship.

  12. Reactor physics verification of the MCNP6 unstructured mesh capability

    Energy Technology Data Exchange (ETDEWEB)

    Burke, T. P. [Department of Nuclear Engineering and Radiological Sciences, University of Michigan, 2355 Bonisteel Boulevard, Ann Arbor, MI 48109 (United States); Kiedrowski, B. C.; Martz, R. L. [X-Computational Physics Division, Monte Carlo Codes Group, Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM 87545 (United States); Martin, W. R. [Department of Nuclear Engineering and Radiological Sciences, University of Michigan, 2355 Bonisteel Boulevard, Ann Arbor, MI 48109 (United States)

    2013-07-01

    The Monte Carlo software package MCNP6 has the ability to transport particles on unstructured meshes generated from the Computed-Aided Engineering software Abaqus. Verification is performed using benchmarks with features relevant to reactor physics - Big Ten and the C5G7 computational benchmark. Various meshing strategies are tested and results are compared to reference solutions. Computational performance results are also given. The conclusions show MCNP6 is capable of producing accurate calculations for reactor physics geometries and the computational requirements for small lattice benchmarks are reasonable on modern computing platforms. (authors)

  13. Value for money in particle-mesh plasma simulations

    International Nuclear Information System (INIS)

    Eastwood, J.W.

    1976-01-01

    The established particle-mesh method of simulating a collisionless plasma is discussed. Problems are outlined, and it is stated that given constraints on mesh size and particle number, the only way to adjust the compromise between dispersive forces, collision time and heating time is by altering the force calculating cycle. In 'value for money', schemes, matching of parts of the force calculation cycle is optimized. Interparticle forces are considered. Optimized combinations of elements of the force calculation cycle are compared. Following sections cover the dispersion relation, and comparisons with other schemes. (U.K.)

  14. Dynamic mesh optimization based on the spring analogy

    Directory of Open Access Journals (Sweden)

    Schmidt Jonas

    2014-01-01

    Full Text Available We present an implementation of the spring analogy for three dimensional meshes in OpenFOAM. All parameters of the spring system are treated as fields that can either be pre-defined by the user, or updated at each time step according to specified geometrical regions or diffusion equations. The purpose of the method is to provide a pre-processing tool for mesh optimization. We study three simple test cases, a deformed block, an airfoil and a hill, and we analyze the evolution of skewness, non-orthogonality and aspect ratio during the approach of dynamic equilibrium.

  15. 802.11s Wireless Mesh Network Visualization Application

    Science.gov (United States)

    Mauldin, James Alexander

    2014-01-01

    Results of past experimentation at NASA Johnson Space Center showed that the IEEE 802.11s standard has better performance than the widely implemented alternative protocol B.A.T.M.A.N (Better Approach to Mobile Ad hoc Networking). 802.11s is now formally incorporated into the Wi- Fi 802.11-2012 standard, which specifies a hybrid wireless mesh networking protocol (HWMP). In order to quickly analyze changes to the routing algorithm and to support optimizing the mesh network behavior for our intended application a visualization tool was developed by modifying and integrating open source tools.

  16. Implementation of LDG method for 3D unstructured meshes

    Directory of Open Access Journals (Sweden)

    Filander A. Sequeira Chavarría

    2012-07-01

    Full Text Available This paper describes an implementation of the Local Discontinuous Galerkin method (LDG applied to elliptic problems in 3D. The implementation of the major operators is discussed. In particular the use of higher-order approximations and unstructured meshes. Efficient data structures that allow fast assembly of the linear system in the mixed formulation are described in detail. Keywords: Discontinuous finite element methods, high-order approximations, unstructured meshes, object-oriented programming. Mathematics Subject Classification: 65K05, 65N30, 65N55.

  17. The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review.

    Science.gov (United States)

    Forgione, Antonello; Guraya, Salman Y

    2017-01-01

    Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program. Several data sources were searched using MeSH terms "Laparoscopic surgery" and "Surgical training" and "Surgical curriculum" and "fundamentals of endoscopic surgery" and "fundamentals of laparoscopic surgery" and "Telementoring" and "Box trainer." The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study. Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints. The existing world-renowned surgical training centers employ various clusters of training

  18. Video games and surgical ability: a literature review.

    Science.gov (United States)

    Lynch, Jeremy; Aughwane, Paul; Hammond, Toby M

    2010-01-01

    Surgical training is rapidly evolving because of reduced training hours and the reduction of training opportunities due to patient safety concerns. There is a popular conception that video game usage might be linked to improved operating ability especially those techniques involving endoscopic modalities. If true this might suggest future directions for training. A search was made of the MEDLINE databases for the MeSH term, "Video Games," combined with the terms "Surgical Procedures, Operative," "Endoscopy," "Robotics," "Education," "Learning," "Simulators," "Computer Simulation," "Psychomotor Performance," and "Surgery, Computer-Assisted,"encompassing all journal articles before November 2009. References of articles were searched for further studies. Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery. Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance. Copyright (c) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  20. Adaptive and dynamic meshing methods for numerical simulations

    Science.gov (United States)

    Acikgoz, Nazmiye

    For the numerical simulation of many problems of engineering interest, it is desirable to have an automated mesh adaption tool capable of producing high quality meshes with an affordably low number of mesh points. This is important especially for problems, which are characterized by anisotropic features of the solution and require mesh clustering in the direction of high gradients. Another significant issue in meshing emerges in the area of unsteady simulations with moving boundaries or interfaces, where the motion of the boundary has to be accommodated by deforming the computational grid. Similarly, there exist problems where current mesh needs to be adapted to get more accurate solutions because either the high gradient regions are initially predicted inaccurately or they change location throughout the simulation. To solve these problems, we propose three novel procedures. For this purpose, in the first part of this work, we present an optimization procedure for three-dimensional anisotropic tetrahedral grids based on metric-driven h-adaptation. The desired anisotropy in the grid is dictated by a metric that defines the size, shape, and orientation of the grid elements throughout the computational domain. Through the use of topological and geometrical operators, the mesh is iteratively adapted until the final mesh minimizes a given objective function. In this work, the objective function measures the distance between the metric of each simplex and a target metric, which can be either user-defined (a-priori) or the result of a-posteriori error analysis. During the adaptation process, one tries to decrease the metric-based objective function until the final mesh is compliant with the target within a given tolerance. However, in regions such as corners and complex face intersections, the compliance condition was found to be very difficult or sometimes impossible to satisfy. In order to address this issue, we propose an optimization process based on an ad