A device for determining the abdominal wall dynamic biomechanical behavior, and a method making use of such a device

The invention relates to a device (1, 20, 30) for non-invasively evaluating or monitoring an intra-abdominal pressure and/or abdominal wall deformations and/or a risk of incisional hernia of a subject at a preventive stage and/or a pre-operative stage and/or a post-operative stage, said device comprising: - an adjustable and flexible frame (12), the frame comprising a central area (231, 31), a left lateral area (233, 33) and a right lateral area (232, 32); - a network of main sensors (35) suitable for measuring local deformations and/or local forces on the surface of the abdomen of the subject, said network of main sensors being assembled to the frame, wherein at least one main sensor is located in each area of the frame; - connecting means (15) adapted for connecting said network of main sensors (35) to a treatment unit (2, 22); and possibly - positioning means adapted for positioning the device on the abdomen and/or - adjustment means adapted for adjusting the device on the abdomen. The invention also relates to a system comprising a device (20, 30) and a treatment unit (2, 22), and to a method for determining the abdominal wall dynamic biomechanical behavior of a subject, using a device (30) or a system (1)

Dynamic-MRI quantification of abdominal wall motion and deformation during breathing and muscular contraction

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Semiautomatic quantification of abdominal wall muscles deformations based on dynamic MRI image registration

International audiencein the diagnosis of abdominal muscle deficiency. Here, wepresent a dedicated semiautomatic dynamic MRI postprocessing method enablingthe quantification of spatial and temporal deformations of the antero-lateral abdominalwall muscles. Ten healthy participants were imaged during a controlled breathingsession at the L3–L4 disc level using real-time dynamic MRI at 3 T. A coarse featuretrackingstep allowed the selection of the inhalation cycle of maximum abdominalexcursion. Over this image series, the described method combines (1) a supervised2D+t segmentation procedure of the abdominal wall muscles, (2) the quantificationof muscle deformations based on masks registration, and (3) the mapping of deformationswithin muscle subzones leveraging a dedicated automatic parcellation. Thesupervised 2D+t segmentation (1) provided an accurate segmentation of the abdominalwall muscles throughout maximum inhalation with a 0.95 ± 0.03 Dice similaritycoefficient (DSC) value and a 2.3 ± 0.7 mm Hausdorff distance value while requiringonly manual segmentation of 20% of the data. The robustness of the deformationquantification (2) was indicated by high indices of correspondence between the registeredsource mask and the target mask (0.98 ± 0.01 DSC value and 2.1 ± 1.5 mmHausdorff distance value). Parcellation (3) enabled the distinction of muscle substructuresthat are anatomically relevant but could not be distinguished based on imagecontrast. The present genuine postprocessing method provides a quantitative analyticalframe that could be used in further studies for a better understanding of abdominalwall deformations in physiological and pathological situations

Tensile mechanical properties of the cervical, thoracic and lumbar porcine spinal meninges

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Preoperative Prediction of Small Bowel Length Using CT Scan and Tridimensional Reconstructions: a New Tool in Bariatric Surgery?

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A French National Study on Gastropleural and Gastrobronchial Fistulas After Bariatric Surgery: the Impact of Therapeutic Strategy on Healing

International audiencePurposeGastropleural and gastrobronchial fistulas (GPF/GBFs) are serious but rare complications after bariatric surgery whose management is not consensual. The aim was to establish a cohort and evaluate different clinical presentations and therapeutic options.Materials and MethodsA multicenter and retrospective study analyzing GPF/GBFs after bariatric surgery in France between 2007 and 2018, via a questionnaire sent to digestive and thoracic surgery departments.ResultsThe study included 24 patients from 9 surgical departments after initial bariatric surgery (21 sleeve gastrectomies; 3 gastric bypass) for morbid obesity (mean BMI = 42 ± 8 kg/m2). The GPF/GBFs occurred, on average, 124 days after bariatric surgery, complicating an initial post-operative gastric fistula (POGF) in 66% of cases. Endoscopic digestive treatment was performed in 79% of cases (n = 19) associated in 25% of cases (n = 6) with thoracic endoscopy. Surgical treatment was performed in 83% of cases (n = 20): thoracic surgery (n = 5), digestive surgery (n = 8), and combined surgery (n = 7). No patient died. Overall morbidity was 42%. The overall success rate of the initial and secondary strategies was 58.5% and 90%, respectively. The average healing time was approximately 7 months. Patients who had undergone thoracic surgery (n = 12) had more initial management failures (n = 9/12) than patients who had not (n = 3/12), p = 0.001.ConclusionComplex and life-threatening fistulas that are revealed late require a multidisciplinary strategy. Thoracic surgery should be reserved once the abdominal leak heals; otherwise, it is associated with a higher risk of failure