an opening in the abdomen an opening in the market: hernia tensiometer group 2: martha ingram megan...
TRANSCRIPT
An Opening in the Abdomen
An Opening in the Market:
Hernia Tensiometer
GROUP 2:Martha Ingram
Megan JohnstonChelsea Samson
What Is a Hernia?
Laparoscopic
Open
“Tension-Free” Repair
Method
MAKING THE CASE FOR HERNIA RESEARCHBK Poulose, MD, MPH; J Shelton, MD; S Phillips, MSPH; DE Moore, MD, MPH; W Nealon, MD; D Penson, MD, MPH; MD Holzman, MD, MPH
Background:
$ Inpatient discharges from 2001-2006 Healthcare Cost and Utilization Project
$ Outpatient estimates from 2006 CDC National Survey of Ambulatory Surgery
$ Total number of ventral hernia repair procedures performed in the U.S.
$ Extrapolated operation dollars from 2006 to 2009 monies using Consumer Price Index
Methods:
“Currently, there is a lack of standardization in ventral hernia repair procedures, with widespread variation in delivery”
Lack of standard delivery Increased complications post-surgery increased cost
Results
IN 2006: 154,278 inpatient + 193,543 outpatient =
348,000 operations
1 inpatient operation = $15,374 1 outpatient operation = $3,745
Total Expenditure in Procedures =$3.1
billion on VHR
Mean Cost of Ventral Hernia Repair
Procedures over Time
*adapted from BK Poulose, J Shelton, DE Moore, W Nealon, D Penson, M Holzman, Making the Case for Hernia Research. 2011.
Year
Cost
per
Dis
ch
arg
e
*adapted from BK Poulose, J Shelton, DE Moore, W Nealon, D Penson, M Holzman, Making the Case for Hernia Research. 2011.
Mean Frequency of Ventral Hernia Repair Operations over
Time
Year
Nu
mb
er
of
Dis
ch
arg
es
IT IS ESTIMATED THAT A
1% REDUCTION IN VHR OPERATIONS COULD SAVE
$31 MILLION IN HEALTHCARE COSTS IN
THE U.S. PER YEARThe application of an intra-operative tension-measuring
device could increase understanding of and prevent
hernia recurrence, significantly decreasing costs
•Measure tension resisting closure at the suture line
after:- dissection of the injury area
- separating fascia from muscle-placing the mesh
•Isolate abdominal tissue•Bring edges together
•Read tension at center of hernia
User Feedback: Get a force (Newtons) and want to know if failure will
occur…
Tension (N)
Probability of Recurrence
100 %90 %80 %70 %60 %50 %40 %30 %20 %10 %0 %
User Response:
Relaxing Incisions
Mesh Placeme
nt
Suture Closed
Clamp both hernia edges between metal
plates
Large, sharp serrations hold tissue in place
Lash force sensors across
opening
Static arm
Mobile arm
Digital display
Gear to wind hernia edges
together
Force Sensor
Indentation Testing
Calibration1. Initial calibration
– Known weights (0-5 kg) applied
– Measure voltage output in Labview
– Convert to force
2. Tare– Zero weight zero force
3. Pre-operative testing– Surgeons will calibrate with
weights every 5-10 uses to confirm precise results (calibration curve is still relevant)
Timeline – Near Future
• Attach sensors and test with weights –
today• Test on porcine
model – 4th week of Feb
• Modify design – early March