an opening in the abdomen an opening in the market: hernia tensiometer group 2: martha ingram megan...
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An Opening in the Abdomen
An Opening in the Market:
Hernia Tensiometer
GROUP 2:Martha Ingram
Megan JohnstonChelsea Samson
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What Is a Hernia?
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Laparoscopic
Open
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“Tension-Free” Repair
Method
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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
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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
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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
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*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
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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
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•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
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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 %
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User Response:
Relaxing Incisions
Mesh Placeme
nt
Suture Closed
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Clamp both hernia edges between metal
plates
Large, sharp serrations hold tissue in place
Lash force sensors across
opening
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Static arm
Mobile arm
Digital display
Gear to wind hernia edges
together
Force Sensor
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Indentation Testing
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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)
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Timeline – Near Future
• Attach sensors and test with weights –
today• Test on porcine
model – 4th week of Feb
• Modify design – early March