Patient-specific stomach biomechanics before and after laparoscopic sleeve gastrectomy

• DOI: 10.1007/s00464-022-09233-7
• Publication Date: 2022-04-22T15:02:48Z
• Authors: Ilaria Toniolo; Alice Berardo; Mirto Foletto; Claudio Fiorillo; Giuseppe Quero; Silvana Perretta; Emanuele Luigi Ca...
• Keywords: Bariatric surgery; Stomach; Computational modeling; Article; Biomechanical Phenomena; Obesity, Morbid; 3. Good health; Laparoscopic sleeve gastrectomy; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Gastrectomy; Quality of Life; Humans; Biomechanics; Patient-specific model; Laparoscopy

Abstract Background Obesity has become a global epidemic. Bariatric surgery is considered the most effective therapeutic weapon in terms of weight loss and improvement of quality of life and comorbidities. Laparoscopic sleeve gastrectomy (LSG) is one of the most performed procedures worldwide, although patients carry a nonnegligible risk of developing post-operative GERD and BE.

Objectives The aim of this work is the development of computational patient-specific models to analyze the changes induced by bariatric surgery, i.e., the volumetric gastric reduction, the mechanical response of the stomach during an inflation process, and the related elongation strain (ES) distribution at different intragastric pressures.

Methods Patient-specific pre- and post-surgical models were extracted from Magnetic Resonance Imaging (MRI) scans of patients with morbid obesity submitted to LSG. Twenty-three patients were analyzed, resulting in forty-six 3D-geometries and related computational analyses.

Results A significant difference between the mechanical behavior of pre- and post-surgical stomach subjected to the same internal gastric pressure was observed, that can be correlated to a change in the global stomach stiffness and a minor gastric wall tension, resulting in unusual activations of mechanoreceptors following food intake and satiety variation after LSG.

Conclusions Computational patient-specific models may contribute to improve the current knowledge about anatomical and physiological changes induced by LSG, aiming at reducing post-operative complications and improving quality of life in the long run.