TRANSFASCIAL HERNIA FIXATION DEVICE

PHYSICIAN:
Ali Tavakkoli-zadeh, MD, Harvard Medical School

STUDENTS:
Megan Roberts, Michael Eilenberg, Jessica Galie

MODERATOR:
Rajiv Gupta, MD: MGH

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INTRODUCTION:

With the goal of engaging graduate students and accelerating ideas into prototypes, teams of MIT graduate students in Electrical Engineering and Mechanical Engineering spend a semester collaborating with clinicians in CIMIT-affiliated hospitals to develop innovative medical devices. Clinicians (physicians, nurses, and scientists) present clinical problems and initial ideas on how they might be solved. Students form teams to work with the clinicians to turn these ideas into reality. The goal is for the students to deliver a working prototype and a journal-quality article in one semester. The course has been a great opportunity for clinicians to test out new ideas and to stimulate new collaborations. For example, Robopsy, a robotic device to assist radiologists performing tumor biopsies was invented by an MIT team led by Rajiv Gupta, MD, in 2004. The team has been awarded the 2007 MIT $100K prize, the world's leading entrepreneurship competition.

SUMMARY:

The abnormal protrusion of an organ through a wall supposed to contain it is referred to as a hernia.  Hernias can occur anywhere, and most require surgical repair to alleviate pain and to prevent life-threatening complications.  A ventral hernia refers to a case in which the intestine protrudes through the middle of the abdominal wall.  Around one hundred thousand ventral hernias are treated each year, either via open surgery or via laparoscopic surgery.  The latter is less invasive and seems to be the most effective treatment strategy.  In the laparoscopic procedure, small incisions are made and a mesh is fixed over the breach in the abdominal muscles to prevent any organs from protruding.  The mesh can be tacked to the abdominal wall, but the tacks sometimes work loose and allow the hernia to return.  Transfascial sutures can also be used, but these can be difficult to place laparoscopically and can cause significant post-operative pain.  Students from MIT are exploring a new technique that uses anchors to hold the mesh in place.  The anchors are placed above the fascial layer and below the adipose tissue, and they are compatible with most sutures.  The anchors have yet to be perfected and are not ready to be tested in humans, but the students have number of ideas to improve their design and their materials.