How I do it: using physics and progressive defect tensioning to close large hernia defects during MIS ventral hernia repair
- 01.12.2025
- How-I-Do-It
Erschienen in:
- Verfasst von
- Xavier Pereira
- Pedro De Oliveira
- Daniel Tagerman
- Gustavo Romero-Velez
- Rockson Liu
- Flavio Malcher
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Introduction
Closure of large hernia defects with minimally invasive surgery has long-been a challenge. Barbed sutures have helped us bridge this technical gap, but their off-label use is not well studied.
Materials and methods
We describe a suturing technique for minimally invasive ventral hernia repair (MIS-VHR) termed “progressive defect tensioning” and explore its theoretical advantages. Progressive defect tensioning utilizes barbed sutures to progressively and evenly re-approximate the fascia along the entire defect length. Tension is then sequentially applied to each throw, distributing the load across multiple anchor points along the closure. This redistribution of tension is explained using a physics model to depict its theoretical benefit. We also explore how biomechanical properties, such as tissue creep and hysteresis, impact closure of complex defects.
Results
Our initial, proof-of-concept cohort of 12 patients with hernias larger than 10 cm undergoing MIS-VHR had acceptable perioperative outcomes compared to the literature.
Conclusions
Ultimately, progressive defect tensioning leverages the properties of barbed sutures and the biomechanics of fascia to achieve optimal tension distribution during MIS-VHR.
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- Titel
- How I do it: using physics and progressive defect tensioning to close large hernia defects during MIS ventral hernia repair
- Verfasst von
-
Xavier Pereira
Pedro De Oliveira
Daniel Tagerman
Gustavo Romero-Velez
Rockson Liu
Flavio Malcher
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03230-6
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