RESUMEN
OBJECTIVE: The aim was to evaluate the effectiveness, clinical practicability, and complication rate of the intraoperative fascial traction (IFT) procedure for the treatment of large ventral hernias. METHOD: This study evaluated 50 patients from 11 specialized centers with an intraoperatively measured fascial distance of more than 8â¯cm, who were treated by IFT (traction time 30-35â¯min) using the fasciotens® hernia traction procedure. RESULTS: Fascial gaps measured preoperatively ranged from 8â¯cm to 44â¯cm, with most patients (94%) having a fascial gap above 10â¯cm (W3 according to the European Hernia Society classification). The mean fascial distance was reduced from 16.1⯱ 0.8â¯cm to 5.8⯱ 0.7â¯cm (stretch gain 10.2⯱ 0.7â¯cm, pâ¯< 0.0001, Wilcoxon matched-pairs signed-ranks test). A reduction in fascial distance of at least 50% was achieved in three quarters of the patients and in half of the treated patients the reduction in fascial distance amounted to even more than 70%. The closure rate achieved by IFT after a mean surgical duration of 207.3⯱ 11.0â¯min was 90% (45/50). Hernia closure was performed in all cases with a mesh augmentation in a sublay position. Postoperative complications occurred in 6 patients (12%). A reoperation was required in 3 patients (6%). CONCLUSION: The described IFT method is a new procedure for abdominal wall closure in large ventral hernias. The presented results demonstrate a high effectiveness, a good clinical practicability and a low complication rate of IFT.