New system of mesh fixation for ?onlay hernia repair“, based on a new principle – ?the equally-distributed-tension principle“ – innovative surgical technique

摘要

Introduction. This article presents a new mesh fixation technique for “onlay hernia repair”, based on a new principle – the “Equally-Distributed-Tension Principle”. Methods. The fixation technique is based on a continuous suture, different from any other continuous suture, with no stiffened points of attachment. It allows a slight glide of the thread, making possible the equally-distribution of tension. Based on this technique it is possible to realize a mesh fixation under tension. The ?tension-free” concept is not suitable for ventral hernias. The mesh should be sutured under tension – the only way to remove the tension from the midline suture and offer the posibility for the aponeurotic layer to heal and regain its strenght. A new fixation system is necessary, a more efficient one, that will sustain this tension, without failure. In the same time, this system is the only one capable to realize an uniform distribution of tension. Results. Between February 2016 and November 2018, 49 patients were treated by this method in the Ilfov County Emergency Hospital, Bucharest, Romania, with only one recurrence until now (a bridging technique was used in this case). Conclusions. The new suture system is very easy to apply, very fast, extremely reliable and offers the posibility to manage a large variety of ventral hernias.