P-029 USE OF INTRAOPERATIVE FASCIAL TRACTION DEVICE (FASCIOTENS®). INITIAL EXPERIENCE IN A WALL SURGERY UNIT

Abstract

Abstract Aim We present the use of the Fasciotens-abdomen® fascial traction device for the closure of large eventrations in three patients treated in our department. Material & Methods Description of three cases of large eventration in which we used the Fasciotens-abdomen® device. Results The first patient is a 61-year-old woman with a history of anterior ultra-low rectal resection. She presents an M2-M4W3 10 cm eventration. A Rives eventroplasty was performed with placement of a 25×10cm retromuscular PPL mesh. Fasciotens-abdomen® device was applied with a 14–16 kg load during 25 minutes. The second case is a 45-year-old female patient with a previous umbilical hernioplasty in 2016. She presents an M2-M4W3R1 11 cm eventration. During the eventroplasty, fascial approach with Fasciotens-abdomen® device was performed for 25 minutes/14–16 kg, and a mesh of 22×11 cm was placed onlay. Thirdly, a 60-year-old female patient with a previous eventroplasty in 2015. She presented an M2-M3W3 14 cm eventration. During the Rives eventroplasty, 70 cm of small bowel were resected due to firm adhesions. The closure was performed with retromuscular mesh placement and fascial approximation with Fasciotens-abdomen®, for 25 minutes/14kg. All three patients received an infiltration of 15 IU of botulinum toxin weeks before the reconstruction surgery and were discharged from the hospital uneventflul. Conclusions Large incisional hernias pose a challenge to the surgeon. Adjunctive procedures for abdominal wall reconstruction, like the Fasciotens®fascial traction device, help to achieve tension-free midline closure.