Abstract
Abstract Aim Hernia meshes can be classified according to the tackiness towards cyclic load. Meshes with the best adhesiveness are named DIS class A. Are reconstructions with these meshes durable after 3 years? Material and methods Biomechanical principles of the reconstruction of the abdominal wall were analyzed ex vivo with cyclic loading common in material sciences. The resulting GRIP concept was clinically applied. The patients were followed in yearly intervals. Results A total of 129 patients (68 males and 61 females) were followed for 3 years after treatment for 93 primary and 36 recurrent incisional hernia. Progrip® was used in 53 cases (P), Dahlhausen® Cicat in 76 cases (C). P was used for smaller hernia with lower overlap due to the higher tackiness. Hernia sizes treated with C were significantly larger (u-test: p > 0.001). The mesh-defect area ratio was higher with P compared with C (11.9 vs 5.8). Fixation requirements were lower with 8 points for P and 80 points for C to reach adequate GRIP levels. GRIP was twice that minimally required. Larger hernia took longer OR times (median P: 104 vs. median C: 183 min; p > 0.001). Larger hernias were associated with more postoperative minor complications (6–14%, 1 re-operation for seroma). Length of stay was comparable with 5–6 days. During follow up, no recurrence was detected. Pain levels were low (median NAS = 0 after 3 years; u-test: p = 0.07672). Conclusion Incisional hernia can be repaired safely and durably based on biomechanical principles.
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