P-080 THE GRIP CONCEPT CONSIDERS BIOMECHANICAL PRINCIPLES FOR A DURABLE REPAIR OF INCISIONAL HERNIA – 3 YEAR FOLLOW UP

Abstract

Abstract Aim Durable hernia repair is based on specific biomechanical principles. How are the results after three years in primary and recurrent hernias? Material and methods The biomechanical principles were analyzed ex vivo with cyclic loading using a self-built bench test. The minimal requirements for a biomechanically durable repair were defined. The resulting GRIP concept was clinically applied. Results A total of 233 patients (123 males and 110 females) were treated for incisional hernia. Primary hernia was repaired in 170, recurrence in 63 patients with an average of 1.3 risk factors with most patients grouped as ASA III (n= 120). Emergency repairs were necessary in 11 patients. Hernia orifices were mostly median (N= 209) and lateral (89 patients, 59 combined). Hernia sizes were on average 9 + 6 cm wide and 13 ± 8 cm long. The mesh-defect area ratio was 7.8. Fixation was necessary (median of 60 fixation points). Recurrences required more effort for a durable repair (Primary OR duration: 165 ± 75 min; recurrence: 233 ± 89 min). A total of 138 patients were followed for three years so far. Four patients died during follow-up (Follow-up rate 100%). A second hernia in the un-repaired abdominal wall occurred three times (gunshot wound, appendectomy, cholecystectomy). Pain levels were low (median NAS = 0 at rest and under load). One recurrence was detected 8 months after primary repair in a liver transplant recipient reconstructed with a sandwich. Conclusion Primary and recurrent incisional hernia can be repaired durably based on biomechanical principles.