Tension measurements in abdominal wall hernia repair: Concept and clinical applications

Abstract

Tension has always been and remains an important concept in hernia repair. Revolutionary techniques in the field of hernia repair have generally aimed to reduce tension and thereby reduce recurrence rates. Despite the uniformly agreed upon idea that tension is an important part of hernia repair, little is known about this subject in ventral and incisional hernias. We reviewed all published journal articles related to abdominal wall tension. Articles were organized into basic science and clinical reports, and results were evaluated for type and technique of tension measurement and implications for clinical practice. Several cadaveric and clinical studies relate to the measurement of abdominal wall tension. Despite similar methods of measuring, there is no uniformly agreed upon device or measurement. Abdominal wall tension has not been correlated with hernia width, and abdominal wall tension measurement has shown to be a useful adjunct intraoperatively. Abdominal wall tension measurements likely have a role in both the research and clinical practice of hernia surgery.