Clinical Application of the Measurement of Abdominal Wall Tension in Hernia Repair.

Clinical Application of the Measurement of Abdominal Wall Tension in Hernia Repair. Surg Technol Int. 2019 Oct 04;35: Authors: Bilezikian JA, Faulkner JD, Fox SS, Hooks WB, Hope WW Abstract Abdominal wall tension is an integral concept in hernia repair. Most of the described techniques attempt to reduce abdominal wall tension by using mesh prosthetics or myofascial release. Although the concept of a "tension-free" hernia repair is well-understood and appreciated by surgeons, quantitative information about abdominal wall tension is limited. This review evaluates the published literature related to abdominal wall tension and summarizes how the measurement of intraoperative tension can guide clinical decision-making. Most of the methods and techniques for measuring abdominal wall tension are similar and involve the use of tensiometers. However, there is no accepted standardized technique. Baseline tension measurements confirm the concept of a baseline physiological tension, and it has been observed that tension does not correlate with hernia width. When the tension is considered to be too great during hernia repair, intraoperative techniques such as myofascial release can be used to reduce tension to physiological values. Emerging data from clinical studies on tension have added to our understanding of the mechanics and physiology of the abdominal wall. Standardized devices and measurement techniques need to be developed and validated t...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research