ArticleHernia : the journal of hernias and abdominal wall surgery2025
Robotic-assisted treatment of flank hernias with progressive intracorporeal fascial traction (PIFT): A novel technique for secure fascial adaptation.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIncisional flank hernias pose a particular challenge due to scarred, retracted fascial edges and complex regional anatomy. This study evaluates a robotic-assisted technique employing progressive intermittent intracorporeal fascial traction (Vicryl 0 sliding-knot) combined with barbed-suture augmentation (STRATAFIX™ Symmetric PDS 0) in large-volume defects.
methodsBetween June 2023 and January 2025, 13 patients with symptomatic incisional flank hernias underwent repair with the da Vinci X
resultsMedian total operative time was 167 min (IQR 117-193.5), console time 141 min (IQR 104.5-176.5). The median defect size was 138.75 cm² [IQR 55.5-249]. Meshes with a median size of 433 cm² [315-572.5] and a mesh-to-defect ratio of > 3:1 were implanted. Pain scores remained stable at median VAS 2/10 on postoperative days 1-3. One patient developed seroma (Clavien-Dindo I); no Clavien-Dindo ≥ II complications occurred. No hernia recurrences were observed till the six months follow-up. Median length of stay was 2 days (IQR 2-3).
conclusionProgressive intracorporeal fascial traction with sliding-knot technique and barbed-suture reinforcement allows safe, tension-reduced repair of large incisional flank hernias, resulting in low pain levels, brief hospitalization, and no early recurrences. Longer-term, comparative studies are warranted.
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