We have experience with thirty fascia traction procedures performed so far with the fasciotens device in large loss-of-domain hernias with widths up to 40 cm (W III +++): 28 hernias could be closed primarily without tension after 30 minutes of intraoperative traction with 12 kg.
In 2 cases with a width of 40 cm and 25 cm (in this case, however, with considerable scar bone formation), we were also able to achieve a stretch gain of approx. 10 cm in each case, but were then able to close the abdominal wall by means of additional transversus abdominis release (TAR) and use of a large sublay mesh as well as a bridging mesh.
Fascia traction with fasciotens presents itself to us as a simple procedure for the treatment of large loss-of-domain hernias and helps to avoid complicated and complicating component separations in some cases.

Prof. Dr. Henning NiebuhrHead of Surgery, Hamburger Hernien Centrum, Hamburg

Abdomen apertum occurs especially after aortic rupture (incidence 10-20%). In this patient, pressure relief on the abdominal organs is essential and, as far as I know, the fasciotens system is the only system that can really guarantee this. It is a very new and effective procedure.


We have also used fasciotens on awake patients, with intermittent traction… the patient tolerated it well and it did not subjectively affect his respiratory function….

Prof. Dr. Eike Sebastian Debus
Prof. Dr. Eike Sebastian DebusHospital Director, UKE Hamburg

We were able to use the fasciotens system in a planned operation and a huge hernia with loss of domain. It was amazing to see how the abdominal wall distended within 40 minutes. We did not have to perform a lateral release and were able to achieve closure of the abdominal wall with the help of a sublay placed mesh.

Prof. Dr. med. Johannes Schmidt, MHBA
Prof. Dr. med. Johannes Schmidt, MHBAChief Physician General, Visceral and Thoracic Surgery, Landshut-Achdorf Hospital

In my experience, the fasciotens system can be used quickly and easily even by the inexperienced. The material is of high quality and works reliably. The results I have achieved in a short time thanks to the system, both with open abdomens and with large abdominal wall hernias, have convinced me. Fasciotens is now an integral part of our surgical armamentarium!

Krieglstein
Prof. Dr. Christian KrieglsteinChief Physician Surgery, St. Elisabeth Hospital Cologne-Hohenlind

It is amazing what the Fasciotens device can do. This applies to the closure of large abdominal wall hernias with “loss of domain” as well as to patients with open abdomens in intensive care. It succeeds in closing the abdomens without the use of surgical procedures such as “component separation ” or “TAR”. In patients with giant hernias, securing the result with a sublay mesh is crucial from my point of view. The long-term results for patients with open abdomen remain to be seen, as they cannot receive sublay mesh reinforcement.  In some of these cases, an elective second operation with mesh is a conceivable option for lasting success.

Prof. Dr. Hans Martin Schardey
Prof. Dr. Hans Martin SchardeyChief Physician Surgery, Hospital Agatharied GmbH Hausham

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Dr. Thomas Halama
Dr. Thomas Halamaltd. Oberarzt St. Vinzenz-Hospital Köln

We succeeded in directly closing a 25 x 22 cm hernia after 30 minutes of intraoperative traction. For augmentation of the abdominal wall, in the case of additional lateral hernias on both sides, in addition to mesh placement in the sublay position, a bds. TAR was performed to enlarge the mesh bed. The postoperative course was without complications and the patient left our hospital satisfied on the 6th postoperative day.

Claus Franke
Prof. Dr. med. Claus FrankeChief Physician Surgery, Sana Kliniken Düsseldorf GmbH

When I first heard about the technique, I found the biomechanical principle behind it ingenious and was almost annoyed that I hadn’t thought of it myself. I only had reservations about whether the fascia stretching would also last postoperatively. These concerns were immediately dispelled during the first application. A loss-of-domain hernia with a more or less destroyed abdominal wall after 6 previous operations and we managed to almost completely close a 23 cm defect. A year later it is still holding!

Marc Renter
Dr. Marc RenterHead Physician of Surgery, St. Josef Hospital Moers

Fasciotens®Abdomen supports intraoperative fascial stretching and can contribute to prompt, primary abdominal wall closure, e.g. in “open abdomen treatment” (OAT) in the context of “abdominal compartment syndrome” (ACS). In a small feasibility study (n=9), the system could be used even in complex abdominal incisions. Multiple cycles promote approximation of fascial edges and in combination with “negative pressure wound therapy” (NPWT) it can be used comfortably, e.g. in ICU. This is certainly a step forward for this highly complicated patient group.

Burkhard Stoffels
PD Dr. Burkhard StoffelsChief Physician Surgery, Heilig Geist Hospital Cologne

When an innovation is created with boundless euphoria, the simplicity of the active principle is celebrated together with the managing director at the operating table (on 24.12.) and everyone afterwards knows exactly what they have to do and enjoys implementing it, then the Fasciotens company has just solved another problem. Thank you for the product and the excellent support.

Dr. Henning Langwara
Dr. Henning LangwaraChief Surgeon, Rheinlandklinikum Dormagen

In acute care surgery we have to face sometimes very challenging situations with hostile abdomens. Fascial retraction, visceral edema and loss of domain might become a nightmare also in experienced hands. A simple concept as vertical traction obtained with the use of Fasciotens helped me to close an abdomen that seemed to be a “mission impossible”. Surprisingly, with few tips and tricks provided by the company and colleagues that had previous experience with this new device, the management has been quite simple.

Hayato Kurihara, M.
Dr. M. Hayato KuriharaHead of Emergency Surgery and Trauma Unit, Humanitas Research Hospital Rozzano, Italy

With fasciotens I was able to close a 16 cm wide hernia without further component separation. The patient complained of hardly any pain postoperatively and could be discharged after 7 days. This is an impressive result for such a large hernia.
In particular, the risk of a postoperative wound complication is significantly lower due to the much smaller wound area compared to the transversus abdominis release.
After this experience, I am absolutely convinced of the effectiveness and benefit of fasciotens in the treatment of complex abdominal wall hernias.

Dr. Woeste
PD Dr. med. Guido WoesteChief Physician Chrirugy, AGAPLESION ELISABETHENSTIFT Darmstadt

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Prof. Dr. med. Henning Niebuhr
Prof. Dr. med. Henning NiebuhrHernienzentrum Hamburg

After Dietmar Eucker presented the method at the Hernia Days in Cologne in 2018, D. Eucker, O. Stern and I formed the AWEX (Abdominal wall expanding System) study group because of the simplicity and the promising effects. The results, including the long-term results, are really very good! After treating a patient with Fasciotens for the first time, I was immediately enthusiastic about the device. Fasciotens leads to a very high comparability of data from different centres due to the standardisation of the traction device and especially due to the precisely defined traction force that is possible for the first time with Fasciotens. Fasciotens thus raises intraoperative abdominal wall stretching to a new level.
A major advantage of the method is that it is possible to dispense with the dissection of the intact lateral abdominal wall and thus achieve a significant reduction in the wound cavity.
Also, parts of the dissection outside the hernial orifice can be performed according to minimally invasive principles. Thus, the undermining of the linea alba cranially and causally can be performed in a less-open sublay technique. In this way, the tissue can be additionally spared.

Clinton Luedtke
Dr. Clinton LuedtkeSenior Physician Hernia Center, Westpfalzklinikum Kusel

Fasciotens is a very promising new option for the treatment of large abdominal wall and incisional hernias.

Wolfgang Reinpold
Dr. Wolfgang ReinpoldHead of Surgery, Hamburger Hernien Centrum, Hamburg

In Emergency Surgery it is not uncommon to carry out repeated and prolonged open abdomen (OA) operations in order to control and eradicate complex intra-abdominal infections. These open operations involve inevitable fascial retractions making it difficult or impossible to close the abdominal wall except with the use of prostheses with additional risks of early or late infections.

The idea that vertical traction increases abdominal volume, reduces intra-abdominal pressure, stretches the fascial surface and facilitates the direct closure of OA is very fascinating.

In April 2020, we used fasciotens®Abdomen in a young patient with prolonged open abdomen due to multiple abscesses both central and bilateral, following severe necrotizing pancreatitis.

For the first time, in Italy, fasciotens Abdomen was used in a bilateral subcostal laparotomy with a loss of substance of 18 cm after 3 weeks of open abdomen and within 15 days we were able to perform a direct closure of the abdomen.

Prof. Dr. Gabriele SgangaChief Surgeon, A. Gemelli University Hospital Foundation IRCCS, Rome