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Treat incisional hernias reliably with the GRIP concept

Interdisciplinary treatment team | Photo: Heidelberg University Hospital
Research for the new concept has been conducted at Heidelberg University Hospital's Department of Surgery | Photo: Heidelberg University Hospital

Incisional hernia is common after substantial surgery. Risk factors for the development of incisional hernia include increased age, overweight, diabetes mellitus, respiratory conditions and others. Patients generally notice the incisional hernias themselves: there is a bump, sometimes painful. Incisional hernia limits movement and restricts ability to work as well as quality of life.  Thus, patients search for solutions to eliminate the hernia or wear a truss.

All hospitals and many established surgeons treat incisional hernias. When the hernia is small, repair is simple. When it reaches a diameter over 5 cm, repeat complications such as wound suppuration, chronic pain, and further herniation often occur.

For incisional hernia repair, a synthetic mesh is typically placed to strengthen the weak abdominal wall. There are close to 150 different synthetic meshes. These meshes can be inserted in four distinct positions in the abdominal wall and secured with at least ten different systems. Thus, there are over 4500 potential alternatives for incisional hernia repair.

Research at Heidelberg University Hospital's Department of Surgery shows that treatments vary markedly. A self-developed model was used to test repair stability with coughing. Over the last five years, this globally-unique model has found that very good care coexists with very unstable repairs. A method was developed to calculate the stability of an incisional hernia repair: the GRIP concept. Large hernias and weak connective tissue require higher GRIP to ensure biomechanically stable repair. The GRIP concept enables selection of optimal treatment for individual patients from many options. 

Further information:

European Pancreas Center

(Medical Director: Prof. Dr. Markus Büchler)