--- title: Case Reports & Publications description: See how fasciotens®Hernia is used in clinics or read our publications --- [Go Back Up](https://www.fasciotens.com/case-reports-hernia#top) [Skip to Content](https://www.fasciotens.com/case-reports-hernia#body) [![fasciotens home](https://www.fasciotens.com/hs-fs/hubfs/Logos/fasciotens_logo_aws_2020.png?width=200&height=52&name=fasciotens_logo_aws_2020.png "fasciotens home")](https://www.fasciotens.com?hsLang=en) Toggle Menu - [Open Abdomen](https://www.fasciotens.com/abdomen) Toggle children for Open Abdomen Main Menu (Press to Return) \> Open Abdomen - [Discover more](https://www.fasciotens.com/abdomen) - [Publications & Case Reports](https://www.fasciotens.com/case-reports-abdomen) - [E-learning courses](https://academy.fasciotens.com/pages/abdomen) - [How-tos & Instructions](https://www.fasciotens.com/how-tos-abdomen) - [Complex Hernias](https://www.fasciotens.com/hernia) Toggle children for Complex Hernias Main Menu (Press to Return) \> Complex Hernias - [Discover more](https://www.fasciotens.com/hernia) - [Publications & Case Reports](https://www.fasciotens.com/case-reports-hernia) - [E-learning courses](https://academy.fasciotens.com/collections/hernia) - [How-tos & Instructions](https://www.fasciotens.com/how-tos-hernia) - [Congenital Defects](https://www.fasciotens.com/pediatric) Toggle children for Congenital Defects Main Menu (Press to Return) \> Congenital Defects - [Discover more](https://www.fasciotens.com/pediatric) - [How-tos & Instructions](https://www.fasciotens.com/how-tos-pediatric) - [Congresses & Workshops](https://www.fasciotens.com/congresses-workshops) - Services Toggle children for Services Main Menu (Press to Return) \> Services - [E-Learning](https://academy.fasciotens.com) - [Case Discussion](https://www.fasciotens.com/case-discussion) - [Product Feedback & Complaints](https://www.fasciotens.com/product-feedback) - [Downloads](https://www.fasciotens.com/downloads) - [Newsletter](https://www.fasciotens.com/newsletter) - [About us](https://www.fasciotens.com/about-us) - [Local Distribution Partners](https://www.fasciotens.com/contact#distributor) - [Contact](https://www.fasciotens.com/contact) - - [English](https://www.fasciotens.com/case-reports-hernia) - [Deutsch](https://www.fasciotens.com/de/case-reports-hernia) # Clinical use and scientific data of fasciotens®Hernia Our [**case reports**](https://www.fasciotens.com/case-reports-hernia#case-reports) give you valuable insights: Explore how fasciotens® is used in ORs worldwide in clinical routines. To read more about the scientific aspects head to the [**publications**](https://www.fasciotens.com/case-reports-hernia#publications). ## Case Reports Get detailed insights in the OR and see how the system works in real cases All ##### Giant 25cm hernia Hernia repair with use of Botox ![25 cm Giant Hernia\_NL\_\_0008\_04\_Attaching the sutures to the fascia](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2023_10_NL_25cm/25%20cm%20Giant%20Hernia_NL__0008_04_Attaching%20the%20sutures%20to%20the%20fascia.jpg?width=770&name=25%20cm%20Giant%20Hernia_NL__0008_04_Attaching%20the%20sutures%20to%20the%20fascia.jpg) ##### Laparoscopic treatment Inguinal hernia repair with 7 kg hernia sac ![Giant scrotal hernia\_Distribution Suture Threads](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2023_11_DE_Laparoscopic/Giant%20scrotal%20hernia_Distribution%20Suture%20Threads.jpg?width=770&name=Giant%20scrotal%20hernia_Distribution%20Suture%20Threads.jpg) ##### Lateral hernia IFT in lateral hernia ![Lateral hernia\_\_0000\_Standing](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2022_12_DE_Lateral%20Hernia/Lateral%20hernia__0000_Standing.jpg?width=770&name=Lateral%20hernia__0000_Standing.jpg) ##### IFT & PPP Holistic approach for managing a large hernia ![Case Reports Hernia\_York](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Case%20Reports%20Hernia_York.jpg?width=770&name=Case%20Reports%20Hernia_York.jpg) ##### Infected Mesh Recurrent hernia repair with infected mesh ![Case Reports Hernia\_Infected Mesh Pisa](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Case%20Reports%20Hernia_Infected%20Mesh%20Pisa.jpg?width=770&name=Case%20Reports%20Hernia_Infected%20Mesh%20Pisa.jpg) ##### Hybrid Approach Laparoscopic sleeve gastrectomy & hernia repair ![Mumbai - Rahul Mahadar Case1\_photo2](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2024_12_IN_Hybrid%20Approach/Mumbai%20-%20Rahul%20Mahadar%20Case1_photo2.jpg?width=770&name=Mumbai%20-%20Rahul%20Mahadar%20Case1_photo2.jpg) ##### IFT Combined with BTA Open repair of recurrent ventral hernia ![Mahadar (Mumbai) - Open Approach 15cm\_photo8](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2024_IN_Open%20Repair%20Mumbai/Mahadar%20(Mumbai)%20-%20Open%20Approach%2015cm_photo8.jpg?width=770&name=Mahadar%20(Mumbai)%20-%20Open%20Approach%2015cm_photo8.jpg) ##### IFT in Ventral Hernia Incisional Hernia Repair Following Open Abdomen due to Pancreatitis ![Pre-Op Herne](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2025_04_DE_Herne/image1.jpg?width=770&name=image1.jpg) ##### IFT & TAR Repair of a large incisional hernia with loss of domain ![Frankfurt - Terence Alapatt Case 1\_photo1 small](https://www.fasciotens.com/hs-fs/hubfs/Case%20Reports/Hernia_2022_02_DE_Frankfurt_TAR/Frankfurt%20-%20Terence%20Alapatt%20Case%201_photo1%20small.jpg?width=770&name=Frankfurt%20-%20Terence%20Alapatt%20Case%201_photo1%20small.jpg) ## Publications & clinical data ![Info Graphic Barbosa Scrotal Hernia](https://www.fasciotens.com/hs-fs/hubfs/Emails/Newsletter/Info%20Graphic%20Barbosa%20Scrotal%20Hernia.jpg?width=800&height=800&name=Info%20Graphic%20Barbosa%20Scrotal%20Hernia.jpg) Springer Hernia, 30:136 (2026) ### Laparoscopic application of intraoperative fascial traction (fasciotens®Hernia) during loss of domain scrotal hernia repair: A European multicenter case series with technical details and preliminary results Barbosa, E., Barone, G., Bertoglio, C.L. et al.  Giant inguinoscrotal hernias with loss of domain (LOD) represent a complex surgical indication with a relevant risk of abdominal compartment syndrome (ACS) after reconstruction, due to limited intra-abdominal volume compared to hernia content. Intraoperative fascial traction (IFT) is used to increase abdominal volume and facilitate controlled reintegration of herniated abdominal organs. In this retrospective case series including 9 patients, vertical traction was applied laparoscopically whilst the linea alba remained intact. This study evaluated whether IFT can safely enable hernia reduction and prevent postoperative ACS. Included patients had large scrotal hernias classified as S2 or S3 treated across eight European centers with a median follow-up of 19 months. The paper indicates a reduced need for PPP to increase intra-abdominal volume and demonstrates a potential strategy for preventing ACS by using IFT. - **0% postoperative ACS** - **0% recurrence at 19 months follow-up** - **Median IAP after reconstruction: 11.4 mmHg** - **Median hospital stay 9.5 days** [Download the publication](https://www.fasciotens.com/hubfs/Publications/Barbosa%202026%20-%20Loss%20of%20domain%20scrotal%20hernia%20repair%20IFT.pdf?hsLang=en) ![Infographic\_Hernia\_Niebuhr-Algorithm\_EN](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Infographic_Hernia_Niebuhr-Algorithm_EN.jpg?width=800&height=800&name=Infographic_Hernia_Niebuhr-Algorithm_EN.jpg) Journal of Abdominal Wall Surgery, 5:16018 (2026) ### Intraoperative Fascial Traction - From Concept to Comprehensive Application Niebuhr, H., Woeste, G., Winkler, C., Behle, S., Reinpold, W., Dag, H., Köckerling, F. This review paper proposes an algorithmic use of intraoperative fascial traction in complex abdominal wall hernias. Based on defect width and intraoperative findings, traction is applied to assess and optimize medialization before considering additional reconstructive steps. The approach aims to standardize decision-making in CAWR. *Treatment Subgroups by Defect Width:* - **I: Rives-Stoppa repair forms the surgical base in all defect sizes** - **II: Defect 8 to 19 cm: add IFT to achieve primary fascial closure** - **III: Defect \> 19 cm: Component separation plus IFT to enable additional medialization** [View algorithm full size](https://www.fasciotens.com/hubfs/Website%20Images/Publication_IFT%20Algorithm_large.jpg?hsLang=en) [Download the publication](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202026%20-%20IFT%20Review%20Paper.pdf?hsLang=en) ![Infographic\_Hernia\_Follow Up\_Woeste](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Infographic_Hernia_Follow%20Up_Woeste.jpg?width=800&height=800&name=Infographic_Hernia_Follow%20Up_Woeste.jpg) Springer Hernia, 29:154 (2025) ### Follow-up of Complex Hernia Repair with Intraoperative Fascial Traction Woeste, G., Dascalescu, G., Wegner, F. et al. This is the first publication to report long-term follow-up data on intraoperative fascial traction in complex hernia repair. The study includes data from 100 patients compiling 30-days postoperative outcomes and follow-up data gathered after outpatient appointments, including standardised dynamic abdominal wall ultrasound (DAWUS). The defect width in this cohort was 15.8 cm on average. 87 % of all patients were pre-treated with Botulinum Toxin A. - **Low recurrence rate of 2%** - **Mean follow-up time of 19.6 months** - **Direct closure rate of 94%** - **Significantly higher complication rate if additional TAR was performed** [Download the publication](https://www.fasciotens.com/hubfs/Publications/Woeste%202025%20-%20Follow-up%20of%20complex%20hernia%20repair%20with%20intraoperative%20fascial%20traction.pdf?hsLang=en) ![Pub\_Niebuhr\_Algorithm](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Pub_Niebuhr_Algorithm.jpg?width=645&height=656&name=Pub_Niebuhr_Algorithm.jpg) Springer Hernia, 28:2273–2283 (2024) ### Preoperative botulinum toxin A (BTA) and intraoperative fascial traction (IFT) in the management of complex abdominal wall hernias Niebuhr, H., Wegner, F., Dag, H. et al. The study provides an overview of using IFT and BTA in complex hernia surgery and assesses short-term outcomes (after 30 days). Cases were included if BTA and Rives-Stoppa alone didn't lead to a reconstruction of the abdominal wall. Intraoperative reduction of transverse hernia diameter of 9.81 cm (mean) is in line with findings from previous studies. The **Hamburg algorithm** was developed based on the results. - **Closure rate of 95.6% in cases up to 15 cm width** - **Mean operative time of 183.6 min including 30 min of IFT (less than comparable data for TAR)** - **TAR rate increases with hernia diameter** - **Complication and re-operation rates are significantly higher if additional TAR was performed** [Download the publication](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202024%20-%20BTA%20and%20IFT%20in%20the%20management%20of%20complex%20hernias%20(143%20cases).pdf?hsLang=en) ![Infographic\_Hernia\_50](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Infographic_Hernia_50.jpg?width=800&height=800&name=Infographic_Hernia_50.jpg) Chirurg 93, 292–298 (2022) ### Intraoperative fascial traction (IFT) for the treatment of large ventral hernias Niebuhr, H., Malaibari, Z.O., Köckerling, F. et al. This study summarises a retrospective analysis of 50 cases treated with IFT. 94 % of the patients had a hernia width above 10 cm (W3 according to EHS). Mean defect size before traction was measured at 16.1 cm intraoperatively. - **90% successful closure** - **Low complication rate: 12% postoperative complications whereof 50% didn't need surgical intervention** - **all patients received augmentation in sublay position** - **No cases of abdominal compartment syndrome** [Download the publication](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202022%20-%20retrospective%2050%20cases%20IFT.pdf?hsLang=en) ![Publications\_Hernia-Bloemendaal\_Tile\_1024x1024](https://www.fasciotens.com/hs-fs/hubfs/Website%20Images/Publications_Hernia-Bloemendaal_Tile_1024x1024.jpg?width=1024&height=1024&name=Publications_Hernia-Bloemendaal_Tile_1024x1024.jpg) Journal of Abdominal Wall Surgery, 1:10356 (2022) ### Intraoperative Fascial Traction in Robotic Abdominal Wall Surgery; An Early Experience A. L. A. Bloemendaal The first article reporting of 3 cases combining robotic ventral hernia repair and  intraoperative fascial traction. A retromusculular hernia repair was performed followed by a transcutaneous IFT. - **First cases showed promising results** - **IFT is easily combinable with robotic hernia repair** - **IFT facilitates robotic suturing of the hernia defect** - **IFT can potentially be used in robotic repair for very large defects** [Download the publication](https://www.fasciotens.com/hubfs/Publications/Bloemendaal%202022%20-%20Case%20Report%20Robotic%20Hernia.pdf?hsLang=en) #### More publications about fasciotens®Hernia [M. Rivano, 2026](https://www.fasciotens.com/hubfs/Publications/Rivano%202026%20-%20Fasciotens%20for%20abdominal%20wall%20closure%20current%20evidence%20and%20clinical%20perspectives.pdf?hsLang=en)[Fasciotens® for abdominal wall closure: current evidence and clinical perspectives](https://www.fasciotens.com/hubfs/Publications/Rivano%202026%20-%20Fasciotens%20for%20abdominal%20wall%20closure%20current%20evidence%20and%20clinical%20perspectives.pdf?hsLang=en) [E. Barbosa, 2026](https://www.fasciotens.com/hubfs/Publications/Barbosa%202026%20-%20Loss%20of%20domain%20scrotal%20hernia%20repair%20IFT.pdf?hsLang=en) [Laparoscopic application of intraoperative fascial traction (fasciotens®Hernia) during loss of domain scrotal hernia repair: A European multicenter case series with technical details and preliminary results](https://www.fasciotens.com/hubfs/Publications/Barbosa%202026%20-%20Loss%20of%20domain%20scrotal%20hernia%20repair%20IFT.pdf?hsLang=en) [S. Groß, 2025](https://www.fasciotens.com/hubfs/Publications/Gro%C3%9F%202025%20-%20Osterix%20im%20Land%20der%20Hernien.pdf?hsLang=en) [Osterix im Land der Hernien](https://www.fasciotens.com/hubfs/Publications/Gro%C3%9F%202025%20-%20Osterix%20im%20Land%20der%20Hernien.pdf?hsLang=en) [H. Gök, 2025](https://www.fasciotens.com/hubfs/Publications/G%C3%B6k%202025%20-%20Intraoperative%20Fascial%20Traction%20for%20increasing%20intra-abdominal%20volume%20in%20LOD%20Hernias%20.pdf?hsLang=en) [Case Report: Intraoperative Fascial Traction for Increasing Intra-Abdominal Volume in Loss-of-Domain Incisional Hernias: A Report of Two Cases](https://www.fasciotens.com/hubfs/Publications/G%C3%B6k%202025%20-%20Intraoperative%20Fascial%20Traction%20for%20increasing%20intra-abdominal%20volume%20in%20LOD%20Hernias%20.pdf?hsLang=en) [H. Niebuhr, F. Wegner, H. Dag et al., 2024](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202024%20-%20BTA%20and%20IFT%20in%20the%20management%20of%20complex%20hernias%20(143%20cases).pdf?hsLang=en) **[Preoperative botulinum toxin A (BTA) and intraoperative fascial traction (IFT) in the management of complex abdominal wall hernias](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202024%20-%20BTA%20and%20IFT%20in%20the%20management%20of%20complex%20hernias%20(143%20cases).pdf?hsLang=en)**  [Niebuhr et. al., 2024](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202024%20-%20Assessment%20of%20myofascial%20medialization%20following%20IFT%20in%20a%20cadaveric%20model.pdf?hsLang=en) [Assessment of myofascial medialization following intraoperative fascial traction (IFT) in a cadaveric model](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202024%20-%20Assessment%20of%20myofascial%20medialization%20following%20IFT%20in%20a%20cadaveric%20model.pdf?hsLang=en) [D. Eucker, R. Rosenberg, 2023](https://doi.org/10.1007/s00104-023-01997-5) [„Loss of domain“ und Verringerung der medianen Nahtspannung](https://doi.org/10.1007/s00104-023-01997-5) [J. Gorjanc et. al.,2023](http://dx.doi.org/10.4103/ijawhs.ijawhs_17_23) [The use of intraoperative fascial traction in W3-incisional hernia repair: A revolution or an emergency exit (two case reports)](http://dx.doi.org/10.4103/ijawhs.ijawhs_17_23) [B. Romain, G. Sauvineta, T. Rebierea, 2022](https://www.fasciotens.com/hubfs/Publications/Romain%202022%20-%20A%20complex%20incisional%20hernia%20repair%20with%20Fasciotens.pdf) [A complex incisional hernia repair with Intraoperative Fascial Traction device (with video)](https://www.fasciotens.com/hubfs/Publications/Romain%202022%20-%20A%20complex%20incisional%20hernia%20repair%20with%20Fasciotens.pdf?hsLang=en) [H. Niebuhr et. al., 2021](https://doi.org/10.1007/s00104-023-01997-5) [Intraoperative Fascia Tension as an Alternative to Component Separation. A Prospective Observational Study](https://www.fasciotens.com/hubfs/Publications/Niebuhr%202021%20-%2021%20Cases%2c%20prospective%20IFT.pdf) [See all our publications](https://www.fasciotens.com/downloads?hsLang=en#publication) [![fasciotens home](https://www.fasciotens.com/hs-fs/hubfs/Logos/fasciotens_logo_aws_2020.png?width=200&height=52&name=fasciotens_logo_aws_2020.png "fasciotens home")](https://fasciotens.com?hsLang=en) - [About us](https://www.fasciotens.com/about-us) - [Contact](https://www.fasciotens.com/contact) - [Privacy](https://www.fasciotens.com/privacy) - [Terms & conditions](https://www.fasciotens.com/terms-conditions) - [Imprint](https://www.fasciotens.com/imprint) [tel:+4920199999630](tel:+4920199999630) [mailto:info@fasciotens.de](mailto:info@fasciotens.de)