{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T22:47:35Z","timestamp":1771454855065,"version":"3.50.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019559","name":"Carl von Ossietzky Universit\u00e4t Oldenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019559","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Incisional 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\u2122 Symmetric PDS 0) in large-volume defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Between June 2023 and January 2025, 13 patients with symptomatic incisional flank hernias underwent repair with the da Vinci X\n                      <jats:sup>\u00ae<\/jats:sup>\n                      system. A macroporous polypropylene mesh was implanted. Patients were followed up at 1-, 3-, and 6-months including ultrasound, VAS pain scoring, and recurrence screening.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median total operative time was 167\u00a0min (IQR 117\u2013193.5), console time 141\u00a0min (IQR 104.5\u2013176.5). The median defect size was 138.75\u00a0cm\u00b2 [IQR 55.5\u2013249]. Meshes with a median size of 433\u00a0cm\u00b2 [315-572.5] and a mesh-to-defect ratio of &gt;\u20093:1 were implanted. Pain scores remained stable at median VAS 2\/10 on postoperative days 1\u20133. One patient developed seroma (Clavien-Dindo I); no Clavien-Dindo\u2009\u2265\u2009II complications occurred. No hernia recurrences were observed till the six months follow-up. Median length of stay was 2 days (IQR 2\u20133).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Progressive 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-025-03527-0","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T11:24:43Z","timestamp":1763551483000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robotic-assisted treatment of flank hernias with progressive intracorporeal fascial traction (PIFT): A novel technique for secure fascial adaptation"],"prefix":"10.1007","volume":"30","author":[{"given":"Anna","family":"Hannebauer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Al-Mawsheki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Bockhorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9116-5016","authenticated-orcid":false,"given":"Fadl","family":"Alfarawan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"3527_CR1","doi-asserted-by":"publisher","first-page":"2692","DOI":"10.1007\/s00464-009-0477-4","volume":"23","author":"C Edwards","year":"2009","unstructured":"Edwards C, Geiger T, Bartow K et al (2009) Laparoscopic transperitoneal repair of flank hernias: a retrospective review of 27 patients. 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Written informed consent was obtained from all patients and\/or their legal representatives for publication of potentially identifiable data or images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"For this work, no studies were performed on humans or animals by the authors.\u00a0The data collection of this study is based on a positive ethics vote of the Ethics\u00a0Committee of University Oldenburg, and the studies were performed based on the\u00a0ethical guidelines specified therein. For images or other information in the\u00a0manuscript that can be used to identify patients, written consent was obtained\u00a0from the patients and\/ or their legal representatives.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights and informed consent"}},{"value":"Anna Hannebauer, Ahmed Al-Mawsheki and Maximilian Bockhorn declare that they have no conflicts of interest. The Department for General \u2013 and Visceral Surgery, University Hospital Oldenburg, has been a European Reference Centre for DaVinci Hernia Surgery (Intuitive) since 2024; Fadl Alfarawan is a proctor for Intuitive and the income from this activity goes in full to the Klinikum Oldenburg A\u00f6R. This research received no external funding. The APC was funded by the University of Oldenburg.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13"}}