DynaMesh®-CICAT

Optimally adapted tri-elasticity
Because of its tri-elasticity, which is adapted to the anatomical and biomechanical properties (dynamometry) of the human abdominal wall, DynaMesh®-CICAT provides the highest possible degree of patient comfort

1. Skin incision 2 to max. 5 cm via hernial orifice (Fig. A).
2. Display of hernial defect and preparation of the hernia sac.
3. Optional: minimal opening of the hernia sac allowing for manual probing, followed by open or laparoscopic adhesiolysis.
4. The peritoneum is freed up approx. 2 cm from the linea alba in a circular pattern and the posterior layer of the rectus muscle is freed.
5. The posterior layer of the rectus muscle is opened laterally on both sides (instrument: EndoTORCH ) (Fig. B) about 1 cm from the medial border of the rectus muscle (Fig. C).
6. Using long slim retractors and under endoscopic monitoring, the posterior layer of the rectus sheath is freed laparoscopically from the rectus muscle. In the midline endoscopically assisted dissection is performed in the preperitoneal plane: The peritoneum is freed up from the linea alba.
7. The further totally extraperitoneal preparation is performed through the hernia, either under direct vision with laparoscopic instruments or with endoscopic assistance.
8. The posterior layer of the rectus sheath generally remains open with a completely closed midline peritoneum.
9. Placement and spreading of the DynaMesh®-CICAT mesh implant in the extraperitoneal cavity as a double roll and without skin contact.
10. Closure of the hernia defect over the mesh implant under minimal tension (Fig. D).11. Fixation of the DynaMesh®-CICAT me
11. Fixation of the DynaMesh®-CICAT mesh implant is only required if the hernia defect cannot be completely closed and there is bridging of the hernia defect.