Figure 10.

Pre-operative assessment of the incisional hernia of a liver transplant recipient, 65–70 years old, as a function of the diameter of his round hernia defect. The large shaded circles indicate the hernia sizes at various time points with magnetic resonance (MR), computed tomography of the abdomen (CTA) at rest (sup) and during a Valsalva maneuver (V). The required critical resistance to impacts related to pressure (CRIP) is depicted by the small circles, the hernia size at a given diameter by the dots. The cornered symbols indicate the respective resistance toward impacts related to pressure (GRIP) gained by a 30 × 45 cm ellipsoid mesh with a coefficient of 1 in various mesh-defect area ratios (MDAR), a sublay/retromuscular position, combined with a posterior component separation (TAR), and two distinct fixation factors (FF50 = 100 suture points or FF100 = 200 sutures points). A double peritoneal flap reconstruction (DPF) gains space for mesh placement. A sandwich reconstruction (SW) with a biosynthetic mesh adds to the MDAR of the reconstruction. The area covering durable repair options is shaded in light gray with marked borders.