Dear Editor,
With great interest, we read the invited commentary by Dr. Hollinsky published in Hernia in 2017 [Oct; 21(5):793] [1] as a response to our recent article in Hernia [Oct; 21(5):783–791] [2]. In our opinion, these kinds of commentaries are of vital importance to the academic discussion. Although we agree with the author that there might be some slight practical imperfections present in our study, we would like to respond to some of the issues addressed by the author.
First, it is stated that “…no closure technique was tested up to failure and at the end it is impossible to say how close or far away from reality this artificial abdominal wall simulator is” [1]. This would only be necessary in the case of testing the occurrence of burst abdomen and this was not the purpose of our study.
Second, we agree with the author that the addition of vertical forces would increase the clinical resemblance of the human abdominal wall. However, the issue of the potential friction between the Vacufix® bag and the abdominal wall was compensated for by placing two PTFE sheets between the bag and the abdominal wall.
Finally, we agree with the last issue addressed. In fact, we also address this issue in our article. The lack of tissue healing does not make the AbdoMAN suited for every situation desired for. However, the direct accessibility of testing equipment and the animal-free testing possibilities make the AbdoMAN a potentially useful addition to current experimental abdominal wall research.
References
Hollinsky C (2017) Hernia 21:793. https://doi.org/10.1007/s10029-017-1660-5
Kroese LF, Harlaar JJ, Ordrenneau C et al (2017) Hernia 21:783. https://doi.org/10.1007/s10029-017-1615-x
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Kroese, L.F., Jeekel, J., Kleinrensink, G.J. et al. Reply to Invited comment to the ‘AbdoMAN’: an artificial abdominal wall simulator for biomechanical studies on laparotomy closure techniques. C. Hollinsky. Hernia 21, 999 (2017). https://doi.org/10.1007/s10029-017-1701-0
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DOI: https://doi.org/10.1007/s10029-017-1701-0