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Closure Mechanics Matter

The challenge in hernia repair is managing  the imbalance of forces that weaken tissue over time.

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key Consideration

Abdominal wall closure and hernia repair present several well-recognized clinical challenges, Whether performed with primary suture repair or mesh reinforcement.1

These ongoing challenges have driven continued interest in technologies designed to improve tissue approximation and abdominal wall force distribution.

Suture repair creates high tension at the closure site

Primary suture repair concentrates mechanical forces at individual suture fixation points, particularly when closure is performed under tension. Excessive tension has been associated with impaired tissue perfusion, suture pull-through, wound failure, and higher recurrence rates.

  • Tissue ischemia and necrosis
  • Suture pull-through
  • Poor healing & wound dehiscence
  • Hernia recurrence

Mesh fixation is an imperfect suture-only replacement

Mesh reinforcement became widely adopted to reduce the high recurrence rates associated with tensioned suture repair and to reinforce abdominal wall closure, particularly for larger ventral and incisional hernias.3 Although mesh reinforcement reduces recurrence compared with suture repair alone, mesh-related complications include 4
  • Infection & fibrosis
  • Erosion & chronic inflammatory response
  • Chronic pain
  • Revision & complex re-operation
Mechanistic Superiority

TAS works differently

TAS is engineered to support primary fascial closure by redistributing biomechanical forces across the abdominal wall, reducing localized stress during tissue approximation. The system is designed to facilitate controlled closure while preserving native tissue planes and minimizing implant burden.

By providing an alternative approach to tissue approximation, TAS is intended to expand the surgeon’s options for managing complex abdominal wall defects, including cases that may otherwise require extensive suturing, large mesh reinforcement, component separation, or bridged repair.

Mechanism of Action

Broader force distribution, away from the suture-tissue interface

7× larger

Surface area vs. #0 polypropylene suture — broadening tissue contact and minimizing localized stress.

−86% PSI

Lower force-per-area at the tissue interface, reducing the risk of tearing and necrosis.

3.5× stronger

Fixation tensile strength vs. #0 nylon or polypropylene suture.

Sub gross histology, H&E. Cranial incision – TAS (Test Article), level A3 (mid incision), cranial face – skin (top of image) to peritoneum (bottom of image). Demonstrating the incision site, with a focal device imprint (black arrows) within a moderate localized fibrous reaction.
Scientific Evidence

TAS: as safe as a suture — the FDA challenge

TAS has been evaluated through bench testing, preclinical studies, FDA clearance testing, and growing clinical experience. In a preclinical chronic wound-healing in-vivo study, an independent board-certified DVM pathologist concluded:

“Implantation of TAS T-4000 zip-ties and nylon monofilament sutures for 13 weeks in a porcine laparotomy model resulted in normal healing at incision sites that was comparable between Test and Control Articles. No adverse events or findings were observed.”

Cross-Section Analysis

Purposefully Engineered.

Four design decisions, tested against the anatomy they contact. Select a marker on the cross-section or a feature below to see how it works.

TAS strap cross-section with four engineering callouts
Fig. 01 — TAS Strap, Sectional View Scale N/A
Closure

Allows for serial or sequential closure with a high-strength, adjustable lock to facilitate earlier definitive closure.

Tissue Pressure

Ameliorates tissue pressure profile, with a theoretical decrease in acute and chronic dehiscence potential.

Tensioning

For sequential, serial tightening and predictable tensioning — progressive approximation.

Atraumatic

Helps minimize tissue trauma upon contact.

An alternative native tissue solution

As a native tissue approximation technology, TAS is designed to provide an alternative approach to abdominal wall closure. By supporting progressive tensioning and controlled tissue accommodation, TAS is intended to facilitate approximation of native tissues while potentially reducing reliance on mesh-based reinforcement in selected cases.

TAS is designed to support primary fascial closure in cases where surgeons may otherwise consider additional reinforcement strategies, including bridging mesh, based on patient anatomy and clinical judgment.

Implementation Pathways

TAS, the Tissue Approximation System, represents a distinct approach to abdominal wall closure, designed to complement existing surgical techniques beyond traditional sutures and mesh reinforcement. Connect with our team to discuss the technology, clinical applications, hospital evaluations, and training opportunities.

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Page References
1.     Muysoms FE, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015.
2.     Deerenberg EB, et al. Small bites versus large bites for closing abdominal midline incisions (STITCH Trial). Lancet. 2015.
3.     Luijendijk RW, Hop WCJ, van den Tol MP, et al. A Comparison of Suture Repair with Mesh Repair for Incisional Hernia. New England Journal of Medicine. 2000;343(6):392–398.
4.     Holihan JL. Current Problems in Surgery. 2016.
5.     TAS Medical Files


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