Hernia[JOURNAL]
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200 papers
Clinical outcomes and risk prediction in inguinal and femoral hernia repair: a 12-year retrospective cohort study from a Colombian tertiary center.
Barrientos ML, Herrera LÁ, Gaviria DA … +5 more , Ramírez AS, Del Mar Luna M, Mayorga PS, Melguizo MM, López CAD
Hernia · 2026 Feb · PMID 41729331 · Publisher ↗
PURPOSE: Hernia repair is among the most common surgeries worldwide, but outcome data from Latin America remain scarce. This study evaluated the outcomes of inguinal and femoral hernia repair and internally validated a r...
PURPOSE: Hernia repair is among the most common surgeries worldwide, but outcome data from Latin America remain scarce. This study evaluated the outcomes of inguinal and femoral hernia repair and internally validated a risk prediction score for postoperative complications. METHODS: This 12-year retrospective study included 628 adults undergoing hernia repair at a high-complexity hospital in Colombia (2013–2024). Data on demographics, procedures, and outcomes were collected. Multivariable logistic regression identified predictors of complications, and a 4-variable risk score was validated internally. RESULTS: Most patients were male (80.4%), with a mean age of 61.4 ± 16.7 years; 17.4% of the cohort underwent urgent surgery. The overall 30-day complication rate was 7.0% (95% CI, 5.1–9.3). One-year recurrence occurred in 10.9% of patients with available follow-up (n = 211, 33.6%). However, interpretation of recurrence rates was limited by substantial attrition and selection bias. Femoral hernias accounted for 8.9% of cases, predominantly affecting older women (mean age 75 years, 85.7% of cases female), with 67.9% of cases requiring urgent presentation and 26.8% resulting in postoperative complications. Laparoscopic repair was used in 20.1% of cases and showed increasing adoption over the study period, rising from 9.9% in the early years to 29% in later years. This increase reflects institutional improvement and proficiency. Laparoscopic repair was associated with lower unadjusted complication rates (2.4% vs. 8.2% for open repair; P = 0.019). However, this difference was confounded by selection bias, as laparoscopic patients tended to be younger, had lower ASA classifications, and underwent elective surgery more frequently. Independent predictors of postoperative complications included non-clean wound classification, urgent admission, hemodynamic instability, and age. The 4-variable clinical risk prediction model demonstrated good discrimination and calibration, with an optimism-corrected C-statistic of 0.754 (95% CI, 0.668–0.812) and a Hosmer–Lemeshow P-value of 0.243. CONCLUSIONS: Inguinal and femoral hernia repair in a Latin American tertiary center produced outcomes comparable to those reported in European registry-based studies. The internally validated 4-variable risk score proved to be a practical and reliable tool for individualized complication risk stratification, preoperative counseling, resource allocation, and institutional benchmarking. Femoral hernias remain a high-risk presentation, particularly in older women, with high urgency rates and a 26.8% postoperative complication rate. These findings highlight the need for early identification and elective repair in this patient population to improve outcomes. Furthermore, the gradual institutional adoption of laparoscopic techniques indicates an improvement in surgical capacity, although outcome differences must be interpreted with caution, given potential confounding by patient selection. Efforts to enhance longitudinal follow-up infrastructure are essential for more accurate monitoring of recurrence and for quality-of-care evaluations.
Telemedicine-enabled surveillance after hernia repair: A prospective programmatic experience.
Prymak R, Kalmeta SL, Bosley ME … +4 more , Emerson K, Forgue K, Balke A, Nikolian VC
Hernia · 2026 Feb · PMID 41729318 · Publisher ↗
INTRODUCTION: Despite advancements in inguinal hernia repair techniques and implants, surveillance rates remain low, thus limiting our understanding of long-term outcomes such as chronic pain. This study evaluates the im...
INTRODUCTION: Despite advancements in inguinal hernia repair techniques and implants, surveillance rates remain low, thus limiting our understanding of long-term outcomes such as chronic pain. This study evaluates the implementation of a standardized telemedicine-based follow-up program intended to improve long-term surveillance following inguinal hernia repair. METHODS: This is a retrospective cohort study comparing a standardized telemedicine-based surveillance program versus traditional in-person surgeon-driven follow-up for patients who underwent inguinal hernia repair. Follow-up adherence at 12- and 24-months were the primary outcomes of interest. RESULTS: Telemedicine-based surveillance significantly improved long term follow-up adherence; 66% vs. 47% at 12 months and 44% vs. 6% at 24 months (p < 0.001). There were no significant differences in recurrence rates or post operative complications. Virtual surveillance identified a patient concern in 15.6% of cases, and subsequently resulted in imaging or an in-person evaluation in 4.5% of cases. CONCLUSIONS: Telemedicine-based surveillance is an effective and resource-conscious option for long-term follow-up after inguinal hernia repairs. Utilizing virtual surveillance methods increased follow-up adherence, identified patient concerns, and facilitated prompt interventions.
Open elective prosthetic repair of Spigelian hernias: long-term outcomes from a single-center experience.
Fernández ÁG, Alonso MT, Fe MJC … +5 more , Riu SV, Díaz CS, Vázquez AM, Tejerina JG, Porrero JL
Hernia · 2026 Feb · PMID 41701376 · Publisher ↗
AIM: The primary objective was to describe a single-center experience in the elective surgical management of Spigelian hernia, analyzing surgical approaches, perioperative morbidity, and long-term outcomes, with an empha...
AIM: The primary objective was to describe a single-center experience in the elective surgical management of Spigelian hernia, analyzing surgical approaches, perioperative morbidity, and long-term outcomes, with an emphasis on the recurrence rate. METHODS: A descriptive, retrospective, single-center study was conducted on adult patients (≥18 years) undergoing elective Spigelian hernia repair at the Santa Cristina University Hospital (Madrid) between June 2010 and May 2025. Emergency surgeries, ASA IV patients, and contaminated surgical fields were excluded. Demographic data, comorbidities, surgical technique (open approach), morbidity, length of hospital stay, and recurrence were analyzed. RESULTS: A total of 59 patients were included, with a mean age of 64 years (64.4% female) and a mean follow-up of 82 months (median 79). The most frequent presentation was pain associated with a mass (61%), and ASA II was the most common status (69.5%). Spinal plus local anesthesia was used in 62.7% of cases. The predominant approach was open repair with sublay mesh (91.5%), predominantly retromuscular (64.4% of sublay repairs). No intraoperative complications were reported. The postoperative seroma rate was 3.4%. Ambulatory surgery (same-day discharge) was performed in 50.8% of patients, and there were no readmissions. The recurrence rate was 3.4% (2 patients). CONCLUSION: Elective open repair of Spigelian hernia using sublay mesh is a safe, effective, and durable technique. In our series, this approach was associated with minimal perioperative morbidity, no readmissions, and a very low recurrence rate, maintaining excellent long-term outcomes (median follow-up > 6 years).
"Long-term outcomes of ventral hernia repair using heavyweight non-woven polypropylene mesh".
Risser KM, Schmidt EM, Woo KP … +6 more , Beffa LRA, Prabhu AS, Krpata DM, Rosen MJ, Petro CC, Miller BT
Hernia · 2026 Feb · PMID 41701370 · Full text
PURPOSE: Polypropylene mesh is available in the configurations: knitted polypropylene (KP) and nonwoven polypropylene (NWP). Although there is robust literature regarding KP, there is a knowledge gap in the long-term per...
PURPOSE: Polypropylene mesh is available in the configurations: knitted polypropylene (KP) and nonwoven polypropylene (NWP). Although there is robust literature regarding KP, there is a knowledge gap in the long-term performance of NWP in ventral hernia repair (VHR). We recently reported one-month outcomes of KP versus NWP mesh after VHR; however, long-term outcomes of NWP were not evaluated. This study aims to describe these long-term outcomes. METHODS: Patients who underwent open, clean VHR with Surgimesh WN, a heavyweight NWP mesh, from 2022 to 2025 with one year follow-up were included. Outcomes such as SSO (surgical site occurrence), SSI (surgical site infection), SSOPI (surgical site occurrence requiring procedural intervention), and hernia recurrence were reported at 30-day, one-year, and two-years. Hernia recurrence was defined pragmatically, a composite of patient-reported bulges, clinical exam, and cross-sectional imaging. RESULTS: 160 patients were included. Ventral hernias had a median width of 15 cm. At 30 days, there were 20 SSOs, six SSIs, eight SSOPIs, and no hernia recurrences. At one year, there were three SSOs, one SSI, one SSOPI, and no reoperations for recurrence. At two years (N = 35), there was one SSO and no hernia recurrences. CONCLUSION: Our early experience with Surgimesh WN indicates it is a safe and effective for VHR. NWP mesh is especially useful given the 50cmx50cm available for large VHRs. Long term follow-up in larger cohorts is needed to support these findings and explore potential advantages of NWP.
External validation of the Penn hernia risk calculator: an evaluation of model transportability for incisional hernia prediction in open pancreatic surgery.
Hellinck S, Boedt M, Hornick MM … +10 more , Gryspeerdt F, Lerut AV, Allaeys M, Rashidian N, Eker H, de Carvalho LA, van Gremberghe I, Broach RB, Fischer JP, Berrevoet F
Hernia · 2026 Feb · PMID 41701363 · Publisher ↗
PURPOSE: Incisional hernia (IH) is the most common long-term complication following open pancreatic surgery. This study aimed to evaluate the transportability of the Penn Hernia Risk Calculator (PHRC) Hepato-Pancreato-Bi...
PURPOSE: Incisional hernia (IH) is the most common long-term complication following open pancreatic surgery. This study aimed to evaluate the transportability of the Penn Hernia Risk Calculator (PHRC) Hepato-Pancreato-Biliary (HPB) model in a geo-temporally diverse population. METHODS: Adult patients undergoing non-palliative pancreatic surgery via a transverse laparotomy from April 2012 to December 2023 at a single tertiary academic center were included. Patients with prior IH diagnosis and/or repair were excluded. Demographics, medical history, lab, and operative data were collected. Composite IH risk scores were calculated using the PHRC. Model performance was assessed using the Area Under the Receiver Operating Characteristic Curve (AUROC) and positive likelihood ratios (LR+) across risk thresholds. RESULTS: A total of 403 patients were included with 4.2% developing IH. The study population differed significantly from the PHRC cohort in 19 of 20 predictive variables. The overall AUROC was 0.548, and LR + values were consistently below 1.8 at all risk thresholds. Calibration plots indicated systematic overprediction of IH risk. Subgroup analysis showed improved performance (AUROC = 0.875, LR + = 0.467) among patients with BMI > 30 kg/m². Malignancy was a protective factor, while undergoing left hemipancreatectomy or central pancreatectomy and BMI 20-30 kg/m² were associated with IH development. CONCLUSION: In this small single-center cohort, the PHRC HPB model demonstrated poor accuracy in predicting early IH following pancreatic surgery through transverse laparotomy. Performance improved in obese patients, suggesting case-mix and outcome incidence differences may largely explain the lack of model transportability.
Parainguinal or Spigelian hernia: a clinically important distinction.
Yu S, Bhimani N, Dodds N … +4 more , Sweeney E, Wickins S, Glover A, Hugh TJ
Hernia · 2026 Feb · PMID 41701236 · Full text
PURPOSE: Parainguinal hernias (PHs) are an uncommon but under-recognised subtype of lateral abdominal wall hernia, located near the ASIS, distinct from the deep inguinal ring and at or just below the interspinous plane....
PURPOSE: Parainguinal hernias (PHs) are an uncommon but under-recognised subtype of lateral abdominal wall hernia, located near the ASIS, distinct from the deep inguinal ring and at or just below the interspinous plane. They are frequently misclassified as Spigelian hernias (SHs) or inguinal hernias due to overlapping features. This study aimed to define the clinical characteristics, diagnostic accuracy, operative management, and long-term outcomes of patients with PHs compared with SHs. METHODS: A retrospective cohort study of all adult patients undergoing mesh repair for PHs or SHs under the care of a single surgeon between 2002 and 2025 was undertaken. Clinical, radiological, and operative findings were analysed alongside complications and long-term outcomes. Pain outcomes were assessed using Cunningham's criteria. RESULTS: Forty-five patients underwent surgical repair: 40 with PHs and five with SHs (41 PH and 5 SH repairs). PH patients were older than SH patients (median 72 vs. 58 years, p = 0.036). PHs were more often left-sided (63%) and commonly misdiagnosed preoperatively as SHs (51%). Clinical diagnosis of PHs showed moderate sensitivity (56%) but high positive predictive value (96%), while CT and ultrasound performed poorly (sensitivities 6-15%). SHs were more reliably identified clinically (80%) but had low predictive values. PHs were repaired predominantly with open or laparoscopy-assisted mesh repair (95%), while SHs were repaired laparoscopically in most cases (80%). Complications were rare (seroma 4%, TIA 2%). At a median follow-up of 8.8 years (IQR 2.4-12.5), 87% of patients reported no pain, 13% had mild symptoms, and there were two recurrences (4%). CONCLUSION: PHs are more common than SHs, and recognition as a separate subtype is warranted to improve diagnostic accuracy and guide tailored management. In this series, open extraperitoneal mesh repair of PHs was associated with low complication rates, and excellent long-term patient outcomes.
Main confounders associated with the outcome of inpatient incisional hernia repair for decision making in ambulatory surgery.
Köckerling F, Uhl W, Witzigmann H … +10 more , Niebuhr H, Reinpold W, Zarras K, Schwab R, Stechemesser B, Kuthe A, Conze J, Adolf D, Bartkowski R, Riediger H
Hernia · 2026 Feb · PMID 41670811 · Publisher ↗
PURPOSE: Ambulatory incisional hernia surgery has not been recommended in guidelines so far. An ambulatory procedure was considered only for small incisional hernias with maximum defect sizes of ≤ 4 cm. From 2005, the fi...
PURPOSE: Ambulatory incisional hernia surgery has not been recommended in guidelines so far. An ambulatory procedure was considered only for small incisional hernias with maximum defect sizes of ≤ 4 cm. From 2005, the first reports were then published on ambulatory incisional hernia repair. Surgeons from the French Club Hernie reported on 272 (19%) of 1,429 patients who had undergone ambulatory incisional hernia repair. To get a better estimate of the risks associated with ambulatory incisional hernia repair and set criteria for patient selection, this paper now explores the factors associated with an unfavorable outcome in incisional hernia repair based on data from the Herniamed Registry. METHODS: Between January 5, 2009 and July 1, 2025 data on 90,051 patients who had undergone primary incisional hernia repair were entered into the Herniamed Registry by hospitals and surgeons in Germany, Austria, and Switzerland participating on a voluntary basis in the registry. The main focus of this analysis was on logistic regression models taking confirmatory, defined patient- and procedure-related characteristics such as defect size into account as potential confounders of the outcome parameters (general, intraoperative and postoperative complications as well as complication-related reoperation). RESULTS: The defect size has the most unfavorable relationship with the outcome in inpatient incisional hernia repair. With an increasing defect size greater than W I (< 4 cm), there is a growing rate of intraoperative (W II ≥ 4–10 cm; OR = 1.883 [1.608; 2.206]; W III > 10 cm; OR = 3.201 [2.682; 3.820]), general (W II ≥ 4–10 cm; OR = 1.713 [1.537; 1.909]; W III > 10 cm; OR = 3.375 [3.004; 3.793]) and postoperative complications (W II ≥ 4–10 cm; OR = 1.641 [1.531; 1.758]; W III > 10 cm; OR = 2.657 [2.459; 2.872]) as well as of complication-related reoperations (W II ≥ 4–10 cm; OR = 1.621 [1.467; 1.792]; W III > 10 cm; OR = 2.701 [2.421; 3.015]). CONCLUSION: When selecting patients for an ambulatory incisional hernia procedure, increasing perioperative complications must be expected for defect sizes greater than W I (< 4 cm).
Ergonomic evaluation of a novel suturing device (SutureTOOL) versus traditional needle-driver for aponeurotic closure: a randomized experimental study.
Bernard de Lajartre D, Dochez V, Sarcher A … +1 more , Thubert T
Hernia · 2026 Feb · PMID 41670747 · Publisher ↗
INTRODUCTION: Adequate aponeurotic closure is essential to reduce postoperative complications, particularly incisional hernia. However, maintaining guideline-recommended closure principles such as a suture length-to-woun...
INTRODUCTION: Adequate aponeurotic closure is essential to reduce postoperative complications, particularly incisional hernia. However, maintaining guideline-recommended closure principles such as a suture length-to-wound length (SL/WL) ratio ≥ 4 can be technically demanding and is often performed at the end of long procedures. The SutureTOOL is a handheld device designed to standardize stitch placement, facilitate SL/WL ≥ 4, and potentially reduce operator workload. METHODS: Sixteen physicians (8 residents, 8 surgeons) performed eight 12-cm aponeurosis closures on silicone models using either the SutureTOOL or a traditional needle driver, under guided and unguided conditions. Upper-limb kinematics and muscle activity were assessed with motion capture and surface electromyography. Primary outcomes were cumulative joint angular displacement (°), integrated muscle activation (%MVC × s), and mean muscle activation per cycle (%MVC). Secondary outcomes included cycle duration, SL/WL ratio, and user evaluation. Exploratory analyses assessed guidance and surgical experience effects. RESULTS: Compared with the needle driver, the SutureTOOL reduced joint displacement across most degrees of freedom, except right shoulder abduction/adduction. Integrated muscle activation was generally lower or equivalent, except for higher right trapezius activity. Cycle duration was shorter with the SutureTOOL (7.5 vs. 10.4 s; p < 0.001). The SL/WL ratio was higher with the device (5.03 vs. 4.65; p = 0.005), indicating improved adherence to closure guidelines. User satisfaction was high in ergonomics, learning, and efficiency domains. No major differences were observed between residents and experts, while free sutures were less demanding than guided sutures. CONCLUSION: The SutureTOOL reduced distal joint displacement and overall integrated muscle workload over time while improving closure reproducibility, including higher SL/WL ratios, and shortening cycle duration. Its intuitive use and short learning curve support potential applications in surgical practice and education.
Comment to: Effect of an abdominal binder on postoperative 65 outcomes after ventral hernia repair.
Ormseth BH, Janis JE
Hernia · 2026 Feb · PMID 41670745 · Publisher ↗
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Parastomal hernia prevention and repair in Australasia: A binational CSSANZ survey of contemporary practice.
Gosavi R, McMurrick P, Nguyen TC … +1 more , Narasimhan V
Hernia · 2026 Feb · PMID 41661373 · Full text
BACKGROUND: Parastomal hernia (PSH) is a debilitating long-term complication of stoma formation, often required as part of curative or palliative treatment for colorectal cancer. As a common downstream consequence of can...
BACKGROUND: Parastomal hernia (PSH) is a debilitating long-term complication of stoma formation, often required as part of curative or palliative treatment for colorectal cancer. As a common downstream consequence of cancer surgery, PSH contributes significantly to chronic morbidity and impairs quality of life, yet practices surrounding its prevention and repair remain heterogeneous. Despite randomised evidence supporting prophylactic mesh, adoption is limited, and operative approaches to elective and emergency repair vary widely. METHODS: A cross-sectional survey of colorectal surgeons in Australia and New Zealand was conducted via the Colorectal Surgical Society of Australia and New Zealand (CSSANZ) to assess current PSH management. The survey examined stoma creation practices, prophylactic and therapeutic mesh use, operative techniques, and responses to clinical vignettes. Subgroup analyses explored variation by surgeon seniority, practice setting, and country. RESULTS: Ninety-three surgeons responded (93/365, 25.5%), including 74/93 (79.6%) from Australia and 19/93 (20.4%) from New Zealand; 79/93 (84.9%) practised in metropolitan centres and 39/93 (41.9%) had > 15 years' experience. Routine prophylactic mesh use at stoma formation was reported by 11/93 (11.8%). For elective repair (n = 89), open access was preferred by 48/89 (53.9%) and Sugarbaker repair was the most common configuration (40/89, 44.9%). Technique selection differed by access: among surgeons favouring minimally invasive surgery (n = 41), 33/41 (80.5%) selected Sugarbaker, whereas those favouring open surgery (n = 48) more often selected keyhole (22/48, 45.8%) or retrorectus "sandwich" repair (18/48, 37.5%) (p < 0.00001). In the emergency small-bowel obstruction vignette, surgeons with > 15 years' experience more often favoured mesh use than those with ≤ 15 years (21/39, 53.8% vs 10/50, 20.0%; p = 0.0015). Overall operative volume was low, with 65/93 (69.9%) reporting 0-5 PSH repairs per year. CONCLUSIONS: PSH prevention and repair across Australasia is marked by wide variability, low uptake of prophylactic mesh, and inconsistent technique selection. Operative approach strongly influenced repair configuration, and seniority appeared to drive emergency decision-making. Addressing PSH represents an important opportunity to reduce treatment-related morbidity in patients with pelvic malignancies undergoing stoma formation.
Loss of domain incisional hernia: challenges simplified by standardizing the use of botulinum toxin A and preoperative progressive pneumoperitoneum.
Rashid A, Samoon AH, Bali RS … +4 more , Ashraf O, Mir IS, Ajaz K, Khursheed H
Hernia · 2026 Feb · PMID 41652093 · Publisher ↗
PURPOSE: The purpose of the current paper is to propose standardized indications and practical protocols for the use of Botulinum Toxin A (BTA) and Preoperative Progressive Pneumoperitoneum (PPP) in the management of LOD...
PURPOSE: The purpose of the current paper is to propose standardized indications and practical protocols for the use of Botulinum Toxin A (BTA) and Preoperative Progressive Pneumoperitoneum (PPP) in the management of LOD incisional hernia. METHODS: A retrospective observational study at a tertiary care hospital in a developing country analyzed 29 patients with LOD incisional hernia (Tanaka Index > 0.25) from June 2019 to June 2025. Patients underwent BTA administration four weeks preoperatively, with PPP added for those with Tanaka Index > 0.35. Preoperative CT imaging assessed hernia sac and abdominal cavity volumes. Surgical repair utilized the Madrid modification of Posterior Component Separation with Transversus Abdominis Release and Fleur-de-lis abdominoplasty. Outcomes included Tanaka Index changes, fascial closure success, complications (Clavien-Dindo classification), and recurrence rates. RESULTS: The mean Tanaka Index significantly decreased from 0.39 ± 0.06 to 0.19 ± 0.02 (p < 0.0001), and the mean hernia defect width reduced from 16.13 ± 2.27 cm to 8.36 ± 1.15 cm (p < 0.0001). Fascial closure was achieved in all patients. Postoperative complications included one case of reactionary hemorrhage (3.45%), three superficial surgical site infections (10.34%), two cases of basal atelectasis (6.89%), and two minor seromas (6.89%). Only one recurrence (3.45%) was observed during a median follow-up of four years. One patient (7.6%) undergoing PPP reported transient shoulder tip pain. CONCLUSION: A protocol-driven approach using BTA and selective PPP effectively reduces hernia dimensions, enables tension-free fascial closure, and minimizes complications in LOD incisional hernia repair, offering a viable strategy in resource-constrained settings.
Diastasis recti in male patients: a literature review and proposed management.
Axelsen KH, Diasso P, Christoffersen MW … +1 more , Henriksen NA
Hernia · 2026 Feb · PMID 41652086 · Publisher ↗
PURPOSE: An increasing number of male patients are referred for surgical evaluation of their rectus diastasis (RD).Studies investigating the clinical relevance of RD in male patients, including the etiology, pathophysiol...
PURPOSE: An increasing number of male patients are referred for surgical evaluation of their rectus diastasis (RD).Studies investigating the clinical relevance of RD in male patients, including the etiology, pathophysiology, and quality of life are limited. Additionally, no national or international consensus on the management of RD in male patients exist. The aim of this review is to summarize the current literature and discuss the management strategy. METHODS: This paper is a multidatabase literature-based scoping review conducted according to the SANRA guidelines investigating the epidemiology, clinical presentation, and management of the rectus diastasis in male patients, including different treatment strategies. RESULTS: Twenty-four studies were included. Studies without sex-stratified findings were excluded. Evidence focusing specifically on male symptomatology and quality of life was limited. Reported management strategies comprised physiotherapy-based core training, minimally invasive mesh repair and open plication (with or without mesh). Across studies, surgical outcomes were generally favorable, though data were heterogeneous and long-term outcomes were sparse. CONCLUSION: RD is more common in male patients over 60 years old with obesity and low levels of physical activity. In most cases, the condition is asymptomatic, but may cause functional symptoms when a concomitant ventral hernia is present. If surgical repair is indicated, there are several surgical options and the choice depends on the individual symptomatology, anatomy and patient concerns. However, the role of RD plication in male patients remains uncertain, and its use should be used with caution.
Abdominal wall reconstruction in combined midline and lateral hernias.
Milos Z, Danijel G, Aleksandar B … +5 more , Marko Z, Milan Z, Ivan P, Rade M, Marinko Z
Hernia · 2026 Feb · PMID 41652075 · Publisher ↗
PURPOSE: Abdominal wall reconstruction in the presence of midline hernia (MH) and lateral hernia (LH) is a challenging procedure. The purpose of this study was to introduce surgical method combining the retromuscular sub...
PURPOSE: Abdominal wall reconstruction in the presence of midline hernia (MH) and lateral hernia (LH) is a challenging procedure. The purpose of this study was to introduce surgical method combining the retromuscular sublay technique and component separation technique with mesh augmentation for the simultaneous repair of midline and lateral hernias. METHODS: Between January 2006 and January 2025, 67 consecutive patients who underwent abdominal wall reconstruction for combined MH and LH or parastomal hernia (PH) were retrospectively analysed. The abdominal wall was reconstructed using a combination of the retromuscular sublay technique and the component separation technique, followed by mesh reinforcement. RESULTS: Of 67 patients, 53 underwent reconstruction surgery for simultaneous MH and LH, and 14 patients underwent surgery for MH and PH. LH was incisional (after previous pararectal, oblique, subcostal, or "J" incisions) in 58.5%, at the site of stoma closure in 37.7%, and as a consequence of blunt trauma in 3.8%. The median total defect width was 15 cm (range, 11-18) for the entire cohort. The median operative time was 150 min. Overall morbidity was 17.9%. After a median follow-up period of 24 months (range, 1-58), recurrence developed in 2 (3%) patients and abdominal wall bulging in 1 (1.5%). CONCLUSION: The combination of the retromuscular sublay technique, the component separation technique and mesh reinforcement is a safe and effective method for the simultaneous repair of MH and LH or PH.
Hernia mesh repair in immunocompromised patients: a comprehensive review.
Latif A, Monshizadeh A, Najjari K … +3 more , Soltani H, Soroush AR, Elyasi Nia F
Hernia · 2026 Feb · PMID 41652060 · Publisher ↗
PURPOSE: The management of hernia in immunocompromised patients remains a distinct surgical challenge, characterized by complex risk profiles, heightened susceptibility to infectious complications, and ambiguous consensu...
PURPOSE: The management of hernia in immunocompromised patients remains a distinct surgical challenge, characterized by complex risk profiles, heightened susceptibility to infectious complications, and ambiguous consensus on optimal mesh selection and perioperative protocols. As the prevalence of immunosuppression continues to rise due to increasing organ transplant rates, autoimmune diseases, oncological therapies, and advanced age, understanding the nuances of mesh repair in this population is of paramount importance. METHODS: This review synthesizes current evidence on the safety, efficacy, and outcomes of hernia mesh repair in immunocompromised adults, traversing mesh materials, infection mitigation strategies, surgical techniques, recurrence and complication rates, patient-reported outcomes, cost-effectiveness, and future research imperatives. RESULTS: Advanced mesh materials-particularly long-acting resorbable meshes-show superior long-term durability but at elevated cost. The risk for mesh infection and recurrence is proportionate to immunosuppression burden, comorbidities, and operative field contamination. Notably, modern synthetic meshes, when coupled with stringent perioperative infection control and risk-mitigation strategies, offer durable repair with acceptable safety profiles, even in immunocompromised hosts. CONCLUSION: There is insufficient evidence to support routine use of biologic mesh, except in select contaminated fields. Patient-reported metrics are increasingly recognized as essential for outcome assessment, though standardization remains incomplete. Cost-effectiveness favors synthetics unless contamination risks predominate or patient preference dictates otherwise. Gaps include inconsistent immunocompromised patient definitions, limited long-term data, and lack of tailored guidelines. Prospective, multicenter studies integrating real-world patient-reported and economic data are needed.
Mesh repair versus anatomical repair of ruptured umbilical hernia in cirrhotic patients, our center experience.
Taki-Eldin A, Elghadban H, Megahed H … +1 more , Lotfy A
Hernia · 2026 Feb · PMID 41636907 · Publisher ↗
PURPOSE: Ruptured umbilical hernia (UH) is a life-threatening condition in cirrhotic patients with a morbidity and mortality rate of 30%. Despite its high risk, the best surgical treatment strategy for this condition rem...
PURPOSE: Ruptured umbilical hernia (UH) is a life-threatening condition in cirrhotic patients with a morbidity and mortality rate of 30%. Despite its high risk, the best surgical treatment strategy for this condition remains controversial. This study aimed to evaluate the feasibility and safety of mesh repair of ruptured UH. METHODS: 149 patients who underwent surgical management for ruptured UH between January 2018 and December 2022 were included in this retrospective study. The patients were divided into two groups: anatomical repair (group 1, n = 92) and mesh repair (group 2, n = 57). Hernia recurrence, wound infection, and other perioperative morbidity and mortality were evaluated. RESULTS: The recurrence of hernia was significantly lower after mesh repair (5.3% vs. 17.4%, P = 0.03). Other postoperative complications were not significantly different between the two groups. However, the incidence of wound infection after mesh repair was higher than that after anatomical repair, but this was statistically non-significant (12.3% vs. 8.7%, p = 0.48). Two patients in the mesh repair group required mesh removal due to infection. CONCLUSIONS: Mesh repair of ruptured UH in cirrhotic patients is a feasible and safe surgical option that results in a significantly lower hernia recurrence rate with acceptable morbidity and mortality, provided that careful patient optimization is carried out.
Novel insights into abdominal wall hernia (AWH) and its negative impact on patients' finances: "Doing my job was pretty impossible".
Smith O, Abbas A, Mierzwinski M … +3 more , Bertram A, Chitsabesan P, Chintapatla S
Hernia · 2026 Feb · PMID 41636841 · Full text
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The impact of the COVID-19 pandemic on scientific publications in the field of hernia surgery: a brief bibliometric analysis.
Kulacoglu H, Celasin H, Hocagil TA
Hernia · 2026 Feb · PMID 41627579 · Publisher ↗
PURPOSE: The aim of this study is to evaluate the impact of COVID-19 pandemic to the publication activity in herniology. METHODS: A PubMed search was used to perform a comprehensive search of the scientific literature ea...
PURPOSE: The aim of this study is to evaluate the impact of COVID-19 pandemic to the publication activity in herniology. METHODS: A PubMed search was used to perform a comprehensive search of the scientific literature each year between 2010 and 2024 by using key words as “inguinal hernia,”“umbilical hernia,” “incisional hernia,” “laparoscopic inguinal hernia,” “laparoscopic incisional hernia,” “robotic inguinal hernia,” and “robotic ventral hernia.” The analysis was done both annually and across three consecutive 5-year intervals: 2010–2014 [Period A], 2015–2019 [Period B], and 2020–2024 [Period C]. Period C, which corresponds to the era of the COVID-19 pandemic, was also searched for the publications about inguinal and ventral hernias which were related to the COVID-19 pandemic. RESULTS: A total of more than 40,000 hernia-related publications were identified between 2010 and 2024. Publication activity demonstrated an overall upward trajectory, with notable shifts in thematic focus over time. The most frequently retrieved keywords were inguinal hernia, hernia mesh, and incisional hernia. Publications on inguinal hernia increased from 3,172 in 2010 to 4,525 in 2020, representing a 1.43-fold increase. Similarly, hernia mesh publications rose from 2,847 to 4,410 (1.55-fold), and incisional hernia publications nearly doubled from 1,187 to 2,336 (1.97-fold). Topics related to minimally invasive and robotic techniques exhibited the most pronounced fold increases. During the pandemic, publication activity in hernia research continued to grow up to 2021 but experienced a temporary slowdown between 2021 and 2022. In negative binomial regression models adjusting only for calendar year, no statistically significant association was observed between the COVID-19 period and overall publication volume (IRR = 1.02, 95% CI [0.47, 2.15]). After adjustment for calendar year and publication topic, the COVID-19 period was associated with a modest but statistically significant increase in publication volume (IRR = 1.16, 95% CI [1.01, 1.33], p = .037). In addition, a significant positive secular trend was observed across years (IRR per year = 1.05, 95% CI [1.03, 1.06]). CONCLUSIONS: The COVID-19 pandemic did not lead to a dramatic reduction in the overall volume of publications. There was a slight slowdown in the number of papers in certain subjects of hernia surgery, however, in the post-pandemic period publication activity rapidly returned to its pre-pandemic trajectory.
Single-port versus multi-port laparoscopic totally Extraperitoneal inguinal hernia repair: a systematic review and Meta-analysis of postoperative outcomes.
Chen L, Jin Z, Zhang J … +1 more , Zong Z
Hernia · 2026 Feb · PMID 41627557 · Publisher ↗
BACKGROUND: Single-incision laparoscopic totally extraperitoneal inguinal hernia repair (SIL-TEP) has gained attention for its potential to minimize surgical trauma and improve cosmesis. However, its comparative efficacy...
BACKGROUND: Single-incision laparoscopic totally extraperitoneal inguinal hernia repair (SIL-TEP) has gained attention for its potential to minimize surgical trauma and improve cosmesis. However, its comparative efficacy and safety versus conventional multi-port laparoscopic totally extraperitoneal repair (MTL-TEP) remain contentious. OBJECTIVE: This meta-analysis aimed to systematically evaluate the feasibility and safety of SIL-TEP compared to MTL-TEP. METHODS: A systematic literature search was conducted in databases including PubMed, Embase, and the Cochrane Library from January 2005 to June 2025. Data on postoperative outcomes were extracted and pooled for meta-analysis. Statistical analyses were performed using RevMan 5.4, calculating mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Analysis of 23 studies (7 RCTs, 16 non-RCTs; 2894 patients) showed SIL-TEP had a longer unilateral operative time (MD = 4.39 min, 95% CI: 0.88-7.89, P = 0.01), though this was not significant in study design subgroup analysis. SIL-TEP offered superior early outcomes, including lower pain scores on postoperative day 7 (MD = -0.57, 95% CI: -1.09 to -0.05, P = 0.03) and higher cosmetic satisfaction (MD = 0.77, 95% CI: 0.27-1.28, P = 0.002). The techniques were comparable in bilateral operative time, overall complications (OR = 0.92, P = 0.48), hospital stay (MD = -0.02, P = 0.50), and recurrence rates (OR = 0.81, P = 0.65). CONCLUSION: This meta-analysis suggests that SIL-TEP is a safe and feasible alternative to MTL-TEP. The pooled results indicate potential benefits of SIL-TEP in reducing early postoperative pain and achieving better cosmetic outcomes, although these advantages were not sustained in the RCT subgroup analysis. Critically, both techniques demonstrated comparable safety profiles, with no significant differences in complication rates, hospital stay, and short-to-midterm recurrence risk. SIL-TEP represents a viable surgical option that can be individualized for patients, particularly those who place a high value on minimal scarring.
Drivers of variation in outcomes after ventral hernia repair: a contemporary registry analysis of over 73,000 ACHQC cases.
Kim I, Towfigh S
Hernia · 2026 Feb · PMID 41627553 · Publisher ↗
PURPOSE: To determine whether differences in operative approach and outcomes after ventral hernia repair (VHR) are primarily associated with case acuity and hernia complexity rather than surgeon practice grouping. METHOD...
PURPOSE: To determine whether differences in operative approach and outcomes after ventral hernia repair (VHR) are primarily associated with case acuity and hernia complexity rather than surgeon practice grouping. METHODS: Adult VHRs recorded in the Abdominal Core Health Quality Collaborative (ACHQC)registry from 2013-2023 were analyzed. Cases were grouped by surgeon practice category (General Surgery [GS], Minimally Invasive Surgery [MIS], and Acute Care/Trauma Surgery [ACS]). Patient characteristics included demographics, ASA class, case urgency, operative approach, mesh width, and operative duration. Outcomes included recurrence at 30 days, 6 months, and 1 year (among patients with available follow-up) and health-related quality of life measured by HerQLes, with moderate-to-major improvement defined as a ≥20-point increase from baseline among patients with paired assessments. RESULTS: A total of 73,241 VHRs were analyzed (GS 56.2%, MIS 28.1%, ACS 15.6%). Operative approach distribution was similar across groups (open 63.8%, robotic 26.0%,laparoscopic 10.2%; p>0.05). ACS cases more frequently involved very large meshes (≥30 cm) and prolonged operative duration (>240 minutes), reflecting higher case complexity (both p<0.05). Early quality-of-life improvement at 30 days was most pronounced among ACS patients, whereas GS patients demonstrated the highest proportion of sustained moderate-to-major improvement at 6 months. Recurrence was uncommon at 30 days across all groups and increased with longer follow-up, with the highest 1-year recurrence observed among ACS patients. CONCLUSIONS: In this large contemporary registry, operative approach selection was similar across surgeon practice groups. Differences in outcomes were most strongly associated with case urgency and hernia complexity rather than surgeon classification. Early quality-of-life gains were greatest in higher-acuity cases, while more durable improvements and lower long-term recurrence were observed in elective repair contexts. These findings underscore the dominant role of patient and case factors in determining VHR outcomes.
Abdominal wall function in hernia and diastasis: systematic review of evaluation methods and clinical relevance.
Brucchi F, Gilardini R, Vetere A … +4 more , Sassun R, Majnardi AR, Muysoms F, Dionigi G
Hernia · 2026 Feb · PMID 41627552 · Publisher ↗
BACKGROUND: Abdominal wall function (AWF) has emerged as a pivotal outcome in patients with diastasis recti (DR) and midline ventral/incisional hernias, yet methods and timing of assessment remain heterogenous and non-st...
BACKGROUND: Abdominal wall function (AWF) has emerged as a pivotal outcome in patients with diastasis recti (DR) and midline ventral/incisional hernias, yet methods and timing of assessment remain heterogenous and non-standardized. This systematic review aimed to synthesize current evidence on how AWF is evaluated in the setting of DR and ventral/incisional hernia, and to appraise the clinical value of different assessment strategies. METHODS: This systematic review was reported according to PRISMA guidelines, with a comprehensive search in MEDLINE, Scopus, Embase, and CENTRAL up to August 31, 2025 (PROSPERO: CRD420251148381). Studies assessing AWF pre and post-surgery in patients with DR and/or ventral/incisional hernia using objective measures (e.g., dynamometry, standardized physical tests) and/or patient-reported outcome measures (PROMs) were included. Risk of bias was assessed using RoB-2 for randomized trials and MINORS for observational studies. RESULTS: Nine studies (2 randomized trials, 7 prospective cohorts; n = 688) evaluated abdominal wall function using trunk dynamometry, standardized clinical tests, and PROMs. Preoperatively, abdominal wall function was consistently impaired. Surgical reconstruction restoring the linea alba led to marked improvements: trunk strength improved on dynamometry, clinical tests normalized, and PROMs showed meaningful gains in quality of life and disability. In postpartum diastasis recti, benefits-including continence-persisted at 3 years. No meta-analysis was conducted, and all findings represent a narrative synthesis. CONCLUSION: In patients with diastasis recti or midline ventral/incisional hernias, most studies suggest that restoration of the linea alba is associated with measurable improvements in abdominal wall function and patient-reported outcomes. Wide adoption of standardized core outcome sets-integrating pragmatic objective tests with disease-specific PROMs-and longer multicenter follow-up are essential to inform surgical decision-making and future guidelines.
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