Hernia[JOURNAL]
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200 papers
Evaluation of usefulness of manual reduction in the management of adult acute irreducible abdominal wall hernia: a study from a community-based teaching hospital.
Jinushi K, Suzuki Y, Hagihara K … +11 more , Odagiri K, Sato Y, Noma T, Matsushita K, Shinno N, Yamashita M, Yanagimoto Y, Tei M, Shimizu J, Kawase T, Imamura H
Hernia · 2026 May · PMID 42118441 · Publisher ↗
PURPOSE: This retrospective study was conducted to clarify the usefulness of manual reduction (MR) in the management of acute irreducible abdominal wall hernia (AIAWH) in a community-based teaching hospital. METHODS: The...
PURPOSE: This retrospective study was conducted to clarify the usefulness of manual reduction (MR) in the management of acute irreducible abdominal wall hernia (AIAWH) in a community-based teaching hospital. METHODS: The study involved 98 patients who underwent MR for computed tomography-proven AIAWH in our hospital between April 2014 and May 2022. The primary endpoint was the success rate of MR, and secondary endpoints included determining the risk factors for failure of MR in inguinal and femoral hernia, number of MR attempts, staff position of the final MR attempter, and rates of perforation and necrosis in the MR success and failure groups. RESULTS: Overall, MR was successful in 45 patients (46%), and the success rate varied among hernia types with significant difference: inguinal 75.0% (30/40), femoral 16.7% (5/30), incisional 36.4% (4/11), obturator 0.0% (0/9), umbilical 75.0% (6/8). For inguinal hernia, hernia sac size and the ratio of hernia sac diameter to hernia orifice diameter (sac-to-orifice ratio; SOR) were significantly associated with MR success rate (both, p < 0.001), whereas for femoral hernia, only SOR was associated with MR success rate (p = 0.026). One patient in the MR success group had perforation and necrosis (2.2%). CONCLUSION: MR appeared to be useful and reasonably safe for the management of AIAWH. The success rate was associated with hernia sac size and SOR in inguinal hernia and with SOR in femoral hernia.
Use of PERitoneal free flap (PERFF) augmentation in complex ventral hernia repair.
Wijerathne S, Yeow M, Baig S … +2 more , Malik S, Lomanto D
Hernia · 2026 May · PMID 42118417 · Publisher ↗
BACKGROUND: In complex ventral hernias, tension-free midline fascial re-approximation may remain unattainable despite posterior component separation (PCS) with transversus abdominis release (TAR). We describe a technique...
BACKGROUND: In complex ventral hernias, tension-free midline fascial re-approximation may remain unattainable despite posterior component separation (PCS) with transversus abdominis release (TAR). We describe a technique and our initial experience using the entire peritoneal sac as a free flap to augment repair in this setting. METHODS: This retrospective single-center study included all consecutive patients who underwent PERitoneal Free Flap (PERFF) reconstruction between January 2024 and January 2025. Demographics, hernia characteristics, operative details, and post-operative outcomes-including complications (Clavien-Dindo classification), surgical site infection, seroma, hematoma, and hernia recurrence-were analyzed. RESULTS: Eight patients underwent ventral hernia repair using PERFF. The mean age was 68.1 years (range, 57-82), and the mean body mass index was 32.5 kg/m² (range, 27-43). The mean defect width was 6.6 cm (range, 5-15 cm), defect sizes ranged from 5 × 5 cm to 12 × 15 cm, and the Tanaka index ranged from 0.25 to 0.45. Six patients required bilateral TAR and two unilateral TAR. Two patients underwent concomitant small bowel resection. All patients were discharged by post-operative day 3. No post-operative complications or hernia recurrences were observed during a mean follow-up of 17.6 months. CONCLUSION: PERFF is a feasible and safe adjunct to augment PCS with TAR in complex ventral hernia repair when midline closure is not achievable. Harvesting the entire peritoneal sac as a free flap provides flexible and durable fascial coverage while maintaining separation of the mesh from visceral and subcutaneous tissues.
Standardization of the latero-medial preperitoneal/pretransversalis dissection in PeTEP ventral hernia repair: single-center outcomes.
García JG, Equisoain-Azcona A, Recuenco CB … +5 more , Sanz-Ongil Estebaranz R, Gutiérrez-Iscar E, Bertomeu-García A, Salido-Fernández S, Morales FJA
Hernia · 2026 May · PMID 42118413 · Publisher ↗
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Comparison of polypropylene versus polyester mesh in lichtenstein inguinal hernia repair with respect to chronic pain and inflammatory changes.
P A, Poral S, Sn S
Hernia · 2026 May · PMID 42118382 · Publisher ↗
PURPOSE: Chronic postoperative groin pain remains a clinically significant complication following Lichtenstein inguinal hernia repair. Prosthetic mesh characteristics may influence both inflammatory response and postoper...
PURPOSE: Chronic postoperative groin pain remains a clinically significant complication following Lichtenstein inguinal hernia repair. Prosthetic mesh characteristics may influence both inflammatory response and postoperative outcomes. This study aimed to compare polypropylene and polyester mesh with respect to chronic pain, postoperative complications, and inflammatory changes. METHODS: This prospective, single-center, single-blind randomized controlled trial was conducted between December 2019 and February 2021. Fifty patients with primary unilateral uncomplicated inguinal hernia were randomized in a 1:1 ratio to receive polyester mesh (n = 25) or polypropylene mesh (n = 25). Postoperative pain was assessed using the Visual Analogue Scale (VAS) at 1 week and 3 months, and chronic pain was evaluated using the Inguinal Pain Questionnaire (IPQ). Surgical site complications were recorded at 1 week and 3 months. Serum Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (HS-CRP) levels were measured preoperatively and at 12 h postoperatively. RESULTS: Baseline characteristics were comparable between groups. At 1 week, mean VAS scores were 1.72 ± 1.43 in the polyester group and 1.84 ± 1.49 in the polypropylene group (p = 0.76). At 3 months, mean VAS scores were 0.76 ± 0.66 and 0.92 ± 0.57, respectively, with no statistically significant difference. IPQ parameters demonstrated comparable chronic pain and functional outcomes. Early postoperative swelling was significantly more frequent in the polypropylene group (p = 0.001), while other surgical site complications were similar between groups. Postoperative IL-6 and HS-CRP levels were significantly higher in the polypropylene group at 12 h (p < 0.05). No recurrence was observed in either group. CONCLUSION: Polypropylene and polyester meshes demonstrated comparable short-term pain, chronic pain, and recurrence outcomes following Lichtenstein inguinal hernia repair. Polyester mesh was associated with lower early postoperative inflammatory markers and reduced early swelling, although these differences did not translate into significant differences in 3-month pain outcomes. Larger multicentric studies with longer follow-up are required to clarify the long-term clinical significance of these findings.
Open retromuscular keyhole for parastomal hernia repair after ureteroileostomy: surgical technique and long-term outcomes.
Barranquero AG, Castillo Acosta JC, Maestre González Y … +2 more , Gas Ruiz C, Villalobos Mori R
Hernia · 2026 May · PMID 42118375 · Publisher ↗
BACKGROUND: Parastomal hernia (PSH) repair following ureteroileostomy (Bricker's technique) presents unique anatomical challenges, as short ileal conduits often preclude safe stoma lateralization. This study describes th...
BACKGROUND: Parastomal hernia (PSH) repair following ureteroileostomy (Bricker's technique) presents unique anatomical challenges, as short ileal conduits often preclude safe stoma lateralization. This study describes the open surgical technique and long-term outcomes of a retromuscular repair utilizing transversus abdominis release (TAR) and a keyhole mesh configuration. METHODS: We conducted a retrospective analysis of a prospective institutional registry including all consecutive patients undergoing elective open PSH repair after ureteroileostomy between 2019 and 2023. All procedures utilized an open retromuscular keyhole mesh placement with a right-sided TAR. Primary outcomes included 30-day complications (Clavien-Dindo classification) and long-term recurrence. RESULTS: Fourteen male patients (mean age 75.4 years; mean BMI 28.0 kg/m) were included. Concomitant midline hernias were present in 42.9% (6/14). The overall 30-day complication rate was 57.1% (8/14), primarily consisting of seromas (5/14) and surgical site infections (3/14). One ureteral injury (7.1%) occurred, requiring nephrostomy (Grade III). At a median follow-up of 42.7 months (IQR: 32.8-48.7), with an 85.7% (12/14) CT surveillance rate, the recurrence rate was 14.3% (2/14). Only one patient required surgical reintervention for recurrence. CONCLUSION: The retromuscular keyhole technique for parastomal hernia repair following ureteroileostomy is feasible but carries high perioperative morbidity, and comparable long-term recurrence to other studies. Randomized trials are required to provide a higher level of evidence.
Perforator-sparing component separation reduces lateral pseudo-bulging in large incisional hernia repair.
Şermet M, Tosun S, Tigrel LZ … +6 more , Eren TT, Gunduz N, Baysal H, Ozsoy MS, Ekinci O, Alimoglu O
Hernia · 2026 May · PMID 42118368 · Publisher ↗
OBJECTIVE: To compare three-piece self-gripping mesh (SGM) onlay following perforator-sparing minimally invasive anterior component separation (MIACS) with conventional ACS plus midline-only SGM onlay in large incisional...
OBJECTIVE: To compare three-piece self-gripping mesh (SGM) onlay following perforator-sparing minimally invasive anterior component separation (MIACS) with conventional ACS plus midline-only SGM onlay in large incisional hernia repair, with wound complication rate as the primary outcome and CT-confirmed lateral pseudo-bulging as a predefined secondary outcome. MATERIALS AND METHODS: Single-centre retrospective analysis of prospectively collected data (Jan 2020-Jan 2024). Of 97 assessed patients, 79 were analysed (MIACS n = 41; conventional ACS n = 38) after exclusions and follow-up losses. The average follow-up was 28 months. PRIMARY ENDPOINT: 24-month wound complication rate; secondary exploratory outcomes included pseudo-bulging, seroma, haematoma, and recurrence. RESULTS: The overall wound complication rate was 19.5% in Group I versus 44.7% in Group II (p = 0.012). Deep necrotic SSI was absent in Group I and occurred in 21.1% of the patients in Group II (p < 0.001). Lateral pseudo-bulging was 4.9% versus 21.1% (p = 0.001). Intraoperative blood loss (120 vs. 185 mL; p < 0.001) and therapeutic antibiotic requirement (4.9% vs. 26.3%; p = 0.008) were significantly lower in Group I. Twenty-four-month hernia recurrence rate was equivalent in both groups (4.9% vs. 5.3%; p = 1.000). CONCLUSION: Three-piece SGM onlay following MIACS substantially prevents lateral pseudo-bulging, dramatically reduces wound morbidity, particularly deep necrotic infection, and does not affect recurrence rates. These findings provide the first comparative evidence for linea semilunaris mesh reinforcement as an adjunct to MIACS.
Obturator hernia in adults: a systematic review of CT diagnosis and surgical management.
Bademkıran E
Hernia · 2026 May · PMID 42118363 · Publisher ↗
PURPOSE: Obturator hernia is a rare but life-threatening pelvic floor hernia occurring predominantly in elderly, underweight women and is associated with delayed diagnosis and high perioperative mortality. This systemati...
PURPOSE: Obturator hernia is a rare but life-threatening pelvic floor hernia occurring predominantly in elderly, underweight women and is associated with delayed diagnosis and high perioperative mortality. This systematic review evaluated the diagnostic performance of computed tomography (CT), factors associated with bowel resection, and short-term outcomes of open versus laparoscopic repair in adults. METHODS: A systematic review was conducted per PRISMA 2020. PubMed/MEDLINE, Scopus, and Web of Science were searched from January 2004 to January 2026. Studies reporting at least three surgically confirmed adult cases were eligible. Three consecutive institutional cases were incorporated as an illustrative clinical adjunct. RESULTS: Twenty-two studies including 876 patients were analysed. The mean age across included studies was 79.7 years; 91.5% were female. Reported preoperative CT sensitivity across included studies was 93.2% (range 66.7-100%). Bowel resection was required in 31.6% and was associated with higher 30-day mortality (19.6% vs. 3.9%). Laparoscopic repair appeared to be associated with lower wound morbidity, shorter hospital stay (5.3 vs. 12.6 days), and lower recurrence (0% vs. 2.8%) in selected patient cohorts, although case-mix differences preclude direct comparison. Mesh was used in 44.3% overall. In three institutional cases (all elderly cachectic women presenting emergently), one underwent TAPP and two underwent open midline laparotomy; primary suture repair was performed in all owing to contamination, bowel compromise, or extreme frailty. CONCLUSION: CT remains the diagnostic cornerstone in obturator hernia. Surgical strategy should be individualised based on haemodynamic status, contamination, and frailty. Reported outcomes represent descriptive trends rather than pooled statistical estimates due to heterogeneity of available data.
Open preperitoneal repair versus laparoscopic totally extraperitoneal repair for primary lumbar hernia: a retrospective cohort study.
Wang B, Yang X, Jin C … +1 more , Shen Y
Hernia · 2026 May · PMID 42118357 · Publisher ↗
BACKGROUND: Primary lumbar hernia is a rare lateral abdominal wall hernia with a clinically relevant risk of incarceration and strangulation. Evidence directly comparing open preperitoneal repair and laparoscopic totally...
BACKGROUND: Primary lumbar hernia is a rare lateral abdominal wall hernia with a clinically relevant risk of incarceration and strangulation. Evidence directly comparing open preperitoneal repair and laparoscopic totally extraperitoneal repair (TEP) remains limited. This study aimed to compare perioperative outcomes, early recovery parameters, and postoperative complications between the two surgical approaches. METHODS: We conducted a single-center retrospective cohort study of consecutive patients undergoing surgery for primary lumbar hernia between January 2023 and December 2024. Patients received either open preperitoneal repair or TEP. Perioperative outcomes, early recovery parameters, postoperative complications, and recurrence were collected. To account for potential confounding, multivariable-adjusted analyses were performed. Log-transformed linear regression was used for operative time and estimated blood loss, linear regression for 24-hour visual analog scale (VAS) pain score, negative binomial regression for postoperative hospital days, and Firth logistic regression for the composite endpoint of any postoperative complication. RESULTS: A total of 38 patients were included (open, n = 21; TEP, n = 17). In the unadjusted analysis, TEP was associated with longer operative time (median 60 [50-65] vs. 40 [35-50] min; P = 0.003), lower estimated blood loss (median 5 [3-5] vs. 10 [5-10] mL; P < 0.001), and lower 24-hour pain scores (VAS 2 [1-2] vs. 3 [3-4]; P < 0.001). No intraoperative vascular, nerve, or visceral injuries occurred. Postoperative events were rare; recurrence occurred in 1 open patient and none in the TEP group. In multivariable-adjusted analyses, TEP remained associated with longer operative time (33.7% increase, 95% CI 6.1% to 68.6%; P = 0.020), lower estimated blood loss (48.1% reduction, 95% CI 23.7% to 64.8%; P = 0.002), and lower 24-hour VAS pain scores (adjusted mean difference - 1.46, 95% CI - 2.12 to - 0.80; P < 0.001). No significant differences were observed in postoperative hospital days (IRR 0.74, 95% CI 0.40 to 1.37; P = 0.342) or any postoperative complication (OR 0.61, 95% CI 0.06 to 4.38; P = 0.628). CONCLUSIONS: In this cohort, TEP was associated with reduced early postoperative pain compared with open preperitoneal repair. The estimated blood loss difference (5 mL vs. 10 mL) was statistically significant but of limited clinical relevance. Short-term safety outcomes were comparable between groups. Although TEP required longer operative time, this difference may reflect technical complexity rather than inferiority. Larger prospective studies with longer follow-up are needed to confirm these findings and better define patient selection.
Chronic pain after Shouldice versus Lichtenstein inguinal hernia repair: a systematic review and meta-analysis.
Silva Carvalho LB, Muricy EF, Habib MM … +2 more , Barros LS, de Lima MLA
Hernia · 2026 May · PMID 42118350 · Full text
PURPOSE: The Lichtenstein (mesh) and Shouldice (non-mesh) techniques are the main options for open inguinal hernia repair. This systematic review and meta-analysis compared the prevalence of chronic postoperative pain be...
PURPOSE: The Lichtenstein (mesh) and Shouldice (non-mesh) techniques are the main options for open inguinal hernia repair. This systematic review and meta-analysis compared the prevalence of chronic postoperative pain between them. METHODS: A systematic search was conducted in Medline, Embase and Cochrane databases for studies comparing the prevalence of chronic pain after Shouldice and Lichtenstein techniques in adult patients undergoing inguinal hernia repair. Meta-analysis was performed using RevMan and the effect model was determined based on heterogeneity, assessed by the I² statistic. Subgroup analyses were conducted by mean follow-up duration and study design. RESULTS: Ten studies with 4,122 patients (59.8% Lichtenstein) were included. Shouldice repair was associated with a 34% relative risk reduction in chronic postoperative pain compared to Lichtenstein (RR 0.66; 95%CI 0.56-0.78; p < 0.00001; I² = 5%). Conversely, the Shouldice technique demonstrated a higher risk of long-term hernia recurrence (RR 2.54; 95%CI 1.15-5.63; p = 0.02). There were no statistically significant differences between the two techniques regarding early postoperative complications (RR 1.01; 95%CI 0.85-1.19; p = 0.95) or mean operative time (MD 5.96 min; 95%CI -0.79 to 12.71; p = 0.08). CONCLUSION: Although the Lichtenstein repair is more widely practiced, the Shouldice technique yields significantly lower rates of chronic postoperative pain, albeit with a higher risk of long-term recurrence. This trade-off highlights Shouldice as a potential alternative in selected patients.
Comparison of short-term outcomes between open and minimally invasive surgery for emergent parastomal hernia repair: A retrospective propensity score-matched analysis.
De la Cruz Ku G, Garcia A, Burke C … +14 more , Desai A, Guart JA, Zevallos Ventura A, Buendia A, Torres K, Rioja F, Hemeryth M, Torres-Roman JS, Escandon J, Barrueto-Deza JL, Mejia N, Enriquez-Vera D, Valcarcel-Valdivia B, Franco Mesa C
Hernia · 2026 May · PMID 42118348 · Publisher ↗
BACKGROUND: Parastomal hernia (PSH) is a common complication after stoma creation and may present emergently with obstruction, incarceration, or ischemia. While minimally invasive surgery (MIS, laparoscopic or robotic) s...
BACKGROUND: Parastomal hernia (PSH) is a common complication after stoma creation and may present emergently with obstruction, incarceration, or ischemia. While minimally invasive surgery (MIS, laparoscopic or robotic) shows benefits in elective PSH repair, data in emergencies are limited. This study compared outcomes following open versus MIS emergent PSH repair. METHODS: In this retrospective cohort using ACS-NSQIP, patients undergoing emergent open, laparoscopic, or robotic PSH repair were identified. Surgical approach was categorized as open or MIS. A 3:1 propensity score-matched analysis balanced demographic, comorbidity, physiologic, laboratory, and operative variables. Primary outcome was 30-day overall postoperative complications; secondary outcomes included wound, medical, and surgical complications, return to the operating room (OR), length of stay, and readmission. Multivariate logistic regression identified predictors of complications. RESULTS: Of 303 patients (249 open, 54 MIS), 192 were analyzed after matching (144 open, 48 MIS) with balanced baseline characteristics. MIS repair had lower overall complications than open repair (22.9% vs. 39.6%, p = 0.037), while wound, medical, and surgical complications were similar. Return to the OR tended to be higher after MIS (14.6% vs. 6.3%, p = 0.070), mainly for ostomy-related revisions. Length of stay and readmission were comparable. Higher ASA class independently predicted complications. Robotic repair was associated with reduced odds of overall complications (OR 0.35; 95% CI 0.15-0.79; p = 0.012). CONCLUSION: MIS repair of emergent PSH was associated with fewer overall complications, though ostomy-related reoperations may be more frequent. MIS is a safe option in selected high-risk patients, with approach guided by patient factors and surgeon experience.
Determining the minimal important change of the abdominal Hernia-Q.
Khan S, Zemberi J, Olsen T … +8 more , McCutchen A, Voytik M, Jarrar S, Hornick MM, Broach RB, Chhatre S, Jayadevappa R, Fischer JP
Hernia · 2026 May · PMID 42118339 · Full text
PURPOSE: The Abdominal Hernia-Q(AHQ) is a validated PRO tool for hernia patients. This study aimed to determine the Minimal Important Change (MIC) for the AHQ, examining changes in AHQ scores and exploring associations w...
PURPOSE: The Abdominal Hernia-Q(AHQ) is a validated PRO tool for hernia patients. This study aimed to determine the Minimal Important Change (MIC) for the AHQ, examining changes in AHQ scores and exploring associations with key clinical characteristics. METHODS: A retrospective cohort design was used. Patients who underwent hernia repair between January 2017 and January 2022 and completed the AHQ preoperatively and six months postoperatively were included. Anchor (Short Form Health Survey (SF-12) and Hernia-related Quality of Life Survey (HerQLes)) and distribution-based methods were used to compute the MIC. The distribution method used 0.5×standard deviation [SD] and minimal detectable change [MDC; 1.96×SEM], to identify the MIC. RESULTS: A total of 147 patients met the inclusion criteria, with a mean age of 55.69 (SD 12.26), 60% female and a BMI of 30.8 km/m2 (26.9-36.5). A grand mean MIC of 6.8 was derived. One hundred twenty-nine patients met or exceeded the MIC, while 18 did not. Patients meeting the MIC had significantly worse baseline AHQ scores (46 vs. 68, p < 0.001) and higher postoperative AHQ scores (86 vs. 67, p < 0.001). There was no difference in operative characteristics or complications between groups, with the exception that patients not achieving MIC had a higher rate of seroma (28% vs. 9.3%, p = 0.038). CONCLUSION: The findings suggest that patients with worse preoperative status may still experience clinically significant benefits. Establishing the MIC for the AHQ may enable the identification of patients likely to experience significant improvements in quality of life after hernia repair.
Absorbable suture material in non-mesh inguinal hernia repair: a narrative review of Shouldice, Bassini, and Desarda techniques.
Paasch C, Wiessner R, Lorenz R … +1 more , Mainprize MY
Hernia · 2026 May · PMID 42118338 · Publisher ↗
BACKGROUND: Tissue-based inguinal hernia repair is traditionally performed with non-absorbable sutures or wire. Interest exists in absorbable sutures, particularly long-term materials. This review summarizes evidence as...
BACKGROUND: Tissue-based inguinal hernia repair is traditionally performed with non-absorbable sutures or wire. Interest exists in absorbable sutures, particularly long-term materials. This review summarizes evidence as a basis for potential future pilot studies in non-mesh techniques aiming to reduce foreign body load. METHODS: A narrative literature review was conducted between October 2025 and January 2026 using a structured and transparent search strategy. Four investigators independently searched PubMed/MEDLINE for clinical studies on non-mesh inguinal hernia repair using absorbable sutures. Eligible studies were qualitatively synthesized, and levels of evidence were assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) classification. The search included title and abstract terms for Shouldice, Bassini, and Desarda. RESULTS: Sixteen studies (1983-2023) were included, comprising randomized trials, prospective studies, and one registry analysis. In Shouldice Repair, recurrence ranged from 0.5% to 8.9% with 3-31 months follow-up, while registry data (9-year follow-up) showed increased reoperation risk versus non-absorbable sutures. Bassini repair using short-term absorbable sutures showed recurrence rates of 3.3% to 20%. Desarda repair demonstrated low recurrence rates (0-2.4%), particularly with long-term absorbable materials. Heterogeneity was substantial across design, materials, follow-up, and outcomes. Follow-up duration and reporting were inconsistent, limiting comparability and meta-analysis. CONCLUSION: Available evidence indicates that absorbable sutures in established tissue-based inguinal hernia repair are associated with higher recurrence and cannot currently be recommended, particularly for Shouldice and Bassini repair. However, reducing permanent foreign body load remains important. Future research should focus on long-term or ultra-long-term absorbable sutures and hybrid approaches to enable durable, mesh-free repair without permanent foreign material.
Outcomes of inguinal hernia repair in octogenarians: A propensity score-matched analysis of the Herniamed Registry.
Lorenz R, Conze J, Fortelny R … +8 more , Köckerling F, Mayer F, Niebuhr H, Reinpold W, Stechemesser B, Wiessner R, Adolf D, Paasch C
Hernia · 2026 May · PMID 42118331 · Full text
BACKGROUND: With increasing life expectancy, a growing proportion of inguinal hernia repairs is performed in elderly patients. Evidence regarding perioperative safety and long-term outcomes in octogenarians remains limit...
BACKGROUND: With increasing life expectancy, a growing proportion of inguinal hernia repairs is performed in elderly patients. Evidence regarding perioperative safety and long-term outcomes in octogenarians remains limited. This study compared perioperative outcomes and one-year follow-up between patients aged < 80 and ≥ 80 years using data from the Herniamed Registry. METHODS: A total of 394,309 fully documented unilateral primary inguinal hernia repairs with valid one-year follow-up were extracted from the Herniamed Registry (data export October 2025). After applying predefined inclusion and plausibility criteria, 45,576 patients aged ≥ 80 years and 348,733 patients aged < 80 years were eligible for analysis. A 1:1 propensity score-matched analysis was performed using demographic, hernia-related, surgical, and comorbidity variables, with exact matching for sex, surgical approach, and procedure type. Outcomes included intraoperative, general, and postoperative complications, complication-related reoperations, and one-year endpoints (pain at rest, pain on exertion, pain requiring treatment, recurrence, trocar hernia, secondary hemorrhage, seroma, and infection). McNemar's test and odds ratios were used for statistical comparison. RESULTS: Before matching, octogenarians more frequently underwent emergency surgery (6.8% vs. 2.1%), presented with scrotal or femoral hernias, and were more often treated under local or spinal anesthesia. Propensity score matching yielded 44,550 matched pairs. After matching, patients aged ≥ 80 years showed significantly higher rates of general and postoperative complications, reoperations, secondary hemorrhage, and infection. Conversely, one-year pain outcomes and recurrence rates were significantly lower in octogenarians. No significant differences were observed for intraoperative complications, trocar hernia, or seroma. CONCLUSIONS: Octogenarians undergoing inguinal hernia repair exhibit increased perioperative risk but favorable one-year outcomes regarding pain and recurrence. These findings support the overall safety and effectiveness of inguinal hernia repair in advanced age, provided that perioperative risk is carefully managed. Elective surgery should not be withheld solely due to age, and early intervention may reduce the risk of emergency presentations and improve postoperative outcomes.
A comparison of outcomes between patients with class I and class II obesity undergoing umbilical hernia repair: a multicenter study using the ACQHC database.
Chin R, Lima DL, Tagerman D … +3 more , Zheng X, Adrales G, Sreeramoju P
Hernia · 2026 May · PMID 42118326 · Publisher ↗
PURPOSE: To better understand the gap in literature by comparing umbilical hernia repair techniques for < 2 cm umbilical hernias in patients with class I and class II obesity Methods: A retrospective review of data from...
PURPOSE: To better understand the gap in literature by comparing umbilical hernia repair techniques for < 2 cm umbilical hernias in patients with class I and class II obesity Methods: A retrospective review of data from the ACHQC was performed to include adult patients with a BMI of 30.0-39.9 kg/m2 who underwent elective UHR for a hernia defect of < 2 cm. Patients within each obesity underwent propensity score matching analysis for diabetes mellitus, hypertension, chronic obstructive pulmonary disorder, and smoking status. Outcomes of interest included: compare surgical site infection, surgical site occurrence, 30-day reoperation, recurrence, and re-admission. RESULTS: 1896 patients were included in the analysis after matching. There was no difference in 30-day recurrence, re-admission, or reoperation. There was a statistically greater number of SSO in the class II obesity group (4.6% vs 2.8%, p = 0.04), but no difference in SSI. When comparing suture-based repair between the obesity classes, there was a higher rate of SSO in patients with class II obesity (18 vs 6, p = 0.002). When comparing open repair with mesh and minimally invasive repair with mesh across the entire cohort, we found a higher readmission rate (7 vs 1, p = 0.038) and SSO rate (12 vs 3, p = 0.019) in patients with class II obesity undergoing open repair with mesh. There was no difference in SSI or SSO between the classes when undergoing MIS repair with mesh. CONCLUSION: Minimally invasive repair for umbilical hernias < 2 cm is favored over open repair in patients with class I or class II obesity in regards to wound morbidity and early postoperative hernia recurrence .
Lateral single-port laparoscopic repair of primary ventral hernias via the plane posterior to the posterior rectus sheath : The world journal of hernia and abdominal wall surgery.
Huang H, Ye J, Zhan L … +2 more , Song K, Hu A
Hernia · 2026 May · PMID 42118318 · Full text
PURPOSE: Laparoscopic ventral hernia repair is widely practiced; however, the use of a lateral single-port approach to access the plane posterior to the posterior rectus sheath for primary ventral hernias is scarcely rep...
PURPOSE: Laparoscopic ventral hernia repair is widely practiced; however, the use of a lateral single-port approach to access the plane posterior to the posterior rectus sheath for primary ventral hernias is scarcely reported. This study explores this novel surgical plane and the relevant approach as an alternative for ventral hernia repair. METHODS: During August 2025-February 2026, total extraperitoneal repair was performed in seven patients with primary ventral hernias using a lateral single-port approach in the plane posterior to the posterior rectus sheath. RESULTS: All procedures were completed using the lateral single-port approach in the target plane. No conversions to open repair, intraperitoneal onlay mesh, or standard extended totally extraperitoneal techniques were required. There were no perioperative complications or early recurrences. CONCLUSION: Repair of primary ventral hernias via the plane posterior to the posterior rectus sheath using a lateral single-port approach is a safe and feasible technique, albeit warranting a selective application by experienced surgeons.
The application of n-butyl-2-cyanoacrylate (NBCA) medical adhesive for IPOM mesh fixation in subcostal hernia repair: a retrospective study.
Fuqiang C, Chen L, Ruotong Z … +2 more , Jie C, Yingmo S
Hernia · 2026 May · PMID 42118315 · Publisher ↗
BACKGROUND: Subcostal hernia is a type of lateral abdominal wall hernia that usually occurs after open hepatobiliary or esophagogastric operations. The complex composition of different myofascial layers makes the anatomi...
BACKGROUND: Subcostal hernia is a type of lateral abdominal wall hernia that usually occurs after open hepatobiliary or esophagogastric operations. The complex composition of different myofascial layers makes the anatomic reconstruction of the abdominal wall difficult. This study aims to evaluate the efficacy and safety of chemical medical adhesive in fixing the mesh during laparoscopic subcostal hernioplasty compared to sutures. METHODS: From Jan 2016 to Dec 2021, the data of 109 patients who underwent laparoscopic intraperitoneal onlay mesh (IPOM) repair for subcostal hernia were retrospectively analyzed. Patients were divided into two groups. In the glue group (n = 60), mesh fixation was achieved using a combination of n-butyl-2-cyanoacrylate (NBCA) medical adhesive (applied as a spray for the supracostal region) and absorbable tacks (for the subcostal region). In the suture group (n = 49), fixation was accomplished with a combination of simple-loose polypropylene sutures (supracostal region) and absorbable tacks (subcostal region). Operative characteristics, perioperative parameters, and postoperative outcomes were analyzed statistically. RESULTS: No differences between the two groups were observed concerning demographic characteristics and operation features such as defect size and mesh size used for operation. In the follow-up period, there were no differences between the two groups in recurrence or other complications, such as acute/chronic pain, seroma/hematoma, postoperative ileus, or surgical-site infection. Notably, the glue group exhibited a significantly shorter operative time compared with the suture group (83.6 ± 31.5 min vs. 101.2 ± 35.4 min, P = 0.007). CONCLUSION: The application of NBCA medical adhesive for mesh fixation during IPOM repair of subcostal hernia is associated with shortened operative time. This technique is characterized by convenience, safety, and efficacy, thus supporting its further promotion as an alternative for mesh fixation.
Abdominal binders in postoperative care: a scoping review.
Nechay TV, Panin SI, Sazhin AV … +3 more , Efremova OI, Li AS, Pozdnyakova AA
Hernia · 2026 May · PMID 42118296 · Publisher ↗
OBJECTIVES: The objective of this study was to provide a review of the evidence base for the use of abdominal binders in patients undergoing surgical procedures involving the abdominal cavity. METHODS: We followed and st...
OBJECTIVES: The objective of this study was to provide a review of the evidence base for the use of abdominal binders in patients undergoing surgical procedures involving the abdominal cavity. METHODS: We followed and structured the manuscript according to the PRISMA Extension for Scoping Reviews. We performed a systematic literature search on September 30, 2025, which was limited to publications in English and Russian, across seven electronic databases: PubMed/MEDLINE, Embase, Scopus, CINAHL, ClinicalTrials.gov, and eLibrary.ru. We included only randomized controlled trials and meta-analyses as eligible study designs. We did not include meta-analyses that summarize the results of using an abdominal binder exclusively after gynecological surgeries and cesarean sections. and presented key outcomes in summary tables. RESULTS: We identified 28 randomized controlled trials and critically appraised five meta-analyses synthesizing evidence from these trials, which compared the use of abdominal binders versus no binder. Pooled evidence has demonstrated that the use of abdominal binders is associated with statistically significant reductions in postoperative pain and improvements in functional mobility following abdominal surgery, with benefits observed during both early and later recovery phases. These advantages were not accompanied by significant changes in pulmonary function. The evidence on the effect of the use of abdominal binders on surgical site infection has demonstrated considerable heterogeneity. Meta-analyses yield conflicting results, with findings ranging from a significant reduction in infection rates after open surgery (laparotomy) to an absence of significant differences across subgroups stratified by surgical type, approach, or binder design. The obtained results may be compromised by substantial heterogeneity in the types of surgical procedures included across randomized controlled trials and by the absence of trial sequential analysis to determine whether the accumulated evidence has reached the required information size for conclusive interpretation. CONCLUSION: The current evidence, though of low to moderate certainty, suggests that abdominal binders may serve as effective adjuncts for postoperative pain management and early mobilization. These benefits appear to be achievable without significant compromise to pulmonary function or increasing respiratory complications, although the perceived safety profile should be interpreted with caution due to limited reporting of complications in the literature.
Efficacy of slowly absorbable versus permanent sutures in primary repair of umbilical hernias.
Zhang D, Hennessy C, Hennessey RL … +1 more , Melland-Smith M
Hernia · 2026 May · PMID 42118220 · Publisher ↗
PURPOSE: For small primary umbilical hernias, suture-only repair remains common, yet there is limited comparative evidence guiding suture material selection. Our study compared the recurrence and complication rates of pr...
PURPOSE: For small primary umbilical hernias, suture-only repair remains common, yet there is limited comparative evidence guiding suture material selection. Our study compared the recurrence and complication rates of primary umbilical hernias using permanent or absorbable sutures. METHODS: We performed a retrospective cohort study using the Abdominal Core Health Quality Collaborative (ACHQC), a national, prospectively maintained hernia registry. Adults undergoing elective, open primary umbilical hernia repair without mesh between May 2014 and February 2024 with ≥ 1-year follow-up were included (N = 1,140). Patients were stratified by suture type: slowly absorbable (n = 500) versus permanent (n = 640). The primary endpoint was 1-year hernia recurrence; secondary endpoints included 30-day surgical site infection (SSI), surgical site occurrence (SSO), readmission, reoperation, and patient-reported outcomes (HerQLes and PROMIS). Multivariable logistic and linear regression models adjusted for suture configuration, BMI, COPD, ascites, smoking, and diabetes. RESULTS: One-year recurrence rates were similar between slowly absorbable and permanent suture repairs (6% vs. 5%; adjusted OR 1.14, 95% CI 0.66-1.96; p = 0.65). Suture configuration, including figure-of-eight closure, was not associated with recurrence. There were no differences in 30-day SSI, SSO, readmission, or reoperation between groups. Patient-reported quality-of-life outcomes (HerQLes and PROMIS pain scores) were comparable at both 30 days and 1 year. CONCLUSIONS: In elective primary open umbilical hernia repair without mesh, suture material-slowly absorbable versus permanent-was not associated with differences in recurrence, wound morbidity, or patient-reported outcomes. These findings support surgeon discretion in suture selection and highlight the need for prospective randomized trials to define optimal closure strategies for small umbilical hernias.
Comment to: Efficacy of totally extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty.
Mainprize M, Paasch C, Svendrovski A … +1 more , Katz J
Hernia · 2026 May · PMID 42118183 · Publisher ↗
Abstract loading — click title to view on PubMed.
Open versus laparoscopic repair in pediatric incarcerated inguinal hernia: a systematic review and meta-analysis.
Huang H, Wu H, Hou L … +1 more , Feng S
Hernia · 2026 May · PMID 42118158 · Publisher ↗
PURPOSE: The optimal surgical approach for pediatric incarcerated inguinal hernia remains controversial. This study aimed to systematically compare the clinical outcomes of laparoscopic repair (LH) and open repair (OH) i...
PURPOSE: The optimal surgical approach for pediatric incarcerated inguinal hernia remains controversial. This study aimed to systematically compare the clinical outcomes of laparoscopic repair (LH) and open repair (OH) in children with incarcerated inguinal hernia through a systematic review and meta-analysis. METHODS: A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to March 2026. Comparative studies evaluating LH versus OH in pediatric incarcerated inguinal hernia were included. Primary outcomes included operative time, intraoperative blood loss, and length of hospital stay. Secondary outcomes included intraoperative injury, wound infection, testicular atrophy, and recurrence. Pooled mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using Review Manager 5.4. RESULTS: Nine studies involving 584 pediatric patients were included in the meta-analysis. Compared with OH, LH was associated with significantly shorter operative time and reduced intraoperative blood loss. The length of hospital stay was also significantly shorter in the LH group. In addition, LH showed a significantly lower risk of intraoperative injury and recurrence. No statistically significant differences were observed between the two groups in terms of wound infection or testicular atrophy. CONCLUSIONS: Laparoscopic repair appears to be a safe and effective alternative to open repair for pediatric incarcerated inguinal hernia. Further high-quality prospective studies are warranted to confirm these findings.
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