Hernia最新文献

{"title":"Mesh fixation in laparoscopic groin hernia repair: a comprehensive review of techniques and devices.","authors":"Patricia Rancke-Madsen, Stina Öberg, Jacob Rosenberg","doi":"10.1007/s10029-025-03276-0","DOIUrl":"https://doi.org/10.1007/s10029-025-03276-0","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic groin hernia repair has increased in popularity in recent years. Many laparoscopic mesh fixation techniques and devices are available, but there is a lack of high-certainty evidence favoring one fixation technique over another. This narrative review aimed to provide a comprehensive summary detailing the available mesh fixation techniques and devices used in laparoscopic groin hernia repair.</p><p><strong>Methods: </strong>Information about mesh fixation techniques and devices was searched in PubMed, groin hernia guidelines, and medical technology companies webpages.</p><p><strong>Results: </strong>This review outlines various mesh fixation techniques, materials, and their features in laparoscopic groin hernia repair. We have summarized and presented in detail the available information on both penetrating and non-penetrating mesh fixation techniques, including the option of not fixating the mesh. Penetrating mesh fixation includes tacks, staples, and sutures. Tacks vary in size, absorption time, and shape and can be further categorized into absorbable and permanent materials. Additionally, this review describes two types of permanent titanium staples and the use of permanent and absorbable sutures as mesh fixation. Non-penetrating mesh fixation includes self-fixating mesh and glue. The types of glue are cyanoacrylate glue and fibrin sealant. While fibrin sealant requires careful thawing from a frozen state before use, cyanoacrylate glue offers easier storage but poses a risk of exothermic reaction with the surrounding tissue. Self-fixating meshes have an adhesive side made of microgrips or adhesive material, and a permanent side.</p><p><strong>Conclusion: </strong>This review provided a comprehensive overview of the various mesh fixation techniques and devices in laparoscopic groin hernia repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"105"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up and operative performance metrics of inguinal hernioplasty training in the Dominican Republic.","authors":"Quilvio Colon Diaz, Jose Morel, Cesar Castillo, Alvaro Torres Velasquez, Taty Gisselle Medina Novas, Ryan W Walters, Corey Lawson, Sardis Sosa, Cynthia Nunez, Jorge Rodriguez, Giampiero Campanelli, David Chen, Charles J Filipi","doi":"10.1007/s10029-025-03286-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03286-y","url":null,"abstract":"<p><strong>Purpose: </strong>The long-term outcomes of inguinal hernioplasty are crucial for evaluating patient benefits, though follow-up can be challenging, especially in low and middle-income countries (LMICs).</p><p><strong>Methods: </strong>Program coordinators in the Dominican Republic reached out to 288 patients operated on between 2014 and 2019 under a Hernia Repair for the Underserved (HRFU) training initiative. Each patient underwent an anterior Lichtenstein procedure performed by either an international HRFU expert surgeon (128 patients) or two local Dominican surgeons (160 patients) certified using the Operative Performance Rating Scale (OPRS).</p><p><strong>Results: </strong>Long-term outcomes were obtained from 30% (86/288) of patients. Follow-up data were obtained from 12% (35/288) of patients by a history and physical examination by independent Dominican surgeons. 18% (51/288) completed telephone follow-up using a four-question survey tailored for standard inguinal hernia outcomes. The phone questionnaire follow-up method (18%) was more effective than the H & P. One patient required reoperation for a mesh granuloma and one had a reoperation for a recurrent hernia. The average length of follow-up was 52 months.</p><p><strong>Conclusion: </strong>This study reports the longest durations of follow-up after inguinal hernia repair performed in a LMIC and the longest clinical outcomes follow-up of operations performed using the OPRS training method.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"99"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the therapeutic landscape in emergency incisional hernia: a scoping review.","authors":"Andrea Carolina Quiroga-Centeno, Sebastian Schaaf, Ana Pilar Morante-Perea, Stavros A Antoniou, Heather Bougard, Umberto Bracale, Sara Capoccia Giovannini, Eva Deerenberg, René H Fortelny, Christine Gaarder, Miguel Ángel García-Ureña, Katie Gilmore, Sergio Alejandro Gomez-Ochoa, Ferdinand Köckerling, Maciej Pawlak, Francesca Pecchini, José A Pereira-Rodriguez, Yohann Renard, Benoît Romain, Elena Schembari, Alexis Theodorou, Cesare Stabilini","doi":"10.1007/s10029-025-03278-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03278-y","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernias (IH) represent common complications following abdominal surgeries, with emergency repair associated with increased morbidity and mortality. This scoping review aimed to map the existing literature on emergency incisional hernia repair, identify research gaps, and inform future guideline development.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed MEDLINE and SCOPUS for studies published between January 2000 and August 2024. Articles addressing any aspect of emergency incisional hernia repair in adults were included. Data extraction focused on study characteristics, patient demographics, surgical approaches, and outcomes.</p><p><strong>Results: </strong>Of 801 unique articles identified, 73 met the inclusion criteria. Most were cohort studies (73.97%), with only one randomized trial. The primary areas of interest were repair methods (47.95%), operative outcomes (31.51%), risk assessment (16.44%), and diagnosis (5.48%). Pooled analysis revealed a predominantly female (63%), elderly (mean age 62.3 years), and comorbid patient population. The most frequent study endpoints were readmission (18%), surgical site infection (12%), reoperation (8%), and mortality (4%). Significant heterogeneity was observed in defect characterization and surgical techniques.</p><p><strong>Conclusion: </strong>This review highlights a paucity of randomized studies guiding emergency incisional hernia management. Key issues identified include inconsistent definitions of emergency presentation, limited data on hernia characteristics, and a lack of standardized outcome reporting. Future research should focus on developing a unified classification system for emergency incisional hernias, evaluating the role of imaging in decision-making, and conducting comparative studies on various treatment strategies across different clinical scenarios.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"102"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative botulinum toxin for complex abdominal wall reconstruction: a meta-analysis of propensity-score matched studies with trial sequential analysis.","authors":"Cynthia Florencio de Mesquita, Enrico Prajiante Bertolino, Amanda Godoi, Augusto Graziani E Sousa, Stalin Isaias Canizares Quisiguina, Sergio Mazzola Poli de Figueiredo","doi":"10.1007/s10029-025-03287-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03287-x","url":null,"abstract":"<p><strong>Purpose: </strong>Large ventral hernias can be associated with significant loss of domain, and preoperative Botulinum Toxin A (BTA) has been suggested as an adjunct therapy to minimize the effects of ventral hernia repair and facilitate fascial closure. However, there is often bias in studies involving BTA and its use is associated with significant cost and its efficacy remains unclear.</p><p><strong>Methods: </strong>We systematically searched Medline, Embase, Cochrane, and ClinicalTrial.gov for propensity-score matched (PSM) studies comparing preoperative BTA and AWR with standard AWR for complex hernias. We pooled odds ratios (ORs) and mean differences with 95% confidence intervals (CIs) to assess outcomes, applying a random-effects model. We used R studio version 4.3.1 for statistical analyses.</p><p><strong>Results: </strong>We included six studies with PSM comprising 851 patients undergoing AWR. The mean age was 60.5 years, mean BMI was 31.8 kg/m², and 46.5% of patients were male. There were no significant differences between groups regarding fascial closure rate (OR 1.54; 95% CI 0.78 to 3.05; p = 0.21), hernia recurrence (OR 0.81; 95% CI 0.33 to 2.01; p = 0.65), component separation (OR 1.50; 95% CI 0.54 to 4.14 p = 0.4), surgical site infections and occurrences (OR 1.31; 95% CI 0.34 to 5.00; p = 0.70), length of hospital stay, or operation time. The Trial Sequential Analysis (TSA) indicated that none of the outcomes reached the necessary sample size for a definitive conclusion.</p><p><strong>Conclusions: </strong>Preoperative BTA did not offer significant benefits in AWR of complex incisional hernia repairs. However, TSA showed that the required sample size was not achieved.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"101"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes in mesh versus suture-only treatment of burst abdomen: a case-series from a university hospital.","authors":"Thomas Korgaard Jensen, Madeline Kvist, Merete Berthu Damkjær, Jakob Burcharth","doi":"10.1007/s10029-025-03279-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03279-x","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery for a burst abdomen after midline laparotomy is associated with later incisional hernia formation. Accommodating prophylactic measures, notably mesh augmentation, are of interest. However, data regarding safety and outcomes are scarce. This study aimed to evaluate the short-term risk profile of mesh prophylaxis in the context of a burst abdomen.</p><p><strong>Methods: </strong>This is a single-center prospective study of patients suffering from burst abdomen from 2021 to 2023. A treatment protocol for the management of burst abdomen was introduced, including the synthetic, partially absorbable onlay mesh. Adult patients (≥ 18 years) with a life expectancy of > 1 year with no plans of future pregnancies were recommended to be treated with a prophylactic mesh. In this analysis, adult patients were included if they suffered from a burst abdomen after elective or emergency laparotomy. The study evaluates short-term outcomes, including 90-day wound complications, length of stay, and mortality.</p><p><strong>Results: </strong>Sixty-seven patients fulfilled the inclusion criteria and underwent treatment for a burst abdomen during the study period. Thirty-eight patients were treated with a suture-only technique, and 29 patients were supplemented with a mesh. 13 of 14 observed wound complications in the mesh group were of mild degree (Clavien Dindo 1-3b), while one patient (3%) needed mesh-explantation. The 90-day mortality rate was 21% and comparable between suture-only and mesh techniques.</p><p><strong>Conclusion: </strong>Mesh augmentation in surgery for a burst abdomen seems safe in well-selected patients at 90 days follow-up. Long-term data on the prophylactic effect on hernia development is needed.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"100"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic perineal hernia repair after abdominoperineal resection.","authors":"Xin Yuan, Yi Lin Zhu, Xue Fei Zhao, Jie Chen","doi":"10.1007/s10029-025-03288-w","DOIUrl":"https://doi.org/10.1007/s10029-025-03288-w","url":null,"abstract":"<p><strong>Purpose: </strong>Perineal hernia(PH) is a complication after abdominoperineal resection(APR), which is a special kind of incisional hernia, lacking consensus about treatment. This study is aimed at the effect of laparoscopic repair with mesh.</p><p><strong>Methods: </strong>A retrospective study was conducted from Januarary 1st 2015 to December 31st 2023 for the patients undergoing laparoscopic perineal hernia repair after abdominoperineal resection(APR). The data of characteristics, surgery details and follow-up were collected and analysed to evaluate the effect and complications.</p><p><strong>Results: </strong>41 cases were included altogether and all patients received laparoscopy approach, 14 males and 27 females, median age was 70 years(range 45-80years), the mean BMI was 25.04 ± 3.38 kg/m². Operations were completed under laparoscopy in 22 cases, combined with open surgery in 19 cases. 40 cases were treated with synthetic mesh and 1 case with biological mesh. The median operative time was 145 min(range 55-270 min), and the post operative hospital day was 13 days(range 4-47 days). The median follow-up time was 30 months(range 6-103months). There were 2 cases of wound infection and 1 case of intestinal obstruction after operation during in hospital days. 1 cases of recurrence and 2 cases of abnormal sensation in the operation area were observed during the follow-up period. The total incidence of complications was 14.6%.</p><p><strong>Conclusion: </strong>Laparoscopic perineal hernia repair with mesh shows low rates of complications, which is a safe and effective method to perineal hernia after APR. For large defects, hybrid technique helps to close the defect and eliminate dead spaces. The appropriate kind and adequate mesh overlap are critical. Short-term follow up shows positive outcomes in this retrospective study and the controlled trial and long-term follow-up is needed in the future.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"103"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional survey investigating surgeon perceptions of pre-operative risk prediction models incorporating radiomic features.","authors":"Jane N Ewing, Zachary Gala, Malia Voytik, Robyn B Broach, Jayaram K Udupa, Drew A Torigian, Yubing Tong, John P Fischer","doi":"10.1007/s10029-025-03292-0","DOIUrl":"https://doi.org/10.1007/s10029-025-03292-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernias are a significant source of morbidity in the United States that impact quality of life and can cause life-threatening complications. Complex patient factors, collected as structured and unstructured data, contribute to the risk of developing an incisional hernia following abdominal surgery. It is unknown how risk prediction models derived from imaging data, or radiomic features, can enhance pre-operative surgical planning. This study investigates surgeons' perspectives regarding risk prediction models derived from radiomic features and assesses the model's impact on surgeon behavior.</p><p><strong>Methods: </strong>An online cross-sectional survey assessing perceptions of a pre-operative risk prediction model was administered to surgeons across the US from April 23, 2024- May 30, 2024. Surgeons' beliefs of the risk model's impact on surgeon behavior and its applicability in the clinical setting were assessed.</p><p><strong>Results: </strong>A total of 166 completed surveys were analyzed. Mean age was 52.3 (SD 10.1), 71.1% were male, 78.9% were White, and 90.4% were not Hispanic or Latino. The majority of the respondents were general surgeons (58%), colorectal surgeons (14%), thoracic surgeons (12%), and urologists (7%). The mean level of accuracy predicted from radiomic features needed to prompt a change in management was 74.5% (SD 15.1%). The mean at which FPR and FNR were unacceptable was 25.9% (SD 16.9%) and 26.1% (SD 21.7%), respectively. Most believed a risk prediction model tool would improve their peri-operative management.</p><p><strong>Conclusion: </strong>A majority of surgeons were positively supportive of incorporating a hernia risk-prediction clinical decision tool incorporating radiomic features in their clinical practice.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"97"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis on robotic assisted ventral hernia repair: the ROVER review.","authors":"Sara Capoccia Giovannini, Maaike Vierstraete, M Frascio, G Camerini, F Muysoms, C Stabilini","doi":"10.1007/s10029-025-03274-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03274-2","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery for ventral hernia repair (VHR) is gaining attention for its potential advantages over laparoscopic and open techniques. This approach combines the advantages of minimally invasive surgery with the ability to perform technically challenging procedures, often required in open surgery but difficult with conventional laparoscopy. We aim to evaluate the efficacy and safety of robotic VHR compared to other surgical approaches, focusing on postoperative complications, operative time, and costs.</p><p><strong>Material and methods: </strong>A systematic review with meta-analysis were conducted, including 67 studies from January 2010 to May 2023 on Robotic VHR compared with other techniques. Primary outcome was 30-days postoperative complications; SSI, SSO, seroma, mortality, recurrence, length of hospital stay, operative time and costs were analysed as secondary outcomes.</p><p><strong>Results: </strong>Robotic surgery was associated with longer operative times compared to both laparoscopic (MD 64.67 min; p < 0.001) and open repairs (MD 69.69 min; p < 0.001). However, it resulted, compared to open surgery, in fewer SSIs (OR 0.62; p 0.05), mortality (OR 0.44; p 0.04) and shorter hospital stay (MD -3.77 days; p < 0.001). No differences were found in overall complications or length of stay between robotic and laparoscopic approaches but higher costs and longer operative times were reported in robotic VHR.</p><p><strong>Conclusions: </strong>Based on the currently available low-quality evidence, robotic VHR appears to offer limited advantages compared to laparoscopic techniques. However, when compared to open approaches, robotic VHR may demonstrate reduced postoperative complications and shorter hospital stays even if an higher rate of seroma formation was retrieved probably related to technical details. Nevertheless, longer operative times and higher costs remain significant limitations. Further high-quality comparative studies are warranted to assess long-term outcomes and cost-effectiveness.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"95"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Botulinum Toxin A (BTA) injection in abdominal wall reconstruction for subxiphoid (M1) hernias.","authors":"Monica E Polcz, Alexis M Holland, William R Lorenz, Sullivan Ayuso, Gregory T Scarola, Dau Ku, Vedra A Augenstein, B Todd Heniford","doi":"10.1007/s10029-025-03290-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03290-2","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative BTA assists with fascial closure during abdominal wall reconstruction. Its efficacy in subxiphoid (M1) hernias has been questioned with high rates of component separation techniques (CST) despite BTA. To assess the role of BTA in these hernias, we compared fascial closure and recurrence rates in patients with M1 hernias requiring CST with or without preoperative BTA.</p><p><strong>Methods: </strong>A prospectively maintained database at a tertiary hernia center was reviewed for M1 hernias who underwent CST, and grouped based on use of preoperative BTA. Standard univariate analysis was performed.</p><p><strong>Results: </strong>Of 67 patients, 30 (44.8%) received preoperative BTA. BTA versus non-BTA groups had similar mean ages (56.0 ± 14.1vs.61.5 ± 11.8 years, p = 0.087), ASA score (p = 0.345), rate of diabetes (p = 0.421), and very large defect size (499.2 ± 185.5vs.416.1 ± 238.6 cm2,p = 0.144). In the BTA group, BMI was lower (28.9 ± 5.1vs.32.7 ± 7.2 kg/m2,p = 0.018), with fewer current smokers (0%vs.10.8%,p = 0.006), and more contaminated (20.0%vs.5.4%) and dirty cases (33.3%vs.13.5%) (p = 0.008). External oblique release was performed in 24 (80.0%) BTA patients versus 23 (62.2%) non-BTA (p = 0.179), posterior CST in 6 (20.0%) versus 14 (37.8%) (p = 0.133). Rates of bilateral CST (90.0%vs.94.6% p = 0.394), fascial closure (90.0%vs.94.6%,p = 0.650), overall wound complications (33.3%vs.43.2%,p = 0.458), and recurrence (6.7%vs.2.7%,p = 0.583) were similar with average follow up of 12.7 ± 18.8 versus 24.1 ± 28.2 months (p = 0.062).</p><p><strong>Conclusion: </strong>Repair of very large M1 hernias requires high rates of CST despite preoperative BTA injection. When CST is needed, BTA as a preoperative adjunct does not appear to offer benefit in terms of fascial closure rates, frequency of bilateral CST, or risk of recurrence.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"96"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative outcomes and wound events in incisional hernia repair using hybrid mesh: results from a prospective multicenter italian study.","authors":"Francesco Pizza, Antonio Iuppa, Pietro Maida, Vincenzo Pilone, Antonio Crucitti, Tomaiuolo Pasquina Maria Carmen, Lorenzo Morini, Jacopo Nicoló Marin, Tommaso Petitti, Camillo Bertoglio, Gianpaolo Marte, Ignazio Sordelli, Simona Gili, Francesco Saverio Lucido, Lugi Busciano, Dario D'Antonio, Ludovico Docimo, Claudio Gambardella","doi":"10.1007/s10029-025-03285-z","DOIUrl":"https://doi.org/10.1007/s10029-025-03285-z","url":null,"abstract":"<p><strong>Purpose: </strong>The complexity of managing ventral hernias leads surgeons to explore different optimal techniques and mesh selection. Hybrid meshes, combining absorbable and permanent components, aim to balance long-term durability and infection risk. This study evaluated the extended-term outcomes of GORE^® SYNECOR intraperitoneal (IP) biomaterial for incisional hernia repair through minimally invasive laparoscopic techniques.</p><p><strong>Methods: </strong>Conducted across eight Italian surgery centers from January 2020 to September 2022, this multicenter analysis prospectively assessed the outcomes of patients undergoing laparoscopic repair of incisional hernias using GORE® SYNECOR. Outcomes included postoperative wound events, pain, recurrence, and mesh bulging.</p><p><strong>Results: </strong>A total of 371 patients participated in the study. No serious adverse events or significant mesh-related complications were observed. Surgical site occurrences (SSO) were recorded in a proportion of cases, and hernia sac volume was identified as the only independent risk factor (p < 0.0001). At three months post-surgery, pain levels and impacts on daily activities were minimal. At 24 months, recurrence and mesh bulging were associated only with patients with hernia sac sizes larger than 450 cm³.</p><p><strong>Conclusion: </strong>Laparoscopic incisional hernia repair using GORE^® SYNECOR hybrid mesh demonstrated satisfactory safety and efficacy regarding wound-related events and recurrence. Minor complications were more closely related to hernia sac size rather than the surgical approach, suggesting that the laparoscopic technique may optimize outcomes, particularly in elderly, smokers, and overweight patients.</p><p><strong>Clinicaltrials: </strong>NCT06166069.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"94"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}