Hernia最新文献

{"title":"Comparison of laparoscopic intraperitoneal onlay mesh (IPOM Plus) and extended totally extraperitoneal (eTEP RS) repair for incisional hernia - a randomized clinical trial.","authors":"Georgy B Ivakhov, Andrey V Andriyashkin, Aleksandra A Kalinina, Deividas Kuzmauskas, Svetlana M Titkova, Vokhidzhon A Mamadumarov, Taras V Nechay, Alexander V Sazhin","doi":"10.1007/s10029-026-03846-w","DOIUrl":"https://doi.org/10.1007/s10029-026-03846-w","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic intraperitoneal onlay mesh repair with a combination of hernial defect closure (IPOM plus) is an effective and common surgical procedure performed in patients with incisional ventral hernia. The introduction of extended-view totally extraperitoneal Rives-Stoppa procedure (eTEP RS) has sparked debate among surgeons regarding the optimal technique for ventral hernia repair. Our randomized clinical study aims to compare IPOM plus and eTEP RS techniques in patients with midline incisional ventral hernias.</p><p><strong>Methods: </strong>This is a prospective, single-center, single-blind randomized clinical trial, that was conducted at Moscow City Hospital №1 (Pirogov Russian National Research Medical University's Faculty Clinic) from February 2023 to April 2025. Patients were randomly allocated in a 1:1 ratio to either the eTEP RS group (Group I) or the IPOM plus group (Group II). The primary endpoint of this study was the level of pain on the first postoperative day, measured using the numerical pain scale (NRS-11). The secondary endpoints included the level of pain after 6 ± 1 h, on the 7 (± 1), 30 (± 3) and 100 (± 5) days after surgery, length of stay, postoperative analgesic consumption, short-term complications rate and the presence of chronic pain.</p><p><strong>Results: </strong>72 patients were allocated equally to eTEP RS (n = 36) and IPOM plus (n = 36) groups. The average pain score on the first postoperative day in the IPOM plus group was significantly higher compared with eTEP RS group (p < 0.001). Comparison of median NRS-11 scores showed significantly lower pain in the eTEP RS group at 6 ± 1 h (p < 0.001), on 7 ± 1 days (p < 0.001), and 30 ± 3 days (p = 0.005). Chronic pain was observed more often in patients who underwent IPOM plus (38.9%, n = 14) than eTEP RS (5.6%, n = 2), p < 0.001. We found no differences in early complications (p = 0.260) and length of stay (p = 0.421).</p><p><strong>Conclusions: </strong>Patients undergoing eTEP RS repair for midline incisional ventral hernias experienced less frequent pain and lower analgesic requirements in the early postoperative period, as well as a lower rate of chronic pain.</p><p><strong>Trial registration: </strong>NCT05528107 (http//www.</p><p><strong>Clinicaltrials: </strong>gov).</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891522","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":"CT-Derived pelvic morphometry for preoperative risk assessment of recurrent unilateral inguinal hernia.","authors":"Mesut Yavaş, Sevcihan Kesen Özbek, Selim Keçeoğlu, Ramazan Kozan, İsmet Canpunar, Tarık Eren Atalay, Faruk Seyda, Mehmet Narin, Ahmet Ziya Anadol","doi":"10.1007/s10029-026-03839-9","DOIUrl":"https://doi.org/10.1007/s10029-026-03839-9","url":null,"abstract":"<p><strong>Background: </strong>Recurrent inguinal hernia remains a significant challenge in abdominal wall surgery despite advances in mesh-based repair techniques and minimally invasive approaches. Although pelvic skeletal morphology has been implicated in inguinal hernia development, its association with recurrent disease remains incompletely understood. This study aimed to evaluate computed tomography (CT)-derived pelvic morphometric parameters and investigate their potential value in preoperative recurrence risk assessment.</p><p><strong>Methods: </strong>This retrospective study included 251 male patients with preoperative abdominal CT examinations and complete clinical records who underwent elective inguinal hernia repair at a tertiary referral center. After applying the predefined eligibility criteria, 188 patients with unilateral inguinal hernias constituted the primary study cohort, including 162 primary and 26 recurrent unilateral hernias. The Radoievitch angle and Ami's line were measured independently by two blinded radiology residents using a standardized CT-based pelvic morphometric measurement protocol, and the mean values were used for analysis. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between pelvic morphometric parameters and recurrent inguinal hernia.</p><p><strong>Results: </strong>Patients with recurrent unilateral inguinal hernias demonstrated significantly greater affected-side Ami's line measurements (8.27 ± 0.63 vs. 7.90 ± 0.71 cm, p = 0.014) and larger Radoievitch angles (40.68 ± 4.02° vs. 38.80 ± 3.68°, p = 0.018) than patients with primary unilateral hernias. Both the Radoievitch angle (OR 1.14, 95% CI 1.01-1.28, p = 0.033) and Ami's line (OR 2.26, 95% CI 1.14-4.49, p = 0.020) remained independently associated with recurrent inguinal hernia after adjustment for age and body mass index. ROC analysis demonstrated modest discriminatory performance (AUC 0.634 for the Radoievitch angle and 0.633 for Ami's line), while the multivariable model incorporating age, body mass index, and Ami's line showed slightly improved discrimination (AUC 0.655).</p><p><strong>Conclusion: </strong>CT-derived pelvic morphometric parameters were independently associated with recurrent unilateral inguinal hernia. Although their individual discriminatory performance was modest, standardized CT-based pelvimetry may serve as an objective adjunctive tool for individualized preoperative recurrence risk assessment in patients who already undergo CT imaging for unrelated clinical indications. Prospective multicenter studies are warranted to validate these findings and determine their clinical applicability.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873934","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":"Correction to: Preoperative botulinum toxin a enables fascial closure and reduces morbidity in complex incisional hernias: results from the BRIDGE-HERNIA study.","authors":"Francesco Pizza","doi":"10.1007/s10029-026-03837-x","DOIUrl":"https://doi.org/10.1007/s10029-026-03837-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873867","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":"Population-based ultrasound reference values for inter-rectus distance: threshold prevalence, percentiles, and the limitations of fixed cutoffs.","authors":"Annukka Marttila, Katariina Kilpivaara, Jenni Kinnunen, Susanna M Savukoski, Pasi P Ohtonen, Riikka K Arffman, Lotta Vuokila, Marika H Kangasniemi, Kaisu Luiro, Maria Rajecki, Tero Rautio, Terhi T Piltonen","doi":"10.1007/s10029-026-03810-8","DOIUrl":"10.1007/s10029-026-03810-8","url":null,"abstract":"<p><strong>Purpose: </strong>This population-based study aimed to characterize the distribution of inter-rectus distance (IRD) and its upper range in adult women using standardized multisite ultrasound measurements and a percentile-based interpretive framework.</p><p><strong>Methods: </strong>Data was driven from the Finnish Women's Health Study (WENDY, 2020-2023), comprising women assigned female at birth with a mean age of 35 years (age range 33-37 years, SD 0,6). Women less than six months postpartum, exclusively breastfeeding, or with prior midline abdominal surgery or hernia repair involving a midline incision or abdominoplasty were excluded. Inter-recti distance was measured at six predefined locations along the linea alba in the supine, knee-flexed resting position using ultrasound. For the analysis, the maximal IRD of each examinee across all sites was used.</p><p><strong>Results: </strong>A total of 1,840 women with naturally occurring anatomy were examined. At the standard site 3 cm above the umbilicus, the mean IRD was 2.37 cm (SD 1.19 cm; range 0.35-9.86 cm). Nulliparous women had a lower mean IRD (1.52 cm, SD 0.70 cm; 0.35-4.37 cm, n = 539) than parous women (2.71 cm, SD 1.18 cm; 0.46-9.86 cm, n = 1,301). The cohort's 80th percentile for IRD was 3.24 cm. Based on maximal IRD, 38.5% had IRD ≥ 3 cm and 5.4% exceeded 5 cm; the 95th percentile was 5.09 cm. Maximal IRD most often occurred at the level of the umbilicus (41.3%) or 3 cm above (44.1%) and rarely below the umbilicus. Maximal IRD correlated weakly with adiposity measures (body mass index (BMI) ρ = 0.227; waist ρ = 0.273; weight ρ = 0.199) and no correlation was observed with height. Regression analysis showed that each childbirth was associated with a 0.42 cm increase in maximal IRD, and BMI increased IRD by 0.061 cm per kg/m².</p><p><strong>Conclusion: </strong>IRD is a continuous anatomical characteristic exhibiting considerable normal variation among adult women. A maximal IRD of up to 5 cm may be regarded as being within the upper tail of the population reference distribution. Fixed cutoff values should be proportionate to clinical symptoms, in order to prevent unnecessary interventions. Altogether, our findings provide population-based reference data for interpreting IRD measurements.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inguinal hernia repair with the trabucco technique: A multicenter analysis with 5-year follow-up.","authors":"Alberto Aiolfi, Piero Giovanni Bruni, Davide Bona, Gianluca Bonitta, Vanja Pecic, Bojan Jovanovic, Niccolò Grappolini, Livia Manfredini, Antonio Gargiulo, Umberto Bracale, Marta Cavalli, Giampiero Campanelli","doi":"10.1007/s10029-026-03840-2","DOIUrl":"10.1007/s10029-026-03840-2","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past three decades, the surgical management of inguinal hernia has undergone considerable advancement. In the setting of open inguinal hernia repair, the Liechtenstein tension-free technique continues to be regarded as the standard treatment; parallelly the Trabucco technique has attracted attention due to its sutureless mesh fixation. This study presents a multicenter evaluation of the Trabucco repair, with an emphasis on hernia recurrence, postoperative complications, chronic pain, and cosmetic outcomes over a five-year follow-up period.</p><p><strong>Methods: </strong>Multicenter retrospective study using a prospectively maintained database from March 2019 to December 2024. The study included all patients who underwent Trabucco repair for monolateral, uncomplicated groin hernia classified as M1-2 or L1-2. Exclusion criteria comprised patients with L3/M3 groin hernias, those undergoing surgery for hernia recurrence, and cases lost to follow-up. The primary outcome was hernia recurrence determined on both clinical and imaging confirmation.</p><p><strong>Results: </strong>Overall, 1,846 patients completed 1-year follow-up and were included in the analysis; follow-up compliance was 92% (1095/1190) at 3 years and 88% (573/658) at 5 years. Hernia recurrence occurred in 2.1% of patients, with 5-year recurrence-free probabilities of 0.95 (95%CI 0.94-0.97). Age- and hernia size-adjusted hazard analysis showed the greatest recurrence risk within the first 2 years after surgery. Chronic pain was reported in 1.1% of patients. Patient-reported outcomes, including pain, activity restriction, cosmetic concerns, and total EuraHS-QoL score, improved significantly from baseline throughout follow-up (). No mesh-related complications were observed during short- or long-term follow-up.</p><p><strong>Conclusions: </strong>In selected patients with uncomplicated unilateral M1-2 or L1-2 inguinal hernia, Trabucco repair appeared to be associated with favorable 5-year outcomes, including low recurrence and chronic pain rates and sustained improvement in quality of life.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857279","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":"Venous thromboembolism-related readmission after ventral hernia repair in the United States: a propensity score-matched analysis of open and minimally invasive surgery and insights from a national database.","authors":"Neil Boyal, Carlos Balthazar da Silveira, Paul Kang, Agnes Premkumar, Sakura Horiuchi, Ana Rasador, Alexandra Janssen, Vikram Deka, Conrad Ballecer, Thomas L Gillespie","doi":"10.1007/s10029-026-03777-6","DOIUrl":"https://doi.org/10.1007/s10029-026-03777-6","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia repairs (VHR) are common surgical procedures, yet patients remain at risk for serious postoperative complications, including hospital readmission secondary to venous thromboembolism (VTE). While minimally invasive surgical (MIS) approaches have shown benefits in reducing other complications and hospital length of stay (LOS), their impact on VTE-related readmissions has been less extensively studied.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the Nationwide Readmissions Database (NRD) from 2016 to 2022 to identify adult patients undergoing VHR, categorizing them into open or MIS approaches. The primary outcome was non-elective 30-day readmission for VTE. Secondary outcomes included LOS, in-hospital mortality at readmission, and total inpatient hospitalization costs. To minimize selection bias and balance baseline characteristics between open and MIS approaches, a propensity score-matched (PSM) analysis was performed, with specific subgroup analyses for hernia type and surgical complexity.</p><p><strong>Results: </strong>Initially, 834,298 patients were identified (Open: 74.5%; MIS: 25.5%). After propensity score matching (n = 418,846), the difference in 30-day VTE-specific readmission was no longer statistically significant (Open 1.98% vs. MIS 2.37%; OR 1.19, 95% CI 0.97-1.46, p = 0.088). MIS was significantly associated with lower odds of all-cause 30-day readmission (OR 0.76, 95% CI 0.74-0.78, p < 0.001), shorter length of stay (4.35 vs. 5.35 days, p < 0.001), and slightly lower hospital costs ($22,315 vs. $23,304, p < 0.001). Independent predictors for VTE-specific readmission included age > 65 years (OR 1.84, p = 0.001) and discharge with home healthcare (p = 0.026).</p><p><strong>Conclusion: </strong>The surgical approach was not a significant predictor of VTE-related readmission. Patient-related factors were associated with VTE-related readmissions, although the relative contribution of these factors could not be determined due to lack of granular data within this dataset. Studies focusing on risk-stratification and care optimization for high-risk patients are crucial for further improving patient outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849977","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":"The effect of surgical approach on opioid prescription rates for outpatient ventral hernia repair.","authors":"John K Ewing, Sullivan A Ayuso, Gediwon Milky, Hannah Bossie, Heather Atchison, I-Fan Shih, B Todd Heniford","doi":"10.1007/s10029-026-03834-0","DOIUrl":"10.1007/s10029-026-03834-0","url":null,"abstract":"<p><strong>Background: </strong>Reducing the use of perioperative opioids in outpatient ventral hernia repair (VHR) has potential to limit negative side effects and the risk of opioid dependence. The effect of operative approach on opioid prescription in VHR is incompletely understood. Our objective is to compare rates of opioid prescription among robotic-assisted (RVHR), laparoscopic (LVHR), and open ventral hernia repair (OVHR).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using a United States insurance claims database of outpatient VHR from 2018 to 2022. The cohort was divided into two groups: hernias coded as ventral or incisional and those coded as umbilical, epigastric, or spigelian. Opioid prescription fills were assessed at postoperative day (POD)0-14, POD15-30, and POD90-180. Surgical approaches were compared after propensity score matching (PSM) using logistic regression.</p><p><strong>Results: </strong>22,899 incisional/ventral hernia repairs (9.4% RVHR, 53.4% LVHR, and 37.2% OVHR) and 40,407 umbilical/epigastric/spigelian hernia repairs (4.3% RVHR, 21.5% LVHR and 74.1% OVHR) were included. In the incisional/ventral hernia group, RVHR and LVHR had similar opioid prescription rates POD0-14, but RVHR patients were less likely to fill opioids POD15-30 (OR = 0.65, p = 0.026). RVHR patients were also less likely to fill opioids POD15-30 (OR = 0.54, p = 0.017) relative to OVHR. In the umbilical/epigastric/spigelian group, RVHR patients were less likely to fill opioids than LVHR at POD15-30 (OR = 0.60, p = 0.033) and at POD90-180 (OR = 0.71, p = 0.021).</p><p><strong>Conclusions: </strong>RVHR was associated with fewer opioid prescriptions between POD15-30 relative to other operative approaches for ventral/incisional hernia. Along with multimodal analgesia and evidence-based prescription practices, the effect operative approach on opioid prescription should be considered.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesh fixation versus non-fixation in totally extraperitoneal inguinal hernia repair: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed Ali Chaouch, Hani Oweira, Wahid Fattal, Adriano Carneiro da Costa, Alessandro Mazzotta, Amine Gouader, Bassem Krimi, Rafael Novaes Jardim, Mohamed Zayati, Jean Marc Bigourdan","doi":"10.1007/s10029-026-03818-0","DOIUrl":"10.1007/s10029-026-03818-0","url":null,"abstract":"<p><strong>Background: </strong>The need for mesh fixation during totally extraperitoneal (TEP) inguinal hernia repair remains controversial. Although fixation has traditionally been used to prevent mesh displacement and recurrence, it may increase postoperative morbidity, particularly chronic postoperative inguinal pain (CPIP). This systematic review and meta-analysis aimed to compare mesh fixation versus non-fixation in adult patients undergoing laparoscopic TEP inguinal hernia repair.</p><p><strong>Methods: </strong>A systematic literature search was conducted up to February 2026. Randomized controlled trials comparing mesh fixation with non-fixation during TEP inguinal hernia repair were included. The primary outcomes were CPIP and hernia recurrence. Secondary outcomes included operative time, early postoperative pain, seroma, urinary retention, length of hospital stay, and costs. Risk of bias was assessed.</p><p><strong>Results: </strong>Sixteen randomized controlled trials including 1,608 patients were included. Mesh fixation was associated with a significantly higher risk of CPIP compared with non-fixation (RR 1.68; 95% CI 1.29 to 2.19; p = 0.0001). No statistically significant difference in hernia recurrence was detected between fixation and non-fixation groups (RR 0.53; 95% CI 0.22 to 1.23; p = 0.14); however, recurrence events were rare, and this analysis may be underpowered to exclude small but clinically relevant differences. Fixation was associated with a longer operative time (MD 3.16 min; 95% CI 1.04 to 5.27; p = 0.003), slightly higher 24-hour postoperative pain (MD 0.21; 95% CI 0.03 to 0.38; p = 0.02), increased urinary retention (RR 3.61; 95% CI 1.88 to 6.93; p = 0.0001), and a marginally longer hospital stay (MD 0.10 days; 95% CI 0.02 to 0.18; p = 0.01). Seroma formation did not differ significantly between groups (RR 1.05; 95% CI 0.70 to 1.58; p = 0.81). Costs were generally higher in the fixation group, mainly because of fixation devices. Publication bias assessment for outcomes with at least 10 studies did not suggest major small-study effects. The certainty of evidence was high for CPIP, moderate for recurrence and most secondary outcomes, and low for urinary retention.</p><p><strong>Conclusions: </strong>Mesh fixation was associated with a higher risk of CPIP without a statistically significant reduction in hernia recurrence. However, recurrence events were uncommon, and the available evidence does not establish equivalence or non-inferiority between the two strategies, particularly for patients with large medial or direct defects. Fixation was also associated with modest increases in operative time, early postoperative pain, urinary retention, hospital stay, and costs. Overall, non-fixation appears to be a reasonable strategy in appropriately selected patients, while selective fixation may remain relevant for large direct defects or other high-risk situations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818295","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":"Open versus robotic transversus abdominis release for ventral hernia repair: an updated systematic review and meta-analysis.","authors":"Jorge Henrique Cavalcanti Orestes Cardoso, Clara Avelar Mendes de Vasconcelos, Guilherme de Carvalho Caldas, Thiago Souza E Silva, Raquel Nogueira, Leandro Totti Cavazzola, Diego Laurentino Lima, Flavio Malcher","doi":"10.1007/s10029-026-03833-1","DOIUrl":"10.1007/s10029-026-03833-1","url":null,"abstract":"<p><strong>Background: </strong>While robotic transversus abdominis release (rTAR) offers distinct advantages over the open technique (oTAR) for complex ventral hernia repairs (VHR), its adoption rate lags behind. Despite superior peri- and postoperative outcomes, oTAR remains more widely utilized. The aim of this study is to conduct an updated systematic review and meta-analysis comparing rTAR and oTAR approaches for ventral hernia repair (VHR) patients.</p><p><strong>Methods: </strong>PubMed, Cochrane, Embase and Web of Sciences were systematically searched from inception to February 2026 to identify randomized controlled trials and observational studies comparing rTAR versus oTAR for VHR. Meta-analyses were performed using a DerSimonian-Laird random-effects model, and statistical heterogeneity was assessed using Cochran's Q test and the I² statistic. All analyses were conducted in R (version 4.4.0).</p><p><strong>Results: </strong>A total of 1,363 references were initially yielded, of whom only 10 observational studies, comprising 1,085 patients, 461 oTAR and 624 rTAR, were included in the analysis. The mean age was 62.3 years in the robotic group and 59.7 years in the open group. The mean BMI was 31.7 kg/m² in the robotic group and 31.4 kg/m² in the open group. Females comprised approximately 56% of the robotic cohort and 57% of the open cohort. The analysis showed that rTAR was associated with a statistically significant reduction in the SSO (OR 0.48; 95%CI 0.28 to 0.80; p-value = 0.004; I² = 15.4%), SSI (OR 0.27; 95%CI 0.13 to 0.55; p-value = 0.0003 I² = 0%) and readmission (OR 0.39; 95%CI 0.20 to 0.75; p-value = 0.004; I² = 0%) rates, being also associated with a statistically significant decrease in the mean LOS time (MD -4.65 days; 95%CI -5.65 to -3.66; p-value < 0.001; I² = 64.8%). However the implementation of rTAR was associated with a significant increase in operation time (MD 42.64 min; 95%CI 9.30 to 75.98; p-value = 0.012; I²= 83.4%) and no statistically significant difference was found regarding the recurrence rates (OR 0.89; 95%CI 0.30 to 2.63; p-value = 0.829; I² = 0%).</p><p><strong>Conclusion: </strong>Current observational data suggests that rTAR may offer a decreased odds of SSO, SSI, readmission rate and LOS when compared with oTAR. However, rTAR was associated with increased operative time.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818302","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":"Perioperative safety and long-term outcomes of mesh repair in nonagenarians undergoing elective inguinal hernia repair: a single-center retrospective study.","authors":"Hekai Shi, Shaochun Li, Binbin He, Xiaoyu Peng, Dongchao Yang, Zhicheng Song, Yan Gu","doi":"10.1007/s10029-026-03830-4","DOIUrl":"https://doi.org/10.1007/s10029-026-03830-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate perioperative safety, long-term outcomes, and factors associated with Clavien-Dindo grade ≥ II complications in nonagenarians undergoing elective inguinal hernia repair.</p><p><strong>Methods: </strong>The main cohort of this retrospective study included nonagenarians who underwent elective inguinal hernia repair between 2013 and2025. Preoperative, intraoperative, and postoperative data were collected. The primary outcome was Clavien-Dindo grade ≥ II complications. Univariable logistic regression was used to identify associated factors. Nonagenarians who underwent emergency groin hernia repair during the same period were analyzed separately as a supplementary descriptive cohort.</p><p><strong>Results: </strong>The elective cohort comprised 152 patients (median age 91.0 years), all of whom underwent mesh repair (Lichtenstein in 129, 84.9%). Median hospital stay was 7.0 days, and median follow‑up was 30.0 months. Postoperative complications occurred in 22 patients (14.5%), including 12 (7.9%) with Clavien‑Dindo grade ≥ II. The 30‑day mortality was 1.3%. During the follow‑up, recurrence was detected in 2 patients (1.3%) and chronic pain in 6 (3.9%). In univariate logistic regression, preoperative functional dependence was significantly associated with grade ≥ II complications (odds ratio 16.27, 95% CI 2.82 to 93.86, P = 0.002). In the emergency repair cohort (n = 29), 10 patients (34.5%) developed grade ≥ II complications, all of which were surgery‑related deaths.</p><p><strong>Conclusions: </strong>In clinically selected nonagenarians undergoing elective inguinal hernia repair, mesh repair showed acceptable perioperative safety and favorable long-term local outcomes. Preoperative functional status, rather than chronological age alone, should be emphasized in surgical decision-making.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818273","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}