Hernia最新文献

{"title":"Multicenter observational study comparing robotic retrorectus and open preperitoneal mesh repair for treatment of primary ventral hernias.","authors":"Maaike Vierstraete, Pieter Dries, Mathias Allaeys, Filip Muysoms, Frederik Berrevoet","doi":"10.1007/s10029-025-03321-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03321-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the long-term surgical outcomes of the open preperitoneal (PREPER) approach versus a robot-assisted Transabdominal Retromuscular Umbilical Prothesis (rTARUP) approach in primary ventral hernia repair.</p><p><strong>Methods: </strong>Patients who underwent primary ventral hernia repair using either the PREPER or rTARUP technique were recruited. Data were collected on demographics, hernia, and mesh dimensions, as well as perioperative outcomes. Patients were contacted by telephone and assessed using the EuraHS-QoL and PINCH-Phone questionnaires to gather information on reoperations, recurrences, and patient reported outcomes. Clinical evaluations were conducted if recurrence was suspected.</p><p><strong>Results: </strong>The analysis included 82 patients having a PREPER repair and 80 patients having a rTARUP repair, with on overall follow-up time of 6.2 and 5.1 years respectively. BMI was higher in the rTARUP group (p = 0.007), and hernia and mesh sizes were significantly larger in the rTARUP group (p < 0.0001). No significant differences in 30-day complications were observed (p = 0.77). Recurrence rates were 0.0% in the PREPER group and 2.5% in the rTARUP group (p = 0.24). EuraHS-QoL scores showed low levels of pain, restriction of activities, and esthetic discomfort in both groups.</p><p><strong>Conclusion: </strong>The PREPER and rTARUP techniques demonstrate favorable long-term outcomes, with low recurrence rates and high quality of life. No clear advantage of one approach over the other was observed in the treatment of small-to medium sized midline hernias. Considering evidence indicating longer operative times and higher costs associated with the robotic platform, its use may provide limited added value in cases of low complexity with inherently low complication and recurrence rates.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"129"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752360","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":"Comparison of anatomical polyester mesh without fixation and conventional flat mesh with fixation in laparoscopic total extraperitoneal repair for inguinal hernia.","authors":"Wei-Chang Lee, Ching-Wei Huang, Le-Wei Fan, Yun-Ren Li, Ying-Hsu Chang, Yu-Chao Hsu, Chung-Yi Liu","doi":"10.1007/s10029-024-03231-5","DOIUrl":"https://doi.org/10.1007/s10029-024-03231-5","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-established technique. In Taiwan, the National Health Insurance (NHI) covers the fees of the procedure and conventional mesh (polypropylene mesh), whereas the anatomical polyester mesh (Parietex™) requires additional self-pay. This study aimed to compare the outcomes of the conventional mesh with fixation versus the polyester mesh (without fixation) in laparoscopic TEP repair.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of male patients who underwent laparoscopic TEP repair between 2017 and 2021. Patients could choose between the conventional mesh with fixation (conventional mesh group) or self-paid Parietex™ mesh without fixation (anatomical polyester mesh group). The outcomes included operation (OP) time, prolonged length of stay (LOS), and postoperative complications.</p><p><strong>Results: </strong>A total of 74 patients with 123 hernias were included, of which 36 patients (67 hernias) underwent the anatomical mesh without fixation, while 38 patients (56 hernias) underwent the conventional mesh with fixation. The mean OP time was 102.6 ± 45.6 and 88.5 ± 42.0 min in the conventional and the anatomical polyester mesh group. After adjusting for body mass index, diabetes mellitus, cardiovascular disease, and hernia type, no significant differences were observed between the two groups in OP time (p = 0.152) and the risk of acute pain (p = 0.337), chronic pain (p = 0.816), seroma (p = 0.941), hydrocele (p = 0.423), or hematoma (p = 0.347).</p><p><strong>Conclusions: </strong>The conventional mesh demonstrates non-inferior outcomes compared to the anatomical polyester mesh. Given that the anatomical polyester mesh is not reimbursed by Taiwan's National Health Insurance (NHI), the use of the conventional mesh with fixation in TEP inguinal hernia repair may be a more cost-effective option in Taiwan.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"128"},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742766","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":"Conflict resolution of the beams: CT vs. MRI in recurrent hernia detection: a systematic review and meta-analysis of mesh visualization and other outcomes.","authors":"Ahmed Abdelsamad, Ibrahim Khalil, Mohammed Khaled Mohammed, Aya Sayed Ahmed Said Serour, Zeyad M Wesh, Omar Zaree, Mohamed Abdelmohsen Bedewi, Zainab Hussein, Torsten Herzog, Khaled Ashraf Mohamed, Florian Gebauer","doi":"10.1007/s10029-025-03308-9","DOIUrl":"10.1007/s10029-025-03308-9","url":null,"abstract":"<p><strong>Background: </strong>Recurrent abdominal hernias remain a significant clinical challenge, with relatively high recurrence rates despite prosthetic mesh repair. Accurate imaging modalities are essential to assess mesh positioning and detect complications. Our study aims to compare computed tomography (CT) and magnetic resonance imaging (MRI) for mesh visualization, recurrence detection, and related postoperative outcomes in recurrent hernia patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted, including CT scan or MRI studies, to assess mesh visualization in recurrent hernia cases. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was performed up to July 2024. Data were extracted for mesh visualization, recurrence rates, seroma detection, and reoperation rates. Statistical analysis employed a random-effects model with subgroup analysis for CT and MRI modalities.</p><p><strong>Results: </strong>A total of 26 studies were included (18 for CT, and 8 for MRI). Recurrence rates were 20% (95% CI: 0-42%) for CT-based studies and 15% (95% CI: 4-26%) for MRI-based studies (p = 0.72). MRI exhibited superior mesh visualization (73%; 95% CI: 42-100%) compared to CT-(48%; 95% CI: 0-100%) (p = 0.44) studies. Seroma detection rates were similar: 12% (95% CI: 4-19%) for CT- and 10% (95% CI: 4-15%) for MRI- (p = 0.65) studies. Reoperation rates were 6% (95% CI: 1-11%) for CT- and 34% (95% CI: 3-66%) for MRI-based studies, showing a non-significant trend (p = 0.08).</p><p><strong>Conclusion: </strong>CT and MRI offer distinct advantages in detecting mesh-related complications after hernia surgery. CT remains preferred for identifying recurrence and acute complications, while MRI excels in mesh visualization and soft-tissue assessment. Tailored imaging strategies based on clinical scenarios can optimize outcomes and improve postoperative care.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"127"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735710","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":"Postoperative lymphatic leakage following laparoscopic totally extraperitoneal inguinal hernia repair: the first case report and review of the literature.","authors":"N Kapellas, S Alkhalil, T Hero, M Senkal","doi":"10.1007/s10029-025-03318-7","DOIUrl":"10.1007/s10029-025-03318-7","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative lymphatic leakage (PLL) is a rare and poorly understood complication following laparoscopic inguinal hernia repair (LIHR). While seroma is a well-documented postoperative finding, the potential for lymphatic leakage and subsequent lymphatic fistula is frequently overlooked and often misclassified. This report presents a unique case of postoperative lymphocele following Totally Extraperitoneal (TEP) inguinal hernia repair and discusses diagnostic considerations, management strategies, and implications for surgical practice.</p><p><strong>Methods: </strong>We report the case of a 56-year-old male who developed a large, symptomatic inguinal lymphocele after undergoing TEP LIHR. Diagnosis was confirmed via magnetic resonance imaging (MRI) and analysis of the drained fluid. Management involved surgical drainage followed by low-dose radiotherapy. A narrative literature review was also performed to identify existing evidence on PLL following LIHR.</p><p><strong>Results: </strong>The patient developed a significant septated fluid collection (115 × 60 × 50 mm) compressing the bladder, consistent with a lymphocele. Drain output peaked at 350 mL/day. Fractionated low-dose radiotherapy (0.5 Gy × 10 sessions) led to a marked reduction in lymphatic output to <10 mL/day, permitting safe drain removal. At two-month follow-up, the patient remained asymptomatic. A narrative literature search revealed no previously reported cases of PLL following LIHR.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first reported case of lymphocele and lymphatic fistula formation following TEP LIHR. This case highlights the need to recognize lymphatic leakage as a distinct complication. Low-dose radiotherapy appears to be an effective, minimally invasive treatment. Standardized terminology and further research are essential to improve diagnosis and management.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"126"},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718769","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: Prophylactic mesh versus primary closure in emergency and elective surgeries: a systematic review and meta-analysis of randomized clinical trials.","authors":"Ana Paula Valério-Alves, Caio Leonardo Dos Santos Saggin, João Marcos Escórcio de Aguiar Portela, Patricia Viana, Gabriela Branquinho Guerra, Camila Mariana de Paiva Reis, Rafael Morriello","doi":"10.1007/s10029-025-03317-8","DOIUrl":"https://doi.org/10.1007/s10029-025-03317-8","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"125"},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729986","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":"One-year outcomes of biological mesh in hiatal hernia repair: a real-world study.","authors":"Xianggang Huang, Xiangyu Shao, Junsheng Li","doi":"10.1007/s10029-025-03316-9","DOIUrl":"https://doi.org/10.1007/s10029-025-03316-9","url":null,"abstract":"<p><strong>Purpose: </strong>The placement of synthetic mesh during laparoscopic hiatal hernia repair has been verified to reduce postoperative recurrence, but mesh erosion and other related complications may occur to synthetic mesh, and our aim was to verify the safety and efficacy of biological mesh in hiatal hernia repair.</p><p><strong>Methods: </strong>Patients with hiatal hernia who were treated at a tertiary teaching university hospital from December 2020 to May 2023 were prospectively included in this study. General clinical data, hernia-related data, and intraoperative data were collected, and the patients were followed up at 1, 3, 6, and 12 months after surgery, after 12 months, follow-up as needed for primary outcome until September 2024. The following parameters were recorded during follow-up visit: gastroesophageal reflux symptoms, Gastroesophageal reflux disease-Health related quality of life (GERD-HRQL) questionnaire, postoperative recurrence, mesh-related complications and patients' overall satisfaction.</p><p><strong>Results: </strong>A total of 82 patients with hiatal hernia were included in this study. The mean age of the patients was 62.68 ± 15.93 years, mean BMI 24.81 ± 4.05 kg/m², the average operation time was 128.21 ± 39.20 min. There was statistically significant improvement of GERD symptom postoperative (p<0.05). 72 cases (93.5%) were rated as \"Great\" on the GERD-HRQL at the 12 months after surgery; 65 cases (84.4%) were rated as \"very satisfactory\" on the overall satisfaction scale at the 12 months after surgery. 6 patients (7.3%) experienced recurrences, with no mesh-related complications reported during the follow-up.</p><p><strong>Conclusion: </strong>At a mean follow-up of 25.43 ± 10.38 months, the present study showed that laparoscopic hiatal hernia repair with biologic mesh results in low rates of 1-year recurrence and complications and increased patient satisfaction.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"123"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709669","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":"Comparison of short-term clinical efficacy and safety between biological and synthetic meshes in laparoscopic hiatal hernia repair: a single-center randomized controlled trial.","authors":"Xiaoli Liu, Yusheng Nie, Qiuyue Ma, Minxian Zhao, Haiyun Li, Lei Guan, Huiqi Yang","doi":"10.1007/s10029-025-03304-z","DOIUrl":"https://doi.org/10.1007/s10029-025-03304-z","url":null,"abstract":"<p><strong>Background: </strong>The optimal choice of mesh material in laparoscopic hiatal hernia repair (LHHR) is debated. This study aimed to compare the short-term clinical efficacy and safety of biological versus synthetic meshes in LHHR.</p><p><strong>Methods: </strong>In a prospective, single-center randomized controlled trial conducted from January 2020 to December 2022, 124 patients undergoing LHHR were enrolled and randomly assigned to either the biological mesh group (n = 62) or the synthetic mesh group (n = 62). The biological mesh group received non-crosslinked biological mesh, while the synthetic mesh group received polypropylene anti-adhesion mesh for hiatal closure reinforcement. Randomization was computer-generated. Baseline characteristics were collected, and patients were followed up at 6, 12, and 18 months postoperatively through telephone interviews or outpatient visits. The primary outcome was the recurrence rate of hiatal hernia, assessed by gastroscopy and upper gastrointestinal contrast radiography. Secondary outcomes included symptom improvement evaluated using the Visual Analog Scale (VAS) and the Short Form-36 (SF-36) Health Survey Questionnaire, as well as quality of life improvements. The safety of mesh was assessed by recording mesh-related complications.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the two groups. At 18 months, the recurrence rate was 1.92% in the synthetic mesh group and 9.26% in the biological mesh group (P = 0.225). At 6 months, the biological mesh group reported significantly less early satiety compared to the synthetic mesh group (0.35 ± 1.09 vs. 0.95 ± 1.99; P = 0.046). Conversely, at 18 months, early satiety was lower in the synthetic mesh group compared to the biological mesh group (0.31 ± 1.35 vs. 1.04 ± 2.21; P = 0.043). No significant differences were observed between the groups for other symptoms or SF-36 domains at any time point (all P > 0.05). Both groups showed significant improvements in some symptoms and quality of life from preoperative to postoperative assessments (P < 0.05). No mesh-related complications were reported in either group throughout the 18-month follow-up period.</p><p><strong>Conclusions: </strong>Both biological and synthetic meshes are effective and safe for use in LHHR, demonstrating similar recurrence rates and improvements in symptoms and quality of life over an 18-month period. The choice of mesh may influence early satiety at different postoperative intervals, suggesting that individualized mesh selection based on patient-specific factors may enhance postoperative outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"124"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709610","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 inguinal hernioplasty under local, spinal and general anaesthesia: a comparative study.","authors":"Abirami J Raghunath, Subhankar Paul, Keddy Janakiraman Raghunath","doi":"10.1007/s10029-025-03295-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03295-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Inguinal hernia repair is one of the most common operations performed in General Surgery accounting for about 10-15% of all surgeries. Inguinal hernia repair can be done under local, spinal or general anaesthesia. Although specialized hernia centres routinely use local anaesthesia for uncomplicated open inguinal hernia repair, very few surgeons adopt this technique, and prefer performing surgery under spinal or general anaesthesia. We compared the short-term outcomes following open inguinal hernia mesh repair under local, spinal and general anaesthesia in our hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;(1) To compare the post-operative pain scores among the three groups. (2) To compare the duration of surgery in minutes, the duration of analgesia, analgesic requirement, the time of return to normal activity such as walking, the time of initiation of diet, and the time of voiding after the surgery. Also to compare any complications, such as urinary retention, need for catheterization, nausea and/or emesis, and the length of hospital stay. (3) To observe the impact on health-related quality of life according to EuroQol and patient satisfaction and acceptance of the type of anaesthesia for the procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single centre non-randomised, prospective, observational study was performed in 135 patients undergoing inguinal hernia repair under local (LA), spinal (SA) or general anaesthesia (GA), with 45 patients in each arm, over the span of one year. After approval from the Ethical Committee, and proper informed consent, patients above 18 years of age who were to undergo uncomplicated open inguinal hernioplasty were recruited for the study. Lichtensteins tension-free hernioplasty was performed in all cases. The duration of the procedure was calculated from the time of induction or infiltration of local or spinal anaesthesia, till the end of dressing, or extubation in case of general anaesthesia. The duration of analgesia was calculated from the end of the procedure to the feeling of first pain as recorded in the questionnaire. A standard postoperative protocol was employed to determine the pain scores for the first 7 days and also to compare the short-term outcomes i.e., duration of analgesia, return to normal activity, complications, post-operative nausea and emesis, analgesic requirement, urinary retention, length of hospital stay, health-related quality of life and patient satisfaction and acceptance were recorded according to standard proforma and EuroQol questionnaire. All the statistical analysis was carried out by SPSS version 16.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean pain scores were lower in the LA group as compared to SA and GA groups from POD-1 to POD-6 (p &lt; 0.001). However, the values from the 7th post-operative days were similar in all three groups and statistically insignificant (p = 0.09). The outcomes such as duration of analgesia, return to activity such as wal","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"121"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648423","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":"Planned iliohypogastric neurectomy for prevention of chronic pain after inguinal hernia repair.","authors":"Kazım Gemici, Ersin Özeren","doi":"10.1007/s10029-025-03283-1","DOIUrl":"10.1007/s10029-025-03283-1","url":null,"abstract":"<p><strong>Purpose: </strong>The present study aimed to investigate the effect of planned ilohypogastric neurectomy (IHPN) in preventing chronic postoperative inguinal pain (CPIP) after anterior herniorrhaphy (AH).</p><p><strong>Materials and methods: </strong>This prospective, randomized study was conducted between 2016 and 2023. Emergency and incarcerated hernia cases, bilateral inguinal hernias, cases with complications such as postoperative hematoma infection, cases in which the neuroanatomy of the inguinal region was unintentionally damaged, femoral hernias, and paraplegic patients with loss of sensation who underwent anterior inguinal herniorrhaphy with prolene mesh were excluded, and the remaining 1375 patients were included in this study. The patients were randomized into preoperative control and study groups. After further excluding 247 patients (18%) in whom the IHN could not be identified during the operation, 82% of the 1375 patients (n = 1128) were included in this study. In the control group, the RCA segment of the IHN that would remain under the mesh was preserved (control group = G1 = 534). The second group in which this segment of the RCA was excised comprised the study group (G2 = 594). Two groups were prospectively followed and pain scores (PS) were recorded regularly with a 4-point scale. The average follow-up period was 15 months (range 11-19 months) in G1 and 14 months (range 10-18 months) in G2.</p><p><strong>Results: </strong>The number of patients with CPIP was 68 in G1 and 19 in G2, this difference was found to be statistically significant (p: < 0.001). There were 19 patients in G1 and 41 patients in G2 with loss of sensation in the operation area, and a significant difference was detected in this respect (p = 0.012).</p><p><strong>Conclusion: </strong>The rate of developing CPIP was significantly lower in patients who underwent IHPN during anterior herniorrhaphy than in those who did not undergo IHPN. The subjective nature of the pain sensation complicates measuring and scoring this sensation and methodologically limits the study.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"120"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614318","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":"Mind the gap: pre-operative diastasis recti increases trocar site hernia risk after laparoscopic cholecystectomy.","authors":"Sarah Lund, Maxwell Mirande, Cecilia Mitchell, Clark Zheng, Sanjna Rajput, Erica Loomis, Stephanie Heller, Henry Schiller, Daniel Stephens, Mariela Rivera","doi":"10.1007/s10029-025-03302-1","DOIUrl":"https://doi.org/10.1007/s10029-025-03302-1","url":null,"abstract":"<p><strong>Purpose: </strong>Trocar site hernias impact 1-10% of patients undergoing a laparoscopic cholecystectomy, typically at the 10 mm port site. Risk factors identified for trocar site hernias include obesity and age; however, little is known about the impact of pre-existing diastasis rectus abdominus (DRA) on trocar site hernia rates. Therefore, we aimed to determine the impact of pre-operative DRA on trocar site hernia rates after laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients undergoing a laparoscopic cholecystectomy for benign gallbladder disease at a single institution from January 2010 to May 2020. CT scan review was used to determine the presence of pre-operative DRA and to diagnose trocar site hernia. Logistic regression was used to determine the factors associated with development of a trocar site hernia.</p><p><strong>Results: </strong>Of the 2,460 patients who underwent a laparoscopic cholecystectomy, 545 (22%) had both a pre- and post-operative CT scan and were included in analysis, with a 1.5 year median length of follow-up. Overall, 434 patients (80%) had pre-operative DRA and 88 patients (16%) developed a trocar site hernia. On logistic regression, presence of DRA was significantly associated with development of a trocar site hernia (OR = 4.12, 95% CI=[1.72,12.24], p = 0.004), while controlling for location of 10 mm port, BMI, age, sex, ASA classification, smoking status, whether surgery was elective, and presence of pre-operative umbilical hernia.</p><p><strong>Conclusions: </strong>Radiologic diagnosis of both DRA and a trocar site hernia is highly prevalent within patients who undergo a laparoscopic cholecystectomy. Further, the presence of pre-operative DRA is significantly associated with development of a trocar site hernia after laparoscopic cholecystectomy.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"114"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614828","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}