Hernia最新文献

{"title":"Incidence and clinical characteristics of occult inguinal hernias: a retrospective analysis of laparoscopic repair.","authors":"Yansheng Zheng, Yuling Xue, Keling Li, Zhe Zhang, Zhenhui Wan, Haipeng Huang, Wenjun Xiong, Jin Li","doi":"10.1007/s10029-025-03298-8","DOIUrl":"https://doi.org/10.1007/s10029-025-03298-8","url":null,"abstract":"<p><strong>Background: </strong>Occult inguinal hernia is a unique clinical challenge characterized by asymptomatic presentation and the absence of detectable signs on physical examination, leading to frequent misdiagnosis and underdiagnosis. The advancement of laparoscopic hernia surgery has facilitated the identification of occult hernias, yet effective diagnostic and predictive methods remain lacking.</p><p><strong>Objective: </strong>This study aims to evaluate the incidence and clinical characteristics of occult inguinal hernias detected during laparoscopic unilateral inguinal hernia repair and to provide evidence-based recommendations for their management.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 868 patients diagnosed preoperatively with unilateral inguinal hernia at the Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2013 and December 2020. All patients underwent laparoscopic hernia repair surgery, during which both sides of the inguinal area were explored for occult hernias. Statistical analysis, including univariate and multivariate logistic regression, was performed to identify significant predictors of occult hernias.</p><p><strong>Results: </strong>Intraoperative detection of occult inguinal hernias was observed in 225 patients (25.92%). Patients with occult inguinal hernia had a higher median age of 68 (59, 76) years, compared to 63 (52, 73) years for those with unilateral inguinal hernia. The incidence was notably higher in females (34.61%) compared to males (25.37%). Stratified by hernia type, the prevalence of occult hernias was 23.84% among patients with indirect hernias (154/646) and 31.75% among those with direct hernias (60/189). Among the 225 patients with occult hernias, 129(57.33%) occult hernias cases occurred on the left side, and 142(63.11%) occult hernias cases were of the indirect type. Multivariate logistic regression analysis identified female gender, high age, and the presence of high-risk factors for intra-abdominal hypertension as independent and significant predictors of occult hernia development.</p><p><strong>Conclusion: </strong>Occult inguinal hernia remains a diagnostic and therapeutic challenge. For older patients presenting with unilateral inguinal hernia and high-risk factors for intra-abdominal hypertension, we recommend TAPP exploration and simultaneous repair of contralateral occult hernias.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"111"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604721","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":"Outcomes of quadratus lumborum blocks for pain control after open abdominal wall reconstruction: a single institution retrospective analysis.","authors":"Sarah Budney, Eric Middleton, Kyle Kleppe, Matthew Mancini, Gregory Mancini, Melissa Phillips, Catherine McKnight, John Griepentrog, Aldo Fafaj, Kaela E Blake","doi":"10.1007/s10029-025-03296-w","DOIUrl":"https://doi.org/10.1007/s10029-025-03296-w","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal wall reconstruction (AWR) is associated with significant post-operative pain for which there is no standardized treatment regimen. Quadratus lumborum (QL) blocks have not been studied in open ventral hernia repair. This study reviews our institution's experience with QL blocks in open AWR.</p><p><strong>Methods: </strong>A retrospective review from October 2022 to October 2024 was completed. Patients undergoing elective, open abdominal wall reconstruction who received pre-operative QL blocks were included. Variables analyzed included patient demographics, comorbidities, operative technique, mesh type, daily opioid consumption reported as morphine milliequivalents (MMEs), and length of stay. The primary outcome was MMEs consumed in the first 24 h after surgery.</p><p><strong>Results: </strong>There were 102 patients included in the study. The first 24-hour median opioid MME consumption was 8 (IQR 0-67.5). The median MMEs peaked on day 2 at 47 (IQR 30-114) and then trended down each day. The median length of stay was 4.3 days (IQR 4.1-5.9). There were no complications related to the QL block procedure.</p><p><strong>Conclusion: </strong>This is the first study to report on post-operative opioid consumption in patients receiving a quadratus lumborum block prior to open ventral hernia repair. We found patients consumed minimal MMEs in the first 24 h after surgery suggesting that QL blocks may provide analgesic benefit in abdominal wall reconstruction.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"118"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614397","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":"Transversus abdominis plane (TAP) block for postoperative pain management after ventral hernia repair: an updated systematic review and meta-analysis.","authors":"Ana Caroline D Rasador, Carlos A Balthazar da Silveira, Natália P Pereira, Raquel Nogueira, Flavio Malcher, Diego Laurentino Lima","doi":"10.1007/s10029-025-03305-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03305-y","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain remains a common concern following ventral hernia repair (VHR), especially for open procedures. We aim to assess the effectiveness of the Transversus Abdominis Plane (TAP) block for the management of postoperative pain following VHR.</p><p><strong>Methods: </strong>Cochrane, EMBASE, and PubMED, MEDLINE, and Web of Science were systematically searched for studies comprising adults undergoing VHR with preoperative TAP block, compared to placebo and epidural analgesia. The outcomes selected for analysis were postoperative pain with the numeric rating scale (NRS), postoperative morphine milligram equivalents (MME) per day, and hospital length of stay (LOS). Subgroup analysis was performed for studies using the Liposomal Bupivacaine (Exparel^®) for TAP block.</p><p><strong>Results: </strong>1,460 results were screened, and 14 included, comprising 9 retrospective cohort studies and 5 RCTs, totaling 1,617 patients. TAP block was associated with a shorter LOS compared to conventional pain measures (MD -1,14 days; 95% CI -2.05, -0.22; P = 0.014) and to epidural analgesia (MD -2.02 days; 95% CI -2.67, -1.37; P < 0.001), and lower NRS scale in the day of surgery (MD -1.24; 95% CI -1.81, -0.68; P < 0.001) and in the POD1 (MD -0.63; 95% CI -1.18, -0.08; P = 0.025) compared to placebo. No benefit was seen for TAP block regarding opioid consumption compared to epidural analgesia and placebo. No differences were seen between TAP block and epidural analgesia for the NRS scores. Subgroup analysis of Exparel^® compared to simple bupivacaine showed no benefit for Exparel^®.</p><p><strong>Conclusions: </strong>The TAP block is associated with shorter LOS compared to placebo and epidural analgesia and is related to less early postoperative pain compared to the conventional pain measures. The TAP block should be considered as a pain management modality for VHR, however cost-effective analysis is required to address the feasibility of the routine utilization of this approach and to balance the financial benefits of its application.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"113"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604723","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":"Mesh-reinforced reconstruction after abdominal wall desmoid tumor resection: a retrospective analysis of 16 cases.","authors":"Xuefei Zhao, Cuihong Jin, Xin Yuan, Yingmo Shen, Jie Chen","doi":"10.1007/s10029-025-03307-w","DOIUrl":"https://doi.org/10.1007/s10029-025-03307-w","url":null,"abstract":"<p><strong>Purpose: </strong>Managing the defect after abdominal wall desmoid tumor resection is challenging due to the wide excision required. This report aims to review our institutional experience with mesh-reinforced reconstruction following desmoid tumor resection in the abdominal wall.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent abdominal wall desmoid tumor resection with mesh-reinforced reconstruction between April 2014 and January 2019. Patient records were analyzed to collect data on demographic characteristics, surgical procedures, and complications.</p><p><strong>Results: </strong>Sixteen eligible patients were identified, including one patient who underwent simultaneous resection of affected intra-abdominal organs. The mean size of the abdominal wall defect was 88.1 ± 71.6 cm², and the mean mesh size was 160.3 ± 56.5 cm². The mean operative time was 87.5 ± 41.4 min, the mean hospital stay was 15.7 ± 6.0 days, and the mean follow-up period was 83.8 ± 18.0 months. Complications included seroma (n = 1) and abnormal sensation (n = 2). Tumor recurrence was observed in 1 patient, who died due to cancer progression (lung cancer). No surgical site infections or mesh infections were observed. Additionally, no patients developed ventral hernias or abdominal bulging.</p><p><strong>Conclusion: </strong>Mesh-reinforced reconstruction is a feasible and effective approach for patients requiring abdominal wall desmoid tumor resection.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"112"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614826","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":"Does quality of life improve after complex incisional hernia repair? A systematic review.","authors":"D L C de Jong, J A Wegdam, E H M Berkvens, T S de Vries Reilingh, S W Nienhuijs","doi":"10.1007/s10029-025-03300-3","DOIUrl":"https://doi.org/10.1007/s10029-025-03300-3","url":null,"abstract":"<p><strong>Introduction: </strong>Health-related quality of life (QoL) is an essential patient-reported outcome in abdominal wall surgery. The aim of this systematic review was to evaluate short term outcome of QoL after complex incisional hernia repair (IHR), focusing on open surgery.</p><p><strong>Methods: </strong>A multi-database systematic search was performed on patients treated for complex IHR. Studies evaluating the outcome in terms of QoL using validated questionnaires, at least three months postoperatively, were included. The methodology was graded, and patients' operative and outcome details were extracted.</p><p><strong>Results: </strong>Seven studies were included, encompassing 729 patients, all of whom underwent an open approach. A significant increase in QoL was found in all types of questionnaires (Short Form-36 (SF-36), Carolinas Comfort Scale, Hernia Related QoL, and Numeric Rating Scale). SF-36 was used most frequently. A pooled standardized mean difference (SMD) of 0.70 (95% CI: 0.08-1.47 p < 0.00001) was yielded, indicating a moderate to large effect of the intervention compared to preoperative scores.</p><p><strong>Conclusion: </strong>A limited number of studies have included QoL measurement after incisional hernia repair. In all studies, a significant increase was seen in QoL postoperatively. This review highlights the substantial benefits of open surgery in improving QoL, while emphasizing the need for further research to standardize outcome measurement and explore long-term results.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"110"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572942","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":"Robotic versus open ventral hernia repair (ROVHR): a randomized controlled trial protocol.","authors":"Alvaro C Carvalho, Kimberly P Woo, Ryan C Ellis, Chao Tu, Benjamin T Miller, Ajita S Prabhu, Michael J Rosen, David M Krpata, Clayton C Petro, Lucas R Beffa","doi":"10.1007/s10029-025-03299-7","DOIUrl":"10.1007/s10029-025-03299-7","url":null,"abstract":"<p><strong>Background: </strong>Robotic retromuscular hernia repair has proven to be feasible and safe but lacks randomized data to demonstrate significant clinical benefit. The majority of current comparative studies published have been case series, retrospective studies, systematic reviews, or large registry data, all of which have significant limitations and bias (Bittner et al. in Surg Endosc 32:727-734. https://doi.org/10.1007/s00464-017-5729-0 , 2018; Bracale et al in Hernia 25:1471-1480. https://doi.org/10.1007/s10029-021-02487-5 , 2021; Carbonell in Ann Surg 267:210-217. https://doi.org/10.1097/SLA.0000000000002244 , 2018; (Warren et al. in Surg Endosc. https://doi.org/10.1007/s00464-024-11202-1 , 2024; Dewulf et al in BJS Open 6:zrac057. https://doi.org/10.1093/bjsopen/zrac057 , 2022; Maskal and Beffa in Surg Clin N Am 103:977-991. https://doi.org/10.1016/j.suc.2023.04.007 , 2023). It was only recently that the first randomized trial was conducted by Warren et al. comparing open and robotic retromuscular hernia repairs with synthetic mesh (Warren et al. in Surg Endosc. https://doi.org/10.1007/s00464-024-11202-1 , 2024). The data currently available has yielded inconsistent outcomes leaving significant knowledge gaps for clinical decision making. Reduced length of stay for robotic retromuscular repairs has been a consistently proven outcome, however, and therefore, we hypothesized that robotic retromuscular hernia repairs would be superior to open retromuscular hernia repair by reducing length of stay in the hospital by 24 h (Carbonell in Ann Surg 267:210-217. https://doi.org/10.1097/SLA.0000000000002244 , 2018).</p><p><strong>Methods: </strong>The Institutional Review Board at all participating sites has approved this protocol. This trial has been registered on clinicaltrials.gov (NCT: 05472987). The ROVHR trial is a registry-based, multicenter, double-blinded randomized trial. The primary hypothesis is robotic retromuscular hernia repairs is superior to open retromuscular hernia repairs by reducing length of stay by at least 24 h. Secondary outcomes include 30-day wound morbidity, readmissions, opioids prescribed and consumed, NRS-11 pain scores obtained daily for the 5 first days after surgery, PROMIS-3a Pain Intensity survey, and patient reported outcomes including Hernia-Related Quality of Life (HerQLes), and EuraHS. Additionally, direct operating room costs will be compared.</p><p><strong>Discussion: </strong>Based existing literature, we designed a randomized trial with a primary endpoint to determine if robotic retromuscular hernia repairs reduce length of in hospital stay by at least 24 h compared to open retromuscular hernia repairs. This study will add high-level of evidence providing evidence-based outcomes for clinical decision making.</p><p><strong>Trial registration: </strong>NCT05472987. Registered on July 20, 2022.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"109"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541783","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":"Subxiphoid hernia, definition and repair: an international delphi consensus.","authors":"Alix Donadieu, Sarfaraz Jalil Baig, Beny Charbit, David Lourié, Miguel Angel Garcia Urena, Yohann Renard","doi":"10.1007/s10029-025-03289-9","DOIUrl":"https://doi.org/10.1007/s10029-025-03289-9","url":null,"abstract":"<p><strong>Purpose: </strong>Subxiphoid incisional hernias (SIH) are rare and challenging to repair, often occurring post- cardiac surgery after sternotomy and pericardial drainage. The literature on SIH is limited, with small patient cohorts and no established consensus on optimal repair strategies published yet. This present study aimed at proposing the definition and the surgical management and decision-making processes for SIH repair through an international Delphi consensus among expert surgeons.</p><p><strong>Methods: </strong>Using a modified Delphi technique, 69 international abdominal wall surgeons were invited. Three rounds were conducted to reach consensus on the definition, characteristics, classification, preoperative imaging and surgical approaches for SIH. Consensus was defined as more than 70% of agreement on 32 statements across 12 topics.</p><p><strong>Results: </strong>Sixty-nine experts were enrolled from 5 continents. Concerning definition of SIH, consensus was reached: a defect where the M1 part represents the most challenging and representative part. According to the expert panel, a mesh should be used in an extraperitoneal position. Both open and minimal invasive surgical (MIS) approach (E-TEP and/or ventral TAPP) are viable for W1 (< 4 cm) SIH repair. Achieving sufficient mesh overlap (> 5 cm) and defect closure are the 2 primary goals during SIH repair, whatever the approach and the technique. Expert panel agreed that a solid understanding of the anatomy is crucial and difficult in this area, due to the proximity of bony structures. For cranial overlap, exposing the central tendon of the diaphragm after cutting the posterior rectus sheath horizontally reached consensus. Concerning lateral overlap, the panel agreed on a retro rectus repair with TAR for ≥W2 hernia, while total preperitoneal repair is not. Mesh fixation is deemed unnecessary if adequate overlap is achieved. In case of difficulties of closure, only TAR might be helpful, with bridging as a last resort. They agreed that SIH ≥W2 should be referred to an expert hernia center.</p><p><strong>Conclusion: </strong>This Delphi consensus defined SIH and was an opportunity to emphasize the anatomy of the subxiphoid region. It opens the way for future strong studies on the subject, leading for recommendations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"108"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523338","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":"Is the recurrence rate higher in obese patients undergoing inguinal hernia surgery?","authors":"Zi-Wei Li, Ming Song, Jun Liu, Bin Jiang, Wei Hu, Xin Zheng","doi":"10.1007/s10029-025-03301-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03301-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether obese patients undergoing inguinal hernia repair surgery have a higher recurrence rate and compare the clinical outcomes of obese and non-obese patients.</p><p><strong>Materials and methods: </strong>The databases of PubMed, EMBASE, and Cochrane Library were used to search for eligible studies from inception to November 1, 2024. Mean difference (MD), Odds ratios (OR) and 95% confidence intervals (Cl) were pooled up to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with Stata (V.16.0) software.</p><p><strong>Results: </strong>A total of nine studies involving 56,833 patients were included in this study. By comparing the baseline information, we found that the obese group had Fewer older (MD=-0.08, I²=62.41%, 95%CI=-0.16 to -0.00, P = 0.04), higher BMI (MD = 2.45, I²=93.67%, 95%CI = 2.08 to 2.81, P < 0.01), more hypertension patients (OR = 1.32, I²=32.96%, 95%CI = 1.02 to 1.67, P = 0.04), more BPH (OR = 0.68, I²=0.00%, 95%CI = 0.49 to 0.94, P = 0.02) and more local anesthesia (OR = 0.82, I²=14.73%, 95%CI = 0.79 to 0.86, P < 0.01) than the none-obese group. In terms of postoperative outcomes, We found that the obese group had higher recurrence rate (OR = 1.27, I²=21.89%, 95%CI = 1.10 to 1.47, P < 0.01), more wound infection (OR = 1.43, I²=0.00%, 95%CI = 1.20 to 1.69, P < 0.01), and more overall complications (OR = 1.12, I²=28.20%, 95%CI = 1.05 to 1.20, P < 0.01).</p><p><strong>Conclusion: </strong>Compared with the non-obese group, the obese group has a higher recurrence rate, more wound infections, and overall more complications.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"107"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500521","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":"Safety and outcome of elective synthetic mesh repair for incisional ventral hernias in immunosuppressed patients - a retrospective propensity-score-matched analysis.","authors":"Ramin Raul Ossami Saidy, Yvonne May Callister, Luca Dittrich, Dennis Eurich, Christian Denecke, Johann Pratschke, Jonas Raakow","doi":"10.1007/s10029-025-03273-3","DOIUrl":"10.1007/s10029-025-03273-3","url":null,"abstract":"<p><strong>Introduction: </strong>Incisional hernia remain an important complication after abdominal surgery. Repair often includes use of synthetic mesh, but certain risk factors for complication after mesh hernia repair have been described. Among these, immunosuppression due to co-existing conditions is hypothesized to increase postoperative complications, but data is scarce and contradicting. Therefore, the aim was to assess outcome after mesh hernia repair in immunosuppressed patients.</p><p><strong>Material & methods: </strong>Patients with and without immunosuppression undergoing elective incisional hernia repair at our clinic between 2010 and 2019 were analyzed in this retrospective study. Pre-existing conditions, details of immunosuppression, postoperative course and outpatient follow-up for hernia recurrence were collected and impact of clinical variables on outcome was analyzed. Propensity score matching was performed for comparison of cohorts.</p><p><strong>Results: </strong>Immunosuppression was associated with increased postoperative complications in the overall cohort of 732 patients undergoing incisional ventral hernia repair in univariate but not multivariate analysis (p = 0.036 and p = 0.25, respectively). Overall postoperative complications did not differ between patients with immunosuppression compared to the matched collective. However, use of > 2 immune suppressive agents and immunosuppression history > 48 months showed significant impact on postoperative complications in univariate and multivariate analysis (p = 0.003/p = 0.023 and p = 0.018/p = 0.03, respectively). Age (< 60 years), duration of surgery (> 120 min), midline hernia according to EHS classification and number of immunosuppressive agents administered were identified as important risk factors for recurrence in immunocompromised patients (p = 0.045, p = 0.023, p = 0.012 and 0.049, respectively).</p><p><strong>Conclusion: </strong>In this study, overall safety with desirable outcome of mesh implantation in immunosuppressed patients was documented. Furthermore, data suggested significant impact of number of immunosuppressive agents as a predicator of postoperative complications in this collective, possibly enabling risk stratification within this subgroup.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"106"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482813","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 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}