HerniaPub Date : 2025-07-09DOI: 10.1007/s10029-025-03402-y
Dinan Arunthavanathan, Rockson Liu, Ihsan Inan, Mehmet Oztoprak, Michael Festersen Nielsen
{"title":"Shorter operative times following robotic-assisted transabdominal preperitoneal inguinal hernia repair (TAPP) compared to laparoscopic TAPP: the Danish Inguinal Randomized Controlled Trial (DIRECT).","authors":"Dinan Arunthavanathan, Rockson Liu, Ihsan Inan, Mehmet Oztoprak, Michael Festersen Nielsen","doi":"10.1007/s10029-025-03402-y","DOIUrl":"10.1007/s10029-025-03402-y","url":null,"abstract":"<p><strong>Background: </strong>Despite the perception of higher procedural costs and longer operative time, robotic-assisted inguinal hernia repair has emerged as an alternative to the laparoscopic procedure. The present study was conducted to determine the time required for robotic and laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair and to determine whether these time profiles differ between the two groups.</p><p><strong>Method: </strong>One hundred thirty-eight patients were randomized to a robotic-assisted r-TAPP (n = 74; 54%) or a laparoscopic l-TAPP (n = 64; 46%) procedure by experienced surgeons. The hernia defect was classified as either simple or complicated according to hernia size, involvement of the scrotum, and whether the hernia was a primary defect, a recurrence, or a bilateral defect.</p><p><strong>Results: </strong>Time from intubation to skin closure (P < 0.05) and from air insufflation to removal of instruments (P < 0.05) were shorter for the r-TAPP than for the l-TAPP procedure. This difference was observed for both simple and complex hernias, the difference between groups being larger for the complicated than for the simple defects. The analysis demonstrated that an additional 5 min were needed to dock the robotic platform and place the instruments. Despite this delay, the time required for the procedure remained shorter for the r-TAPP than for the l-TAPP repair.</p><p><strong>Conclusion: </strong>Robotic-assisted inguinal hernia repair is associated with a shorter operative time than conventional laparoscopy. While the time required for docking and instrument placement caused a minor delay of the procedure, the operating time for the robotic repair was shorter than for the laparoscopic procedure.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"227"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591150","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":"Small bowel perforation into the retro-rectus space following eTEP Rives-Stoppa repair for incisional hernia: a rare and life-threatening complication.","authors":"Toshiro Tanioka, Keisuke Okuno, Masanori Tokunaga, Yusuke Kinugasa","doi":"10.1007/s10029-025-03407-7","DOIUrl":"https://doi.org/10.1007/s10029-025-03407-7","url":null,"abstract":"<p><strong>Background: </strong>The enhanced totally extraperitoneal (eTEP) Rives-Stoppa repair is increasingly adopted for incisional hernia repair due to its minimally invasive approachand favorable outcomes. However, rare but severe complications, such as small bowel perforation into the retro-rectus space, may occur, necessitating prompt recognitionand management.</p><p><strong>Case presentation: </strong>An 80-year-old male underwent eTEP Rives-Stoppa repair for an EHS L2 incisional hernia, involving retro-rectus dissection, transversus abdominis release, and mesh placement. On postoperative day 1, he developed hypotension and extensive subcutaneous ecchymosis, without abdominal pain or fever. Initial computed tomography (CT) revealed a retro-rectus fluid collection suggestive of hemorrhage. By day 2, repeat CT showed increased free air and enteric content, indicating bowel perforation. Emergency laparotomy confirmed a dehiscent posterior rectus sheath with a perforated small bowel segment protruding into the retro-rectus space. The mesh was removed, the affected bowel resected, and temporary abdominal closure was performed due to severe inflammation and edema. The postoperative course was complicated by recurrent bacteremia and abscesses, requiring prolonged antimicrobial therapy and intensive care. The patient recovered and was transferred to a rehabilitation facility six months later.</p><p><strong>Conclusions: </strong>This is the first reported case of small bowel perforation into the retro-rectus space following eTEP Rives-Stoppa repair. Contributing factors included advanced age, high tension in the posterior sheath, pre-existing bowel adhesions, and increased intra-abdominal pressure from postoperative coughing. Surgeons should maintain a high index of suspicion for this life-threatening complication, particularly in elderly or frail patients, and consider early imaging for atypical postoperative symptoms to enable timely intervention.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"223"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591151","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}
HerniaPub Date : 2025-07-09DOI: 10.1007/s10029-025-03413-9
Camilo Ramírez-Giraldo, Sofía Santamaría-Forero, Isabella Van-Londoño, Jorge Navarro-Alean, Carlos Figueroa-Avendaño, Susana Rojas-López, Laura Carolina Camacho, Andrés Isaza-Restrepo
{"title":"Type of mesh and wall plane in prophylactic mesh after stoma closure: A network meta-analysis.","authors":"Camilo Ramírez-Giraldo, Sofía Santamaría-Forero, Isabella Van-Londoño, Jorge Navarro-Alean, Carlos Figueroa-Avendaño, Susana Rojas-López, Laura Carolina Camacho, Andrés Isaza-Restrepo","doi":"10.1007/s10029-025-03413-9","DOIUrl":"10.1007/s10029-025-03413-9","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic mesh placement lowers incisional hernia risk, but the ideal mesh type and anatomical plane remain unclear. This study aims to determine which mesh and placement site are associated with the lowest rates of incisional hernia and surgical site infection after stoma closure.</p><p><strong>Methods: </strong>A systematic review of PubMed, the Cochrane Library, and Embase was conducted to identify comparative studies evaluating the type of mesh and/or the anatomical plane of mesh placement in the abdominal wall following stoma closure for the prevention of incisional hernias. A network meta-analysis was performed to assess incisional hernia and surgical site infection.</p><p><strong>Results: </strong>We included 11 included studies involving 2,148 patients. The use of prosthetic mesh (OR = 0.137, 95%CI 0.056-0.335), bioprosthetic mesh (OR = 0.171, 95%CI 0.061-0.473), and biological mesh (OR = 0.528, 95%CI 0.336-0.828) was associated with a lower risk of incisional hernia compared to no mesh use. Mesh placement in a retromuscular position (OR = 0.068, 95%CI 0.024-0.189), onlay position (OR = 0.224, 95%CI 0.095-0.524), and intraperitoneal position (OR = 0.564, 95%CI 0.366-0.869) was associated with a lower risk of incisional hernia compared to no mesh use. No statistically significant differences were observed in surgical site infection risk between the use of different mesh types or anatomical planes and no mesh placement.</p><p><strong>Conclusion: </strong>Prophylactic placement of prosthetic or bioprosthetic mesh in the retromuscular plane at the time of stoma closure is the most effective approach for reducing the incidence of incisional hernia and surgical site infection.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"228"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591152","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}
HerniaPub Date : 2025-07-07DOI: 10.1007/s10029-025-03417-5
Ying Du, Manli Huang, Shisong Wang, Libin Yang, Yunshou Lin, Wenguan Yu, Zikun Pan, Zhiyu Ye
{"title":"Diastasis recti abdominis: A comprehensive review.","authors":"Ying Du, Manli Huang, Shisong Wang, Libin Yang, Yunshou Lin, Wenguan Yu, Zikun Pan, Zhiyu Ye","doi":"10.1007/s10029-025-03417-5","DOIUrl":"10.1007/s10029-025-03417-5","url":null,"abstract":"<p><strong>Background: </strong>Diastasis recti abdominis (DRA) refers to the separation of the rectus abdominis muscles along the linea alba. Though traditionally viewed as a postpartum cosmetic issue, DRA has functional implications and affects both women and men.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed, Web of Science, and Google Scholar, identifying 355 relevant publications over the past two decades. Priority was given to high-quality studies including randomized trials, observational studies, systematic reviews, and meta-analyses.</p><p><strong>Results: </strong>DRA is highly prevalent in postpartum and menopausal women, and increasingly recognized in males with risk factors such as obesity and aging. Diagnostic tools have evolved from clinical assessment to imaging modalities such as ultrasound, CT, MRI, and elastography. Conservative management, especially core stabilization, improves function in mild cases. Severe DRA may require surgical repair, including open, laparoscopic, or robotic-assisted techniques, often with mesh reinforcement. Rehabilitation and biomaterials enhance surgical outcomes. However, consensus is lacking on treatment indications and long-term efficacy.</p><p><strong>Conclusion: </strong>Advances in diagnostics, surgical techniques, and rehabilitation have improved DRA management. Future efforts should focus on standardizing treatment criteria, enhancing personalized care, and evaluating long-term outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"222"},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575378","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}
HerniaPub Date : 2025-07-05DOI: 10.1007/s10029-025-03418-4
Lydia Tan, Marcus Yeow, Sean Lee Kien Fatt, Rajeev Parameswaran, Mehak Mahipal, Lynette Loo, Sujith Wijerathne, Davide Lomanto
{"title":"Cessation vs no cessation of acetylsalicylic acid preoperatively in laparoscopic totally extraperitoneal inguinal hernia repair (CAPTAIN): final report from a multi-center, single-blinded, randomized-controlled trial.","authors":"Lydia Tan, Marcus Yeow, Sean Lee Kien Fatt, Rajeev Parameswaran, Mehak Mahipal, Lynette Loo, Sujith Wijerathne, Davide Lomanto","doi":"10.1007/s10029-025-03418-4","DOIUrl":"10.1007/s10029-025-03418-4","url":null,"abstract":"<p><strong>Title: </strong>Cessation vs No Cessation of Acetylsalicylic acid Preoperatively in Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair (CAPTAIN): Final Report from a Multi-Center, Single-Blinded, Randomized-Controlled Trial. The CAPTAIN trial is a prospective multi-center randomized-controlled trial evaluating the safety of continuing acetylsalicylic acid preoperatively in patients undergoing elective laparoscopic inguinal hernia mesh repair (LIHR).</p><p><strong>Methods: </strong>Patients undergoing LIHR were eligible for inclusion. Patients unfit for general anesthesia, patients who had obstructed hernias or patients who underwent open operation were excluded. Participants were randomized by the trial coordinator using allocation concealment to either acetylsalicylic acid-cessation or continuation group, without the surgeon knowing.</p><p><strong>Outcome: </strong>Primary outcome was the incidence of bleeding complications evidenced by the presence of postoperative hematomas before the patient was discharged from hospital. Secondary outcomes include incidence of major cardiovascular events, post-operative thromboembolic events, seroma formation and length of hospital stay.</p><p><strong>Results: </strong>100 patients were recruited between April 2016 and June 2024. 5 patients were excluded because they 3 underwent open operation, 1 withdrew consent and 1 had their operation cancelled, leaving 45 patients in the acetylsalicylic acid-continuation group and 50 patients in the cessation group.</p><p><strong>Outcomes: </strong>We found that significantly more patients who continued acetylsalicylic acid had hematomas in the index admission (11 vs 5, p = 0.018). There was no difference in the amount of intraoperative blood loss between the two groups, 12.9 vs 9.3ml (p = 0.130). Both groups of patients had short postoperative stay-an average of less than a day. There were no postoperative thromboembolic events or major adverse cardiac events in either group. The rates of postoperative seroma were similar between both groups, 28.9% vs 26% (p = 0.755). At 30 days post operation, there were no hernia recurrence or readmissions in either group.</p><p><strong>Conclusion: </strong>The increase in the rate of postoperative hematomas formation in the acetylsalicylic acid-continuation group though statistically significant; was not clinically significant as no blood transfusion was required and all hematomas resolved with conservative management by 90-days clinic review despite no cessation of acetylsalicylic acid. Thus, this randomized-controlled trial concludes that it is safe to continue acetylsalicylic acid perioperatively in selected patients undergoing LIHR. Larger scale randomized-controlled trials would be helpful to corroborate these findings.</p><p><strong>Trial registration: </strong>Ethics approval was obtained from our healthcare cluster's Domain Specific Review Board (reference number 2015/00512). The study protocol was registe","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"221"},"PeriodicalIF":2.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567384","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}
HerniaPub Date : 2025-07-05DOI: 10.1007/s10029-025-03408-6
Julia Saxen, Hilkka Peltoniemi, Tiina Jahkola, Jaana Vironen, Reetta Tuominen
{"title":"Long-term patient-reported outcomes after plication of rectus diastasis and simultaneous herniorrhaphy with HELP abdominoplasty.","authors":"Julia Saxen, Hilkka Peltoniemi, Tiina Jahkola, Jaana Vironen, Reetta Tuominen","doi":"10.1007/s10029-025-03408-6","DOIUrl":"10.1007/s10029-025-03408-6","url":null,"abstract":"<p><strong>Purpose: </strong>Midline hernias are common, and when associated with abdominal rectus diastasis, hernia guidelines recommend correction using mesh techniques. We present a retrospective series of patients with primary midline hernias and post-pregnancy moderate or severe abdominal rectus diastasis, who were operated using a comprehensive surgical approach without mesh.</p><p><strong>Methods: </strong>We previously described the HELP (Hydrodissection-Assisted Extended Lateral Plication) abdominoplasty technique for rectus diastasis repair, with or without a midline hernia. In this study, patient records from 2013 to 2018 were reviewed, and patients with a midline hernia who underwent the HELP abdominoplasty were recruited for a retrospective analysis.</p><p><strong>Results: </strong>Seventeen patients were successfully contacted. The mean diameter of the umbilical hernia defect was 13.6 mm (5-30 mm), and 7.7mm (5-20 mm) in epigastric hernias. The mean follow-up period was 5.2 years. None of the patients reported a recurrence of diastasis or of hernias. The overall complication rate was 11.8%.</p><p><strong>Conclusion: </strong>HELP abdominoplasty appears to be a reliable surgical treatment with a low complication rate for normal-weight women with post-pregnancy moderate to severe rectus diastasis and concomitant small primary hernias. In these cases, the entire damaged fascia should be repaired, and mesh correction is not always necessary.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"220"},"PeriodicalIF":2.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564740","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}
HerniaPub Date : 2025-07-02DOI: 10.1007/s10029-025-03411-x
Junsheng Li
{"title":"Comment to: A novel laparoscopic technique for closing the defect of direct inguinal hernia.","authors":"Junsheng Li","doi":"10.1007/s10029-025-03411-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03411-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"218"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540060","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 critical COSMIN-informed scoping review of complex abdominal wall hernia quality of life tools: making a case for patient-driven tool development.","authors":"Catherine Oxley, Olivia Smith, Asim Abbas, Mark Mierzwinski, Christine Davey, Praminthra Chitsabesan, Srinivas Chintapatla","doi":"10.1007/s10029-025-03399-4","DOIUrl":"10.1007/s10029-025-03399-4","url":null,"abstract":"<p><strong>Background: </strong>Health-Related Quality of Life (HRQoL) is increasingly recognized as a key outcome measure in Complex Abdominal Wall Hernia (CAWH) surgery. However, selecting an appropriate HRQoL tool is challenging due to the variety of available instruments and their variable psychometric properties.</p><p><strong>Aim: </strong>This scoping review systematically reviews and evaluates the six CAWH-specific HRQoL tools using the Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) framework. The aim of this scoping review was to assess the clinical suitability and developmental robustness of CAWH-specific HRQoL instruments. This review does not assess post-operative HRQoL outcomes, but rather evaluates the design, content, and methodological quality of CAWH-specific tools themselves using the COSMIN framework.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with PRISMA-ScR and informed by COSMIN and Joanna Briggs Institute (JBI) scoping methodology. Four databases (MEDLINE, EMBASE, Cochrane CENTRAL, ClinicalTrials.gov) were searched (March 2024) to identify studies that used or evaluated CAWH-specific HRQoL tools. Tools were assessed across key COSMIN domains: conceptual framework, psychometric properties, respondent burden, and patient involvement in development.</p><p><strong>Results: </strong>Six CAWH-specific HRQoL instruments were identified: CCS, HerQLes, EuraHS-QoL, AAS/mAAS, AHQ, and HERQL. While these tools demonstrated utility, none fully integrated patient perspectives from initial domain development, and all exhibited gaps in content and structural validity. Comparative psychometric data across tools were limited, further complicating selection.</p><p><strong>Conclusion: </strong>Despite growing interest in measuring HRQoL in CAWH surgery, existing tools show important developmental limitations. While these tools demonstrate utility, none fully integrate patient perspectives throughout their development, and all exhibit gaps in content and structural validity. Additionally, comparative psychometric data remain limited, further complicating tool selection. Given these limitations, there is a clear need for further development-either by refining existing tools or creating a new, patient-informed HRQoL instrument that adheres to robust psychometric standards.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"219"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540059","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}
HerniaPub Date : 2025-06-27DOI: 10.1007/s10029-025-03403-x
Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda
{"title":"The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.","authors":"Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda","doi":"10.1007/s10029-025-03403-x","DOIUrl":"10.1007/s10029-025-03403-x","url":null,"abstract":"<p><strong>Purpose: </strong>Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.</p><p><strong>Methods: </strong>A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.</p><p><strong>Results: </strong>Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.</p><p><strong>Conclusion: </strong>This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"213"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505563","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}
HerniaPub Date : 2025-06-27DOI: 10.1007/s10029-025-03398-5
Marcin Włodarczyk, Łukasz Dziki, Inez Bilińska, Jarosław Szpunar, Krzysztof Konopka, Piotr Kasprzak, Magdalena Tokarska, Agata Kraj, Paulina Łąpieś, Witold Sujka
{"title":"Evaluation of the effectiveness and safety of the ultralight, non-resorbable Optomesh® ULTRALIGHT surgical meshes for surgical treatment of hernias based on open and laparoscopic techniques - a retrospective analysis.","authors":"Marcin Włodarczyk, Łukasz Dziki, Inez Bilińska, Jarosław Szpunar, Krzysztof Konopka, Piotr Kasprzak, Magdalena Tokarska, Agata Kraj, Paulina Łąpieś, Witold Sujka","doi":"10.1007/s10029-025-03398-5","DOIUrl":"10.1007/s10029-025-03398-5","url":null,"abstract":"<p><strong>Background: </strong>According to global data, hernia surgery is the most commonly performed elective surgical procedure. The primary factor that can lead to the development of a hernia is weakening of the abdominal wall. The only effective method of treating hernias, regardless of their type, is surgery. In the following clinical study, a retrospective - prospective analysis was performed. The aim of the study was to determine, based on open and laparoscopic techniques, the effectiveness and safety of Optomesh<sup>®</sup> ULTRALIGHT surgical meshes made from cuts of stabilized monofilament polypropylene knit fabric recommended for reconstructive surgical procedures to fill and/or strengthen soft tissue defects in the treatment of various types of hernias.</p><p><strong>Methods: </strong>The study included 171 patients, aged 22 to 70 years, who met the inclusion and exclusion criteria specified in the clinical trial plan, including 20 women and 151 men. During surgery, the vast majority of hernias were operated using the Lichtenstein surgical technique (132 patients). The other operations were performed using the Rives-Stoppa technique (23) and laparoscopic TAPP, TEP technique (16).</p><p><strong>Results: </strong>The results were collected from intraoperative data and data collected during 2 follow-up visits after the procedure. The presented data collected during interviews with patients concern the frequency of recurrences, pain sensation in the first days after the procedure, discomfort associated with mesh implantation and pain sensation according to the VAS scale. These parameters will help to assess the therapeutic value of this type of implants intended for surgical treatment of hernias. Interviews at the second follow-up visit confirmed the patients' long-term, satisfactory reception in terms of comfort and average pain sensation.</p><p><strong>Conclusions: </strong>The Optomesh<sup>®</sup> ULTRALIGHT implant is not only effective and safe but also imperceptible to the patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"216"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505560","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}