Hernia最新文献

{"title":"Who will repair the next open inguinal hernia? Educational consequences of declining open surgery volumes.","authors":"Jacob Rosenberg, Kristoffer Andresen","doi":"10.1007/s10029-026-03868-4","DOIUrl":"10.1007/s10029-026-03868-4","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108828","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: A randomized controlled trial of a plastic-sheath technique to facilitate self-gripping mesh placement in laparoscopic inguinal hernia repair.","authors":"Jakrapan Jirasiritham, Chairat Supsamutchai, Napaphat Poprom, Thanida Janbavonkij, Pongsasit Singhatat, Tharin Thampongsa, Jarinya Wilasrusmee, Theejutha Meakleartmongkol, Settanan Plangsiri, Panupol Thepyasuwan, Chumpon Wilasrusmee","doi":"10.1007/s10029-026-03871-9","DOIUrl":"https://doi.org/10.1007/s10029-026-03871-9","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108845","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":"Internal ring ligation in laparoscopic transabdominal preperitoneal repair of giant inguinoscrotal hernia: a non-prospective comparative study on seroma outcomes.","authors":"Hongyu Zhang, Jiangjie Liu, Hongbo Liu","doi":"10.1007/s10029-026-03870-w","DOIUrl":"10.1007/s10029-026-03870-w","url":null,"abstract":"<p><strong>Background: </strong>Seroma formation after laparoscopic transabdominal preperitoneal (TAPP) repair of giant scrotal hernia is thought to be associated with persistent dead space at the internal ring. Whether adjunctive internal ring ligation reduces postoperative seroma burden has not been prospectively evaluated.</p><p><strong>Methods: </strong>In this prospective comparative study, 60 adult males with giant inguinoscrotal hernia were allocated according to the operative period to standard TAPP repair or TAPP with internal ring ligation. The primary endpoint was ultrasound-measured seroma volume at 1 month. A multivariable regression model for log-transformed outcomes was adjusted for preoperative hernia volume and internal ring diameter. Associations between residual ring caliber and seroma trajectory were assessed using Spearman correlation and linear mixed-effects modeling.</p><p><strong>Results: </strong>At 1 month, seroma volume was significantly lower in the ligation group (4.2 mL vs. 32.2 mL; P < 0.001). After adjustment, internal ring ligation remained independently associated with a lower geometric mean seroma volume (GMR 0.12; P < 0.001). Residual internal ring caliber correlated positively with seroma volume at 7 days, 1-month, 3-month (r = 0.60-0.70, all P < 0.001), and was associated with differences in longitudinal resolution trajectories (interaction P = 0.022). However, secondary clinical endpoints, including seroma aspiration rates, postoperative pain scores, and overall complication rates, did not reach statistical significance between groups.</p><p><strong>Conclusions: </strong>Internal ring ligation during TAPP repair was associated with reduced postoperative seroma burden and favorable seroma resolution trajectory in patients with giant inguinoscrotal hernia, without an evident increase in morbidity when followed up for 1 year.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108815","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":"Young women are more often dissatisfied with appearance after primary ventral hernia repair: a nationwide survey- and register-based study.","authors":"Nanna Holmager, Jason Joe Baker, Anders Gram-Hanssen, Jacob Rosenberg, Hugin Reistrup","doi":"10.1007/s10029-026-03858-6","DOIUrl":"10.1007/s10029-026-03858-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess age-related differences in appearance satisfaction among women.</p><p><strong>Methods: </strong>This Danish nationwide survey- and register-based study included women aged 20-79 years undergoing elective primary ventral hernia repair (defect width ≤ 4 cm) between 2014-2024. Patient-reported outcomes from the AFTERHERNIA Project included postoperative scar dissatisfaction and overall appearance satisfaction, assessed with the Abdominal Hernia-Q (AHQ) appearance sum score (range 5-20; lower scores indicate worse outcome) and preoperative appearance-related motivation for surgery. Survey data were linked to registry data from the Danish Ventral Hernia Database. Outcomes were analyzed using regression models with marginal standardization.</p><p><strong>Results: </strong>Among 6,018 eligible patients, 4,704 (78%) responded. Younger women were more dissatisfied with their scar, with the highest adjusted prevalence among patients aged 20-29 (26.7% [95% CI 17.3-38.8]) and the lowest among those aged 60-69 (7.6% [95% CI 4.5-12.6]). Younger women were also more dissatisfied with their overall appearance, with adjusted mean AHQ appearance sum scores increasing across the same age groups (16.0 points [95% CI 15.2-16.7] to 18.2 points [95% CI 17.5-18.8]). Among the 1,223 patients reporting appearance-related motivation for surgery, 70-87% experienced postoperative improvement, with the lowest proportion among patients aged 20-29. Results were consistent across sensitivity and subgroup analyses.</p><p><strong>Conclusion: </strong>Young women were more dissatisfied with both the postoperative scar and overall appearance compared with older age groups. Although most women motivated for surgery by appearance reported postoperative improvement, the youngest remained the most dissatisfied, highlighting the importance of preoperative expectation management.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108921","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":"Pain outcomes in emergent versus elective ventral hernia repair: Propensity score matched analysis.","authors":"Sidhant Kalsotra, Li-Ching Huang, Savannah Renshaw, Benjamin K Poulose","doi":"10.1007/s10029-026-03842-0","DOIUrl":"https://doi.org/10.1007/s10029-026-03842-0","url":null,"abstract":"<p><strong>Introduction: </strong>Whether emergent ventral hernia repair (VHR) compromises long-term patient-reported pain recovery compared to elective repair remains unknown. We compared Patient-Reported Outcomes Measurement Information System Pain Intensity (PROMIS Pain 3a) outcomes between emergent and elective VHR using a multicenter registry after risk adjustment.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis using the Abdominal Core Health Quality Collaborative (ACHQC) registry of adults undergoing VHR from 2013 to 2024 with complete baseline and 30-day PROMIS Pain 3a scores were included. Emergent and elective repairs were compared using 1:3 propensity score matching (PSM) across 31 covariates. The primary outcome was PROMIS Pain 3a T-score at one year postoperatively.</p><p><strong>Results: </strong>Of 11,831 patients (94 emergent, 11,737 elective), emergent patients had higher baseline PROMIS Pain 3a T-scores (median 52 [IQR 46-58] vs. 44 [IQR 36-52], p < 0.001), BMI (median 36 [IQR 32-41] vs. 31 [IQR 27-36] kg/m², p < 0.001), and ASA class 3-4 rates (66% vs. 55%, p < 0.001). After PSM (71 emergent, 193 elective), baseline pain scores were equivalent (median 52 [IQR 44-58] vs. 49 [IQR 44-54], p = 0.2). At 30 days, pain scores did not differ (median 44 [IQR 40-52] vs. 46 [IQR 40-52], p = 0.6). At one year, emergent patients reported significantly lower PROMIS Pain 3a T-scores (median 31 [IQR 31-38] vs. 40 [IQR 31-46], p = 0.01) and greater improvement from baseline (median - 21 [IQR - 24 to - 11] vs. -8 [IQR - 16 to 0], p = 0.002). Complication rates and pragmatic recurrence through five years were equivalent between matched groups.</p><p><strong>Conclusion: </strong>Emergent VHR patients demonstrated superior patient-reported pain outcomes at one year compared to propensity-matched elective controls, with equivalent complication and recurrence rates. These findings challenge the notion that emergent repairs inherently lead to worse outcomes and suggest that surgical urgency may not negatively impact long-term pain recovery.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108901","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":"Toward precision hernia surgery: integrating biomarkers, genomics, quantitative imaging, and artificial intelligence in abdominal wall repair.","authors":"Bruno Amantini Messias, Guilherme Costa E Silva, Pedro Henrique de Freitas Amaral, Diogo Parente Falcão, Sergio Roll, Jaques Waisberg","doi":"10.1007/s10029-026-03864-8","DOIUrl":"https://doi.org/10.1007/s10029-026-03864-8","url":null,"abstract":"<p><strong>Purpose: </strong>Despite technical advances, the expansion of minimally invasive approaches and the development of novel biomaterials, recurrence and complications following abdominal wall hernia (AWH) repair remain frequent. This variability likely reflects anatomical and technical factors and host biological heterogeneity. Precision herniology is emerging as a translational paradigm integrating biomarkers, genetics, quantitative imaging, and artificial intelligence to refine risk stratification and therapeutic planning.</p><p><strong>Methods: </strong>We conducted a critical narrative review with translational scope. PubMed/MEDLINE, Scopus, Web of Science, and Embase were searched from January 2015 to June 2026. We prioritized adult studies across four axes: (i) biomarkers of collagen, extracellular matrix, and cellular mechanisms; (ii) genetics and susceptibility to AWH; (iii) immunonutritional markers; (iv) artificial intelligence (AI) and machine learning (ML) for predicting complexity and complications.</p><p><strong>Results: </strong>The literature reveals convergent, albeit heterogeneous, signals indicating that host biology may contribute to variability in hernia phenotype and surgical outcomes. Alterations in collagen turnover and in the MMP-TIMP axis, fibroblast heterogeneity, inflammatory signaling, polygenic architecture related to connective tissue integrity, immunonutritional markers associated with perioperative vulnerability, and quantitative imaging metrics analyzed by AI/ML models represent biologically plausible, clinically relevant domains.</p><p><strong>Conclusion: </strong>Available data support the plausibility that host biological heterogeneity contributes to the formation, healing, prosthetic integration, and recurrence of AWH, thereby broadening the traditional paradigm centered predominantly on defect anatomy. The main value of this work is the critical integration of molecular and cellular biomarkers, genetics, quantitative imaging, and AI/ML into a unified conceptual framework for future precision herniology research.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108877","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":"Network meta-analysis of robotic ventral and incisional hernia repair techniques: intraperitoneal, preperitoneal, retromuscular, and sublay approaches.","authors":"Ibrahim Moqbel, Mohamed Basyouni Helal, Ahmed Hamada Abourageh, Joe C Elhage, Ahmed A Lashin, Amna Mutasim Elazrag, Karim Kamal Ahmed, Mohamed Nabil Galal, Masoud Altabawi, Ivan Capobianco","doi":"10.1007/s10029-026-03828-y","DOIUrl":"https://doi.org/10.1007/s10029-026-03828-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of robotic ventral and incisional hernia repair techniques using network meta-analysis.</p><p><strong>Background: </strong>Robotic ventral hernia repair continues to evolve, but the comparative performance of individual robotic approaches remains uncertain.</p><p><strong>Methods: </strong>We conducted a systematic review and network meta-analysis of 14 studies, including 2 randomized trials and 12 retrospective cohorts, involving 9,348 adults undergoing ventral or incisional hernia repair. Techniques were classified by mesh plane and operative access. Frequently reported approaches were analyzed as separate nodes, whereas less commonly described but conceptually similar techniques were grouped into pooled preperitoneal and retromuscular nodes. Treatment effects were estimated using a R (netmeta); heterogeneity, transitivity were assessed, and certainty was rated with CINeMA.</p><p><strong>Results: </strong>rIPOM and rTAPP ranked highest for operative efficiency (SUCRA 94% and 96%, respectively), whereas rTAR ranked lowest. Compared with rIPOM, overall complications were lower with rTEP-RM (RR 0.23, 95% CI 0.07-0.74) and rTAPP (RR 0.55, 95% CI 0.30-0.99). rTEP-RM was also associated with lower seroma rates (RR 0.28, 95% CI 0.10-0.80) and shorter length of stay (MD - 5.33 days, 95% CI - 9.08 to - 1.58), although postoperative pain was higher. Surgical site infection was lower with rRS (RR 0.11, 95% CI 0.02-0.87) and rTAPP (RR 0.32, 95% CI 0.13-0.78). Pooled preperitoneal approaches were associated with lower short-term recurrence and 30-day readmission.</p><p><strong>Conclusions: </strong>Preperitoneal approaches, particularly rTEP-RM and rTAPP, were associated with more favorable early postoperative outcomes than rIPOM, although certainty of evidence was mostly low or very low.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108882","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":"Self-gripping mesh without fixation versus anatomical mesh with tack fixation for laparoscopic TAPP inguinal hernia repair: a retrospective cohort study.","authors":"Guvenc Diner, Guven Erdogrul, Boran Cihat Karakus, Mehmet Hatip Adıguzel","doi":"10.1007/s10029-026-03861-x","DOIUrl":"10.1007/s10029-026-03861-x","url":null,"abstract":"<p><strong>Background: </strong>Mesh characteristics and fixation techniques may influence operative efficiency, postoperative pain, and resource utilization during laparoscopic trans-abdominal preperitoneal (TAPP) inguinal hernia repair. However, comparisons between self-gripping and anatomically contoured meshes may be inherently confounded when a self-gripping mesh is used without mechanical fixation, whereas an anatomical mesh is routinely fixed. We therefore compared these two routinely used mesh-fixation strategies in patients undergoing primary unilateral TAPP repair.</p><p><strong>Methods: </strong>We retrospectively reviewed 346 patients who underwent primary unilateral conventional laparoscopic TAPP repair between January 2022 and December 2025. Patients were treated using either a self-gripping mesh without additional mechanical fixation (n = 157) or an anatomically contoured mesh secured with absorbable tack fixation (n = 189). The primary outcome was skin-to-skin operative duration. Secondary outcomes included postoperative pain at 6 and 24 h, hospital length of stay, postoperative complications, 12-month recurrence, and direct material costs. Multi-variable linear regression was performed to identify factors independently associated with operative duration. Given the low number of observed complications, an exploratory multi-variable logistic regression analysis was performed and interpreted cautiously.</p><p><strong>Results: </strong>Mean operative duration was significantly shorter in the self-gripping group than in the anatomical mesh with tack fixation group (52.7 ± 15.9 vs. 61.7 ± 19.2 min, respectively; p < 0.001). Postoperative VAS scores were lower in the self-gripping group at both 6 h (5.0 ± 1.2 vs. 6.1 ± 1.4; p < 0.001) and 24 h (5.6 ± 1.3 vs. 6.7 ± 1.5; p < 0.001). Mean hospital length of stay was 1.2 ± 0.4 versus 1.4 ± 0.5 days (p < 0.001), although the absolute difference was modest. Total direct material costs were significantly lower with the self-gripping strategy ($141.2 ± 5.1 vs. $192.2 ± 12.2; p < 0.001), primarily because no disposable fixation device was required. Postoperative complications were uncommon and did not differ significantly between groups (1.9% vs. 3.2%; p = 0.509). At 12 months, one recurrence occurred in the anatomical mesh group and none in the self-gripping group (0.0% vs. 0.5%; p = 1.000).</p><p><strong>Conclusions: </strong>In this retrospective cohort, the self-gripping mesh/no-fixation strategy was associated with shorter operative duration, lower early postoperative pain scores, and lower direct material costs than the anatomical mesh/tack-fixation strategy. These findings should be interpreted as differences between two combined mesh-fixation strategies rather than as evidence that one mesh design is intrinsically superior to the other. Larger prospective comparative studies are needed to determine the independent contributions of mesh design and fixation technique.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative complication burden after ventral hernia repair stratified by modified ventral hernia working group grade: a claims-based cohort study.","authors":"Benjamin K Poulose, Claudia Goldblatt, Mia Weiss, Molly Jung, Catherine C Steele, Catalina Ardila, Hakan Gurcan","doi":"10.1007/s10029-026-03867-5","DOIUrl":"https://doi.org/10.1007/s10029-026-03867-5","url":null,"abstract":"<p><strong>Purpose: </strong>The modified Ventral Hernia Working Group (mVHWG) classification stratifies patients by risk for complications; however, real-world evidence quantifying complication burden across mVHWG grades remains limited. This study developed and applied a claims-based algorithm to approximate the mVHWG classification and assess variations in postoperative complication burden by mVHWG grade.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using MarketScan^®. Adults undergoing VHR between January 2021 and December 2024 were included if they had continuous enrollment for at least 12 months pre-procedure and 6 months post-procedure. Patients were classified into mVHWG Grades 1-3 using diagnosis and procedure codes. Postoperative complications within 6 months were identified using claims data. Incidence and number of complications per patient were assessed.</p><p><strong>Results: </strong>29,845 patients were included, classified as Grade 1 (44.4%), Grade 2 (44%), and Grade 3 (11.6%). Within 6 months, 17.2% experienced postoperative complications, with a significant stepwise increase in incidence by mVHWG grade (10.6%, 15.7% and 48.5% for Grades 1-3 respectively). The number of recorded complications per patient was higher with increased mVHWG grade.</p><p><strong>Conclusion: </strong>This study operationalizes mVHWG classification in claims data and demonstrates an increase in complication burden across mVHWG grades following VHR, including higher incidence and greater number of complications per patient. Grade 2 patients represented a large proportion of the cohort and experience greater complication burden than Grade 1 patients, underscoring the importance of this risk group. Further research is warranted to validate the algorithm against clinically assigned mVHWG grades as well as to examine long-term outcomes and costs associated with early complications across mVHWG grades.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108872","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":"Artificial intelligence-based anatomical segmentation in transabdominal preperitoneal repair of groin hernia.","authors":"Sakurako Izumi, Jumpei Ikeda, Hirofumi Kawakubo, Masashi Takeuchi, Yosuke Morimoto, Kazuaki Matsui, Satoru Matsuda, Shutaro Hori, Yuko Kitagawa","doi":"10.1007/s10029-026-03832-2","DOIUrl":"10.1007/s10029-026-03832-2","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate identification of critical anatomical structures, including hernia orifices and Cooper's ligament, is crucial to ensure appropriate mesh placement during transabdominal preperitoneal repair (TAPP). However, the posterior view of the inguinal wall is often less familiar to general surgeons, possibly contributing to the intraoperative misidentification of key anatomical landmarks. We aimed to develop an artificial intelligence (AI)-based model for supporting the recognition of these critical anatomical structures.</p><p><strong>Methods: </strong>We calculated 2,725 images which were extracted from 89 surgical videos of TAPP procedures by three surgeons at a single center. The extracted frames were annotated for the hernia orifices, Cooper's ligament, inferior epigastric vessels, testicular vessels, and vas deferens. Annotation was initially performed by an experienced medical student and subsequently confirmed by two board-certified surgeons. Ten-fold cross-validation was performed to train and assess the AI-based model. Model performance was evaluated using the Intersection over Union (IoU), which quantifies the overlap between AI-generated and ground-truth segmentations on a scale from 0 (no overlap) to 1 (perfect overlap).</p><p><strong>Results: </strong>The mean IoUs for the direct hernia orifices, indirect hernia orifices, Cooper's ligament, inferior epigastric vessels, testicular vessels, and vas deferens were 0.391, 0.325, 0.562, 0.451, 0.555 and 0.554, respectively. The performance was comparable to or exceeding that reported for selected anatomical structures in previous studies.</p><p><strong>Conclusion: </strong>The AI-based model recognized critical anatomical structures during TAPP. Its integration into clinical practice may improve intraoperative recognition of critical anatomical structures and facilitate appropriate mesh placement during TAPP.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108908","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}