Hernia最新文献

{"title":"Clinical outcomes of oncologic hernia repair using Poly-4-Hydroxybutyrate (P4HB) mesh.","authors":"Jacob Levy, Benjamin D Wagner, Ronnie L Shammas, Lillian A Boe, Charlotte E Ariyan, Mary S Brady, Robert J Allen, Evan Matros, Babak J Mehrara, Jonas A Nelson","doi":"10.1007/s10029-025-03468-8","DOIUrl":"https://doi.org/10.1007/s10029-025-03468-8","url":null,"abstract":"<p><strong>Introduction: </strong>Hernia repair following cancer surgery is often challenging due to prior radiation therapy, malnutrition, and immunosuppression. Poly-4-hydroxybutyrate (P4HB) is a biosynthetic mesh that balances strength and biocompatibility, potentially optimizing outcomes in this high-risk population. This study aimed to evaluate recurrence and surgical site complications associated with P4HB mesh in oncologic patients undergoing incisional hernia repair and to identify surgical techniques related to improved outcomes.</p><p><strong>Methods: </strong>Patients with previous oncologic abdominal or pelvic surgery who developed an incisional hernia and underwent surgical repair using P4HB from January 2018 to December 2023 were identified. Patients were analyzed according to wound classification. Primary outcomes included hernia recurrence and surgical site complications (hematoma, infection/cellulitis, superficial wound dehiscence, and abscess formation).</p><p><strong>Results: </strong>102 patients [median (IQR) age 63 (55-69) years; median BMI 26 (23-30) kg/m²] were included, with a median follow-up of 26.1 (15.1-40.1) months. The overall recurrence rate was 8.8%, significantly differing between clean (Class I) and contaminated (Class II-IV) cases (0% vs. 17%, p = 0.003). Surgical complications occurred in 24% of patients, with seroma (8.8%) and superficial wound dehiscence (7.8%) being the most common, and complication rates comparable between wound classifications. Bilateral external oblique release (HR, 0.16; 95% CI, 0.04-0.65; p = 0.01) and retrorectus mesh placement (HR, 0.05; 95% CI, 0.01-0.36; p = 0.004) were independently associated with reduced recurrence.</p><p><strong>Conclusion: </strong>P4HB mesh in incisional hernia repair for oncologic patients yields low recurrence rates and acceptable complication rates. Bilateral external oblique release and retrorectus mesh placement are surgical techniques significantly associated with improved outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"274"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075132","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":"Chronic groin pain after Lichtenstein inguinal hernia repair: partially absorbable light-weight mesh versus conventional light-weight versus heavy-weight mesh.","authors":"Sarah Budney, Kyle Kleppe, Matthew Mancini, Greg Mancini, Melissa Phillips, Catherine McKnight, John Griepentrog, Michael Reinhorn, Aldo Fafaj, Kaela E Blake","doi":"10.1007/s10029-025-03469-7","DOIUrl":"10.1007/s10029-025-03469-7","url":null,"abstract":"<p><strong>Introduction: </strong>Mesh properties are important contributing factors to chronic postoperative inguinal pain (CPIP) following Lichtenstein inguinal hernia repair. Some studies show using a light-weight mesh (LWM, <50 g/m2) over heavy-weight mesh (HWM, >70 g/m2) may decrease CPIP. However, most studies do not distinguish between partially absorbable light-weight mesh (PA-LWM) and permanent LWM. This study compares the rates of CPIP between PA-LWM, LWM, and HWM after Lichtenstein inguinal hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis of the ACHQC database from 2014 to 2024 was conducted for elective Lichtenstein repair of non-recurrent, unilateral inguinal hernias. Mesh was categorized as LWM <50 g/m2 or HWM ≥70 g/m2 distinguishing partially absorbable LWM. The primary outcome was the rate of CPIP at 6 months postoperatively for PA-LWM, LWM, and HWM.</p><p><strong>Results: </strong>319 patients met criteria for the study with 53 PA-LWM, 122 LWM, and 144 HWM patients. Baseline pain was highest in PA-LWM and lowest in HWM cohorts. At 6 months, 21% of PA-LWM, 21% of LWM, and 19% of HWM patients had chronic pain (p=0.93). This decreased to 3% for PA-LWM at 1-year, but remained approximately 20% for LWM and HWM (p = 0.045). The clinical recurrence rate at 1-year was 50% (2/4), 0% (0/8), and 0% (0/17) for PA-LWM, LWM, and HWM respectively (p = 0.001).</p><p><strong>Conclusion: </strong>This study found that roughly 20% of patients have chronic pain at 6 months regardless of mesh weight or partially absorbable properties. While PA-LWM may decrease CPIP at 1 year, this may be accompanied with a higher clinical recurrence rate.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"275"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075146","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":"What is the preferred mesh placement in primary ventral hernia repair? An international survey of 442 surgeons.","authors":"Usamah Ahmed, Jacob Rosenberg, Sarfaraz Jalil Baig, Sujith Wijerathne, Wah Yang, Shuqing Li, Jason Joe Baker","doi":"10.1007/s10029-025-03429-1","DOIUrl":"10.1007/s10029-025-03429-1","url":null,"abstract":"<p><strong>Purpose: </strong>Primary ventral hernia repair is a common elective procedure; however, mesh placement practices vary widely, and there is limited evidence to guide optimal placement. This international study examined surgeons' preferences and considerations regarding mesh placement in elective primary ventral hernia repair.</p><p><strong>Methods: </strong>We conducted an international cross-sectional survey targeting surgeons experienced in primary ventral hernia repair. The survey was distributed through hernia societies and social media platforms. It included 31 questions addressing surgeon demographics and their beliefs on various mesh placements. Data were collected using REDCap, Google Forms, and Questionstar.</p><p><strong>Results: </strong>A total of 442 surgeons participated, with the majority being specialist surgeons (96%) who had performed at least 100 repairs (82%). Inlay was the least familiar mesh technique (26%). For hernia defects < 1 cm, preperitoneal (28%) and suture-only repair (27%) were considered to yield the best overall outcomes. For defects ≥ 1 to ≤ 4 cm, preperitoneal and retromuscular techniques were equally favored (34%), whereas retromuscular was regarded as the best option for larger defects (> 4 to 9 cm; 68%). Laparoscopic and robotic-assisted approaches were increasingly preferred for larger defect sizes. Hernia defect size (93%), surgical history (90%), and obesity (80%) were the most common factors influencing the choice of mesh placement.</p><p><strong>Conclusion: </strong>Preperitoneal and suture-only repairs were most commonly selected for hernia defects < 1 cm, while preperitoneal and retromuscular placements were equally favored for defects ≥ 1 to ≤ 4 cm. For defects > 4 to 9 cm, retromuscular placement was selected by most surgeons. As defect width increased, laparoscopic and robot-assisted approaches gained preference. Key factors influencing decisions included hernia defect size, surgical history, and obesity. The lack of strong supporting evidence highlights the need for further high-quality research.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"273"},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023214","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":"The invite study: incisional hernia prevention: prophylactic mesh from the patient's perspective.","authors":"Laurie Smith, Laura Knight, Alun Meggy, Tessa Watts, Jared Torkington, Julie Cornish","doi":"10.1007/s10029-025-03463-z","DOIUrl":"10.1007/s10029-025-03463-z","url":null,"abstract":"<p><strong>Purpose: </strong>Mesh-augmented abdominal wall closure (Mesh prophylaxis) reduces incisional hernia rates in high-risk patients. In spite of a large body of evidence supporting its efficacy and safety, use of mesh prophylaxis is low in the US and UK, possibly due to negative perceptions of surgical mesh^(1-2). This study aimed to assess the acceptability of mesh to patients and determine factors that influence acceptability.</p><p><strong>Methods: </strong>Following ethical approval, a convergent mixed-methods study was conducted whereby patients who had undergone elective or emergency surgery (n=332) were approached to participate in a questionnaire assessing knowledge and opinions regarding mesh prophylaxis Semi-structured interviews were conducted in a subset of participants (n=12) and thematic analysis performed.</p><p><strong>Results: </strong>120 questionnaires were returned with a response rate of 36.1%. The majority (61.8%) of participants had heard of surgical mesh, with half (51.7%) having a negative association, driven by the media. Half (50%) of participants had pre-existing concerns about mesh, however the majority (91%) felt mesh prophylaxis to be acceptable, findings which were echoed in the qualitative component. Analysis of interview data identified three themes: \"Knowledge of mesh\" and \"Acceptability of mesh\", which triangulated with findings in the survey data and \"Shared decision-making\", which explored how participants wanted to receive information about mesh. Factors affecting acceptability of mesh included the nature of information given to patients, and the way in which it was delivered.</p><p><strong>Conclusions: </strong>Despite negative pre-conceptions, mesh prophylaxis is broadly acceptable to patients. The results of this work will be used to develop patient resources to support mesh prophylaxis. Future mixed-methods studies identifying the surgeons' barriers to use of mesh are needed to allow targeted implementation of prophylactic mesh.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"272"},"PeriodicalIF":2.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992467","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":"Analysis of polypropylene meshes with embedded silver ions in ventral hernia repair: can they be used in different grades of contamination?","authors":"José Bueno-Lledó, Omar Carreño-Sáenz, Providencia García-Pastor, José Antonio Pereira-Rodríguez, Carlos Hoyuela-Alonso, Carles Olona-Casas, Salvador Pous-Serrano","doi":"10.1007/s10029-025-03450-4","DOIUrl":"10.1007/s10029-025-03450-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the outcomes of patients undergoing ventral hernia repair (VHR) with a polypropylene mesh with embedded silver ions (PSM) in the context of different degrees of contamination, compared to standard conventional macroporous polypropylene mesh (PPL).</p><p><strong>Methods: </strong>From May 2019 to October 2023, a retrospective comparative analysis of patients who underwent elective or urgent VHR with a SilverMesh (PSM group) versus standard macroporous polypropylene mesh (PPL group), based on the Spanish Hernia registry (EVEREG). The exclusion criteria were other PSM indications (groin hernia, prophylaxis) and the use of composite meshes or any material different to PPL. Each Hospital participating in the registry applied its own preoperative antibiotic protocol. The field contamination degree was assessed according the Centers for Disease Control (CDC) classification criteria. Epidemiological data, hernia characteristics, surgical and postoperative variables (Clavien-Dindo classification) of these patients were analysed.</p><p><strong>Results: </strong>From May 2019 to October 2023, PPL group included 446 cases and PSM group 206 cases. The number of PPL cases were reduced from 2655 to 446, to try and match suitable similar cases in both groups. In PSM group, smoking (28.6% vs. 20.6%; p = 0.000), COPD (23.3% vs. 16.9%; p = 0.050), ASA class III-IV (35% vs. 29.2%; p = 0.001), prehabilitation with BTA (16% vs. 4%; p = 0.000) and PPP (5.8% vs. 0.9%; p = 0.000), and W2-W3 hernias (79.9% vs. 53.2%; p = 0.000) were more frequent than PPL group. In PSM group, complex techniques of VHR like RSR and CST (61% vs. 48%; p = 0.000), average duration of surgery (91.7 vs. 69.9 min; p = 0.032) and mean length of stay (5.4 vs. 4.7 days; p = 0.034) were more frequent than PPL group. The overall rate of short-term SSO was slightly lower in PSM than PPL group (30.5% vs. 33.7%; p = 0.155) though statistically insignificant. No mesh infection was reported in PSM group versus 7 cases in PPL group, although this was not statistically significant.</p><p><strong>Conclusions: </strong>The use of PSM for VHR in different degrees of contamination and without a significant superiority over PPL, leads to favourable results, especially in overall rate of SSO and CMI, in patients with preoperative risk factors, large hernias and complex hernia repairs. Being the first clinical study performed with this prosthesis, further comparative studies with longer follow-up are needed to explore further.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"271"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952255","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":"To infinity and beyond: the promise of data-driven 3D printing of hernia mesh - a primer for surgeons.","authors":"Edward Young, James Lawson, Alex Karatassas, Chrys Hensman","doi":"10.1007/s10029-025-03434-4","DOIUrl":"10.1007/s10029-025-03434-4","url":null,"abstract":"<p><strong>Purpose: </strong>Abdominal wall hernias account for a substantial operative caseload in general surgery globally. Optimal hernia care should be tailored to individual circumstances. To repair the three-dimensional (3D) abdominal wall, 3D-printed patient-specific implants may be superior to current mesh products. The aim was to review the current state of 3D printing technology in custom hernia mesh production, and its safety and efficacy for tailored hernia care.</p><p><strong>Methods: </strong>A literature search within PubMed and Scopus databases were performed in March 2025, in accordance to PRISMA-ScR framework, using keyword combinations of printing, mesh, hernia, safety, efficacy and their derivatives. Full-text papers relevant to the study aim in all formats and languages were included, and risk of bias assessment was performed. The review was not eligible for registration with PROSPERO. Papers were grouped by general theme, and a narrative synthesis was performed.</p><p><strong>Results: </strong>Thirty relevant papers were identified from 14,210 abstracts. Literature on 3D-printed hernia mesh was sparse, with majority of papers being preclinical. General focus of the literature was production, cellular toxicity, performance of adjuncts and short-term tolerance in small animals. Risk of bias was globally high to critical, due to underreporting of in vitro and in vivo methodology. Safety and clinical efficacy of 3D-printed mesh remained unknown. Numerous issues, including production, sterilisation and regulations, were identified and discussed.</p><p><strong>Conclusion: </strong>3D-printed hernia mesh is the next step towards tailored hernia care, with significant potential not otherwise available with traditional mesh products. Substantial research is still required to clarify its safety and efficacy.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"270"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952097","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":"Evaluating P4HB mesh in oncologic hernia repair: promise and perspective.","authors":"Aali J Sheen","doi":"10.1007/s10029-025-03465-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03465-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"269"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951911","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":"Principles of rectus diastasis classification and treatment.","authors":"Pilar Hernández-Granados","doi":"10.1007/s10029-025-03458-w","DOIUrl":"https://doi.org/10.1007/s10029-025-03458-w","url":null,"abstract":"<p><strong>Introduction and purpose: </strong>In the last 15 years, rectus diastasis has become a relevant topic for general surgeons. There have been published different classification systems and more than 45 surgical procedures, open or laparoendoscopic, even robotic, for treatment. This article pretends to summarize the different classification system and give some insight about what surgical technique could be recommended in each case.</p><p><strong>Methods: </strong>A literature search of publications on classification systems of rectus diastasis and its treatment was performed in three databases (PubMed, EMBASE and WOS) without time limits, in English or Spanish language.</p><p><strong>Results: </strong>Seven different classifications for rectus diastasis have been found and a great variety of surgical techniques, open, laparo-endoscopic or robotic. Each classification has its own particularities and only two recommend specific surgical procedures in some types of rectus diastasis. There are two main groups of patients with rectus diastasis, with or without midline hernias and in each case, different techniques could be indicated. There are no randomized controlled trials that compare different surgical techniques and in consequence, no evidence in the literature about which treatment is better in each case.</p><p><strong>Conclusion: </strong>Due to the lack of knowledge in this field, the recommendation is to use the EHS classification system, the easiest and most applicable. Shared decision-making process between patient and surgeon must be mandatory to select the right treatment for the right patient. International registries can be helpful to clarify which procedure should be use in each case.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"267"},"PeriodicalIF":2.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952147","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":"Predicting fascial non-closure in ventral hernia repair with transversus abdominis release: risk factors, clinical outcomes, and implications for surgical planning.","authors":"Daphne Remulla, Kimberly P Woo, William C Bennett, Alvaro Carvalho, Brianna L Slatnick, Marisa H Blackman, Kimberly S Miles, Clayton C Petro, Lucas R Beffa, Ajita S Prabhu, Michael J Rosen, David M Krpata, Benjamin T Miller","doi":"10.1007/s10029-025-03455-z","DOIUrl":"https://doi.org/10.1007/s10029-025-03455-z","url":null,"abstract":"<p><strong>Background: </strong>Posterior components separation with transversus abdominis release (TAR) reduces tension on the anterior and posterior fascial elements in complex ventral hernia repairs, but its use does not ensure complete fascial closure. This study evaluates the relationship between hernia size and anterior fascial closure success rates following TAR and identifies predictive factors for non-closure.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,677 patients who underwent open ventral hernia repair with TAR and synthetic mesh placement at a single institution from 2014 to 2023. The primary outcome was the rate of overall anterior fascial closure after TAR. Secondary outcomes included the association of hernia size with fascial closure, predictors of fascial closure and wound morbidity.</p><p><strong>Results: </strong>The overall fascial closure rate was 93.9% (n = 1,574). Hernia width independently predicted fascial closure success, with reduced odds for widths of 15-20 cm (OR 0.39, p = 0.017) and > 20 cm (OR 0.05, p < 0.001), relative to hernias < 15 cm. History of open abdomen (OR 0.33, p < 0.001) and higher ASA classification (OR 0.39, p = 0.042) were associated with non-closure. Fascial non-closure was associated with increased wound morbidity (p < 0.05), while closure independently reduced odds of one-year surgical site infection (SSI) (OR 0.13; p < 0.001) and surgical site infections and occurrences requiring procedural intervention (SSI/O PI) (OR 0.52; p = 0.001).</p><p><strong>Conclusions: </strong>While excellent overall fascial closure rates were achieved among patients undergoing TAR, specific patient and hernia characteristics significantly impact success. These findings establish a reference point for closure rates by hernia width and identify high-risk populations who may benefit from preoperative adjunctive interventions.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"268"},"PeriodicalIF":2.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951968","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":"A novel classification system for hernia recurrence after hernia repair: A call to standardize hernia recurrence nomenclature and severity classification.","authors":"Salvatore Docimo, Diego L Lima","doi":"10.1007/s10029-025-03432-6","DOIUrl":"https://doi.org/10.1007/s10029-025-03432-6","url":null,"abstract":"<p><strong>Introduction: </strong>Avoidance of a hernia recurrence is the most desirable outcome following an on abdominal wall reconstruction, prompting all hernia publications to quote hernia recurrence rates. However, the scientific literature reports recurrence as a dichotomous outcome without evaluating the quality of life or clinical history of patients who present with recurrence after a hernia repair. There is a need for more granular information on the quality of life of patients with hernia recurrence and a need for standardization to allow for comparisons of future studies. The objective of our study is to propose a novel classification for hernia recurrence after ventral hernia repair.</p><p><strong>Methods: </strong>We investigated known classification systems published in the literature such as the Clavien-Dindo classification for surgical complication, The European Hernia Society (EHS) classification, the Morales-Conde classification for seroma and created a new system to evaluate ventral hernia recurrence based on the clinical history of patients presenting with recurrence.</p><p><strong>Results: </strong>A new classification system with five grades was created based on the patient's quality of life and clinical outcomes. Grade 0 - no recurrence. Grade IA - Asymptomatic recurrence, identified by a surgeon or imaing with no need for surgical intervention. Grade IB - Asymptomatic recurrence, patient reported, with no need for surgical intervention. Grade IIA - Symptomatic recurrence with no surgical inveetnion (watchful watiting). Grade IIB - Symptomaotic reucrruence which requires elective repair. Grade III - Symptomatic recurrence requiring an urgent repair with no evidence of a Grade IV hernia recurrence. Grade IV - Life-threatening complications directly related to the recurrence - Strangulation, Bowel Ischemia, Bowel Obstruction, Perforation, Abdominal Compartment Syndrome; Septic Shock, Requiring emergent operation. Grade V - Death of patient directly or related to a complication from the hernia recurrence. Grade IV - Death of a patient not related to the hernia recurrence.</p><p><strong>Conclusions: </strong>A classification for hernia recurrence and division on subgroups was formulated to better understand the clinical outcomes of patients with recurrence after ventral hernia repair and to unify criteria among surgeons when describing it.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"265"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952197","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}