Hernia最新文献

{"title":"Comment to: who will repair the next open inguinal hernia? educational consequences of declining open surgery volumes.","authors":"Francesco Gossetti, Pierluigi Ipponi, Gabriele Munegato, Linda D'Amore, Paolo Negro","doi":"10.1007/s10029-026-03856-8","DOIUrl":"10.1007/s10029-026-03856-8","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982672","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":"Learning curve in robotic inguinal hernia repair: a systematic review and meta-analysis.","authors":"Gabriela Lyons, Ana Luiza Aguiar Peres Kozlowski Breves, Vitor Neves, Paula Cambuli-Bianchi, Raquel Nogueira, Leandro Totti Cavazzola, Diego L Lima, Flavio Malcher","doi":"10.1007/s10029-026-03843-z","DOIUrl":"10.1007/s10029-026-03843-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to perform a systematic review and meta-analysis to assess the learning curve in robotic transabdominal preperitoneal (rTAPP) inguinal hernia repair in adult patients, emphasizing the number of procedures associated with improved operative efficiency and the evolution of operative performance over time.</p><p><strong>Materials and methods: </strong>A systematic review was conducted following PRISMA guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, Lilacs and SciELO was performed through March 2026, including cohort studies on adult patients undergoing elective robotic inguinal hernia repairs. Studies were eligible for quantitative synthesis if operative time was reported across distinct learning phases. Operative time between phases was pooled using a random-effects model, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>622 articles were screened, of which 13 met the inclusion criteria and were included in the systematic review. All studies evaluated learning curves in multiport rTAPP inguinal hernia repair. A total of 1,770 patients were included, of whom 1,465 were male (82.8%), with a mean BMI was 25.3 kg/m² (SD 3.3). Four studies defined two phases (learning and post-learning) and reported operative time per phase, allowing inclusion in the quantitative synthesis. A random-effects meta-analysis demonstrated a significant reduction in operative time between Phase 1 and Phase 2 (MD 17.02 min, 95% CI 5.91-28.14; I² = 86%). CUSUM-based studies for operative time in rTAPP reported a median proficiency threshold of 32 cases (IQR 18.5).</p><p><strong>Conclusions: </strong>Among studies using operative-time-based CUSUM analyses, a median threshold of 32 cases was associated with improved operative efficiency in rTAPP, as reflected by reduced operative time. Progression beyond this initial learning phase is consistently associated with improved operative efficiency, including a pooled reduction of 17.02 min in operative time. Future studies should incorporate competency-based assessments and clinically meaningful outcomes to provide a more comprehensive evaluation of surgical proficiency.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982698","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":"Comment to: Influence of internal ring defect closure on postoperative seroma formation after laparoscopic transabdominal preperitoneal repair for large indirect inguinal hernia.","authors":"Tuğberk Tok","doi":"10.1007/s10029-026-03857-7","DOIUrl":"10.1007/s10029-026-03857-7","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955807","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":"Validation of a novel hernia recurrence grading classification system: a surgeon survey using clinical vignettes.","authors":"Salvatore Docimo, Diego L Lima","doi":"10.1007/s10029-026-03836-y","DOIUrl":"10.1007/s10029-026-03836-y","url":null,"abstract":"<p><strong>Background: </strong>Hernia recurrence following ventral hernia repair (VHR) is the primary outcome reported across the hernia surgery literature, yet it has historically been described as a binary, dichotomous variable - present or absent - without accounting for its clinical severity, symptom burden, or impact on quality of life. Our group previously published a novel grading classification for hernia recurrence (Grades 0 through VI) designed to standardize the nomenclature and provide a clinically meaningful framework for evaluating recurrence after VHR. To advance this classification toward widespread use, external validation is essential.</p><p><strong>Methods: </strong>We designed a web-based survey instrument consisting of 26 standardized clinical vignettes, each constructed to correspond to a single, unambiguous grade within the Hernia Recurrence Grading System. Respondents were asked to assign the most appropriate grade (0, IA, IB, IIA, IIB, III, IV, V, or VI) to each scenario. The survey was distributed to practicing abdomninal wall surgery specialists. A total of 39 respondents completed the survey. Accuracy was defined as agreement with the a priori correct classification grade for each vignette, and overall concordance rates were calculated.</p><p><strong>Results: </strong>Thirty-nine respondents completed the survey, generating 1,014 individual responses across 26 vignettes. The overall concordance rate was 90.5% (918/1,014), with a mean per-vignette accuracy of 90.5% (median 93.6%; range 53.8%-100.0%). Fleiss' kappa was 0.815, indicating almost perfect inter-rater agreement. Three vignettes achieved 100% accuracy, and seventeen of twenty-six (65.4%) met a 90% concordance threshold. The highest grade-level accuracy was observed for Grades IV (97.4%), 0 (96.6%), IIB (96.6%), and III (95.7%). The lowest mean grade-level accuracy was Grade IB (73.5%), driven by a single outlier vignette (53.8%). The predominant misclassification patterns involved adjacent-grade confusion between Grades IB and IIA (21 errors) and between Grades IIA and IIB (16 errors).</p><p><strong>Conclusions: </strong>This surgeon survey using standardized clinical vignettes provides initial evidence supporting the usability and inter-rater comprehensibility of the Hernia Recurrence Grading System. These findings represent an important step toward prospective multicenter validation of the classification and its integration into hernia registry reporting and clinical trial outcome definitions.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919188","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":"Minimally invasive versus open abdominoperineal resection and the risk of postoperative perineal hernia: a systematic review and meta-analysis.","authors":"Beatriz Yukari Yokoyama, Victória Recidivi E Silva, Lucas Carvalho Lemos de Souza Aguiar, Hélder Santos Gonçalves, Lucas Monteiro Delgado, Claudia Theis, Sérgio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga, Bernardo Fontel Pompeu","doi":"10.1007/s10029-026-03841-1","DOIUrl":"10.1007/s10029-026-03841-1","url":null,"abstract":"<p><strong>Background: </strong>The impact of minimally invasive surgery on the risk of postoperative perineal hernia after abdominoperineal resection (APR) or extralevator abdominoperineal excision (ELAPE) remains uncertain. This study compares perineal hernia rates and perioperative outcomes between minimally invasive and open approaches.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and Cochrane Library were searched through June 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. A Bayesian meta-analysis was additionally performed for the primary outcome.</p><p><strong>Results: </strong>Four comparative observational studies involving 763 patients were included; 249 underwent minimally invasive APR/ELAPE, and 514 underwent open APR/ELAPE. Postoperative perineal hernia was significantly more frequent following minimally invasive surgery (OR 4.13; 95% CI 2.24-7.61; p < 0.001). Intraoperative blood loss was significantly lower in the minimally invasive group (MD - 156.5 mL; 95% CI - 298.4 to - 14.5; p = 0.03), as was operative time (MD - 41.7 min; 95% CI - 60.8 to - 22.5; p < 0.01). No significant differences were observed in hospital stay (MD - 2.5 days; 95% CI - 5.4 to 0.4; p = 0.09) or 30-day readmission rates (OR 1.41; 95% CI 0.82-2.42; p = 0.209). Bayesian analysis yielded a posterior mean OR of 4.04 (95% CrI 1.96-8.36), corresponding to a 99.9% posterior probability that minimally invasive surgery increases the risk of postoperative perineal hernia.</p><p><strong>Conclusion: </strong>Minimally invasive APR/ELAPE was associated with an increased risk of postoperative perineal hernia compared with the open approach. Strategies to reduce this complication while preserving the benefits of minimally invasive surgery warrant further investigation.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919179","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":"Efficacy and safety of ovine reinforced tissue matrix for ventral hernia repair: a systematic review and meta-analysis.","authors":"Diego L Lima, Maria Clara Morais, Augusto Graziani E Sousa, Lorraine Michelle da Silva de Almeida, Leticia Graciolli, Eduardo Parra-Davila, Salvador Morales-Conde, Flavio Malcher","doi":"10.1007/s10029-026-03817-1","DOIUrl":"10.1007/s10029-026-03817-1","url":null,"abstract":"<p><strong>Introduction: </strong>OviTex^® mesh is a reinforced tissue matrix (RTM) that combines biologic and synthetic components, aiming to reduce inflammatory response while providing durable abdominal wall support. Comparative analyses indicate it performs similarly to synthetic mesh regarding hernia recurrence and surgical site infection rates, and may be preferable in patients with increased risk factors or prior mesh infection. This systematic review and meta-analysis evaluated the efficacy and safety profile of OviTex, particularly in patients undergoing ventral hernia repair (VHR).</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, Embase, Scopus, and ClinicalTrials.gov from inception to September 2025. Studies comparing the use of OviTex in VHR with synthetic or other biologic meshes were included. The primary endpoint was recurrence rates. Secondary outcomes were surgical site occurrences (SSO) and hospital length of stay (LOS). Statistical analysis was performed with Review Manager 5.4 using a random-effects model.</p><p><strong>Results: </strong>From 202 records, 9 met our inclusion criteria, to which 4 were included in our final pooled analysis. These studies encompassed 534 patients (OviTex n = 194 [36.3%]), with a mean follow-up time of 19.3 months, and a mean hernia defect size of 130.3 cm². An open approach was specified in 171 (32%) cases. The overall primary fascial closure rate was 88%, with mesh most frequently placed in the retromuscular (39%) or intraperitoneal (35%) planes. Overall analysis showed significantly reduced recurrence rates (RR 0.45; 95% CI 0.22 to 0.94; p = 0.03) for patients using OviTex when compared with synthetic or other biologic meshes. There were no significant differences regarding SSO rates (RR 1.27; 95% CI 0.79 to 2.05; p = 0.32) and LOS (MD 3.18 days; 95% CI -6.38 to 12.74 days; p = 0.51) between groups.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis map the role of OviTex^® for ventral hernia repair. Preliminary evidence indicates lower rates of recurrence at a mean follow-up of 19.3 months and comparable outcomes in terms of surgical site occurrences and length of stay. However, these findings are based on a limited number of observational studies, and further prospective research with longer follow-up is needed to confirm reinforced tissue matrices as a reliable alternative in patients at higher risk.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897190","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":"Incremental value of hernia-sac CT attenuation beyond symptom duration for predicting bowel resection in incarcerated obturator hernia: a single-site retrospective cohort study.","authors":"Fuyumi Kobayashi, Jun Watanabe, Hiroharu Yamashita, Hironori Yamaguchi","doi":"10.1007/s10029-026-03847-9","DOIUrl":"10.1007/s10029-026-03847-9","url":null,"abstract":"<p><strong>Purpose: </strong>Symptom duration ≥ 72 h increases bowel resection risk in incarcerated obturator hernia, but onset is often imprecise, especially in patients without pain. We investigated whether hernia-sac computed tomography (CT) attenuation improves prediction beyond symptom duration.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study of patients treated between 2006 and 2023, onset was determined from electronic medical records using the best available clinical information. On non-contrast CT, mean hernia-sac attenuation in Hounsfield units (HU) was measured using a circular region of interest on the slice with the largest hernia-sac area. Firth logistic regression was used with bowel resection as primary outcome. In patients with HU available, incremental value of ≥ 20 HU beyond symptom duration ≥ 72 h was tested with likelihood ratios and changes in the area under the receiver operating characteristic curve (AUC); patients without pain were explored separately.</p><p><strong>Results: </strong>Among 39 patients (median age 88y, median body mass index 16.3 kg/m²), symptom duration ≥ 72 h strongly associated with bowel resection (odds ratio 18.6, 95% confidence interval 4.07-120.7; p < 0.001). HU did not improve model fit in 23 patients (p = 0.99 for ≥ 20 HU, p = 0.82 continuous value) and minimally changed discrimination (ΔAUC ≤ 0.01). In the exploratory subgroup of HU-assessed pain-free patients (n = 7), HU ≥ 20 yielded sensitivity 1.00 and specificity 0.75, with wide exact confidence intervals.</p><p><strong>Conclusions: </strong>Hernia-sac CT attenuation added limited predictive value beyond symptom duration for bowel resection. In an exploratory subgroup of patients without pain, no bowel resection was observed with HU < 20, but this finding requires validation because of small sample size.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897159","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 eTEP-TAR abdominal wall reconstruction for complex post-liver transplant incisional hernia with concomitant inguinal hernia repair: a video vignette.","authors":"Serra Bayrakceken, Cigdem Benlice, Afag Aghayeva, Omar Yusef Kudsi, Bilgi Baca","doi":"10.1007/s10029-026-03849-7","DOIUrl":"10.1007/s10029-026-03849-7","url":null,"abstract":"<p><strong>Introduction: </strong>Complex incisional hernias after major upper abdominal surgery are technically challenging because of altered anatomical planes, multiple fascial defects, and expected adhesions. Robotic enhanced-view totally extraperitoneal repair with transversus abdominis release may provide a minimally invasive option for selected patients by enabling retromuscular dissection, fascial closure, and wide extraperitoneal mesh reinforcement while limiting intraperitoneal manipulation.</p><p><strong>Case presentation: </strong>This video vignette presents an 84-year-old man with multiple incisional hernia defects along a previous Mercedes incision after liver transplantation and a concomitant left direct inguinal hernia. Preoperative imaging demonstrated a wide subxiphoid abdominal wall defect and a fat-containing left inguinal hernia.</p><p><strong>Surgical technique: </strong>A robotic eTEP-TAR approach was performed. Bilateral retromuscular dissection was completed, the inguinal and incisional hernia contents were reduced, and bilateral transversus abdominis release was performed to facilitate medial fascial advancement and lateral extension of the working space. The fascial and peritoneal defects were closed intracorporeally, and wide mesh reinforcement was achieved using a 30 × 30 cm polypropylene mesh, with additional meshes placed for the inguinal and lower quadrant defects. The postoperative course was uneventful, and the patient was discharged on postoperative day 2. At postoperative day 7 follow-up, he had no complaints, and the wounds were clean.</p><p><strong>Conclusion: </strong>This case demonstrates the feasibility of robotic eTEP-TAR abdominal wall reconstruction with concomitant inguinal hernia repair in a selected post-transplant patient with complex abdominal wall defects.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897224","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 after inguinal hernia repair: how strong is the evidence for minimally invasive versus open repair?","authors":"Benjamin A Y Cher, Qinyun Lin, Kenneth A Frank, Courtney J Balentine","doi":"10.1007/s10029-026-03824-2","DOIUrl":"10.1007/s10029-026-03824-2","url":null,"abstract":"<p><strong>Purpose: </strong>It remains controversial whether minimally invasive surgery (MIS) is superior to open surgery for inguinal hernia repair. MIS is growing in popularity, but open surgery remains more common. Consensus remains elusive even though numerous studies have been published about the topic. A new method for sensitivity analysis, the Robustness of Inferences to Replacement (RIR), can summarize the complex body of literature and evaluate the strength of the published findings to better support surgical decision-making. This study applied the RIR to the available evidence about this topic.</p><p><strong>Methods: </strong>We reviewed studies from published meta-analyses that compared MIS versus open surgery for elective, unilateral inguinal hernia repair and calculated the RIR for each study and for the cumulative data. The RIR indicates how many patients in a published study must be replaced from a null-hypothesis population for the published result to be overturned. Higher RIRs indicate more robust conclusions.</p><p><strong>Results: </strong>The literature review identified 40 randomized trials for inclusion. In the cumulative analysis, MIS had higher incidence of hernia recurrence (RIR 21), lower incidence of chronic pain (RIR 276), and lower immediate post-operative pain (RIR 1,282).</p><p><strong>Conclusion: </strong>The evidence supporting MIS for decreased post-operative pain and chronic pain is substantially stronger than the evidence supporting open surgery for decreased hernia recurrence. However, there is likely not a clearly superior method for all patients. The findings demonstrate how the RIR can support better surgical decision-making by helping surgeons to interpret a large and complex body of published literature.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897185","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":"Comparison of laparoscopic intraperitoneal onlay mesh (IPOM Plus) and extended totally extraperitoneal (eTEP RS) repair for incisional hernia - a randomized clinical trial.","authors":"Georgy B Ivakhov, Andrey V Andriyashkin, Aleksandra A Kalinina, Deividas Kuzmauskas, Svetlana M Titkova, Vokhidzhon A Mamadumarov, Taras V Nechay, Alexander V Sazhin","doi":"10.1007/s10029-026-03846-w","DOIUrl":"10.1007/s10029-026-03846-w","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic intraperitoneal onlay mesh repair with a combination of hernial defect closure (IPOM plus) is an effective and common surgical procedure performed in patients with incisional ventral hernia. The introduction of extended-view totally extraperitoneal Rives-Stoppa procedure (eTEP RS) has sparked debate among surgeons regarding the optimal technique for ventral hernia repair. Our randomized clinical study aims to compare IPOM plus and eTEP RS techniques in patients with midline incisional ventral hernias.</p><p><strong>Methods: </strong>This is a prospective, single-center, single-blind randomized clinical trial, that was conducted at Moscow City Hospital №1 (Pirogov Russian National Research Medical University's Faculty Clinic) from February 2023 to April 2025. Patients were randomly allocated in a 1:1 ratio to either the eTEP RS group (Group I) or the IPOM plus group (Group II). The primary endpoint of this study was the level of pain on the first postoperative day, measured using the numerical pain scale (NRS-11). The secondary endpoints included the level of pain after 6 ± 1 h, on the 7 (± 1), 30 (± 3) and 100 (± 5) days after surgery, length of stay, postoperative analgesic consumption, short-term complications rate and the presence of chronic pain.</p><p><strong>Results: </strong>72 patients were allocated equally to eTEP RS (n = 36) and IPOM plus (n = 36) groups. The average pain score on the first postoperative day in the IPOM plus group was significantly higher compared with eTEP RS group (p < 0.001). Comparison of median NRS-11 scores showed significantly lower pain in the eTEP RS group at 6 ± 1 h (p < 0.001), on 7 ± 1 days (p < 0.001), and 30 ± 3 days (p = 0.005). Chronic pain was observed more often in patients who underwent IPOM plus (38.9%, n = 14) than eTEP RS (5.6%, n = 2), p < 0.001. We found no differences in early complications (p = 0.260) and length of stay (p = 0.421).</p><p><strong>Conclusions: </strong>Patients undergoing eTEP RS repair for midline incisional ventral hernias experienced less frequent pain and lower analgesic requirements in the early postoperative period, as well as a lower rate of chronic pain.</p><p><strong>Trial registration: </strong>NCT05528107 (http//www.</p><p><strong>Clinicaltrials: </strong>gov).</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891522","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}