Hernia最新文献

{"title":"The Desarda technique in inguinal hernia surgery during international surgical missions: A Real-World solution.","authors":"Eduardo Perea-Del-Pozo, Carlos Javier García-Sánchez, Manuel Bustos Jimenez, Teresa Butrón Vila, Andrew Kingsnorth","doi":"10.1007/s10029-025-03453-1","DOIUrl":"10.1007/s10029-025-03453-1","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"254"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873009","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":"\"Comparative safety and efficacy of robotic TAPP and IPOM techniques in ventral hernia repair: a systematic review and meta-analysis of Short-term Outcomes\".","authors":"Ahmed Abdelsamad, Ibrahim Khalil, Khaled Ashraf Mohamed, Aya Sayed Ahmed Said Serour, Mohammed Khaled Mohammed, Noureldin Mostafa, Youssef Osama Badie, Zeyad M Wesh, Alaeldin Mohamedsami Mohamedosman Ali, Florian Gebauer","doi":"10.1007/s10029-025-03454-0","DOIUrl":"10.1007/s10029-025-03454-0","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted ventral hernia repair has gained popularity for its enhanced precision and visualization. Two main approaches-r-IPOM and r-TAPP-differ in technique and risk profiles. r-IPOM/+ is technically simpler and preferred for larger defects, but may increase seroma and bowel-related complications. Conversely, r-TAPP employs extraperitoneal mesh positioning, potentially reducing postoperative complications. This meta-analysis aimed to compare perioperative outcomes between r-IPOM and r-TAPP, focusing on seroma, surgical site infection (SSI), and hernia defect closure. Secondary outcomes included recurrence, reoperation, operative time, and hospital stay.</p><p><strong>Methods: </strong>A systematic meta-analysis, including 11 studies and 1001 patients, was performed. Pooled event rates and mean differences were calculated using random-effects models. Subgroup analyses based on mesh type and meta-regression assessing the impact of defect closure on complication rates were conducted. Evidence certainty was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Both approaches achieved high defect closure rates (r-IPOM+: 98%, r-TAPP: 99%; p = 0.9). Seroma and hematoma rates were low without significant differences; however, r-IPOM showed a slightly higher trend. r-TAPP demonstrated a significantly lower Surgical site infection (SSI) rate (1%) compared to (r-IPOM 4%, p = 0.02), although these complications themselves did not differ significantly between groups, indicating a possible but unconfirmed association. Recurrence, reoperation, operative time, and hospital stay were comparable. Meta-regression indicated a non-significant trend toward fewer complications with higher closure rates (p = 0.09). The GRADE assessment rated the certainty of evidence as high across all outcomes.</p><p><strong>Conclusion: </strong>Both r-TAPP and r-IPOM are effective and safe for robotic ventral hernia repair. A significant inverse correlation between closure rates and complication rates underscores the importance of complete, tension-free closure. While perioperative outcomes are largely comparable, r-TAPP may reduce infection risk likely due to lower seroma and hematoma rates. Approach selection should be guided by patient factors, anatomical considerations, and surgical expertise.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"255"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873007","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 the impact of diastasis recti on ipom plus ventral hernia repair.","authors":"Emmanuel E Sadava, Julieta A Giacone Aguiar, Agustin C Valinoti, Sofia Aramburu, Alexis M Flores Gaibor, Francisco Schlottmann","doi":"10.1007/s10029-025-03451-3","DOIUrl":"10.1007/s10029-025-03451-3","url":null,"abstract":"<p><strong>Introduction: </strong>Ventral hernia repair (VHR) via intraperitoneal onlay mesh with primary defect closure (IPOM+) is currently the most widely adopted technique. However, this procedure has not yet been evaluated in patients with diastasis recti (DR). We aimed to determine if the presence of DR affects long-term surgical outcomes of IPOM+.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of a consecutive series of patients who underwent IPOM + technique for VHR. Only patients with defects between 3 and 8 cm in width and with at least 1-year follow-up were included. The cohort was divided into two groups; IPOM+: patients with ventral hernia without DR, and IPOM + DR, patients with ventral hernia and DR. Preoperative, intraoperative and postoperative variables were compared between groups.</p><p><strong>Results: </strong>A total of 106 patients undergoing VHR were included; 41 (39%) IPOM + and 65 (61%) IPOM + DR (the mean DR was: 4.5 ± 1.3 cm). Demographics and preoperative variables were similar between groups. Mean defect width was 5.3 ± 2 cm and: 4.7 ± 2 cm for IPOM + and IPOM + DR, respectively (p = 0.2). Mean follow-up was also similar between groups (IPOM+: 51.8 versus IPOM + DR: 46.3 months, p = 0.44). Recurrence rate was significantly higher in patients with IPOM + DR (21.5% versus 2.4%, p = 0.003). In addition, 5 (7.6%) patients in IPOM + DR group had DR-recurrence as clinical bulging, and all but one needed reoperation.</p><p><strong>Conclusions: </strong>Although IPOM + remains as an effective technique for the repair of midline ventral hernias, the presence of DR increases recurrence rates significantly. Further research is needed to determine the optimal surgical approach in patients with ventral hernias and DR.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"253"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855067","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":"Incisional and parastomal hernias after harvesting of Vertical Rectus Abdominis Myocutaneous (VRAM) flaps: incidence, treatment options and outcomes.","authors":"Camille Vervaet, Camille Maeyaert, Mathias Allaeys, Frederik Berrevoet, Hasan H Eker, Gabrielle H van Ramshorst","doi":"10.1007/s10029-025-03406-8","DOIUrl":"10.1007/s10029-025-03406-8","url":null,"abstract":"<p><strong>Aim: </strong>The Vertical Rectus Abdominis Myocutaneous (VRAM) flap is a versatile reconstructive technique but is associated with donor-site morbidity, including incisional hernia (IH) and parastomal hernia (PSH). Our aim was to assess the incidence, treatment options and outcomes of IH and PSH following VRAM flap harvest.</p><p><strong>Method: </strong>A systematic search was conducted in PubMed, Embase and Scopus (to June 2024) using predefined terms. Studies with at least 10 participants and a follow-up of minimum one year were included. Two reviewers independently performed study selection, data extraction, quality of evidence (GRADE) and risk of bias (ROBINS-I, RoB-2). Primary outcomes were IH and PSH incidence.</p><p><strong>Results: </strong>24 studies (2200 patients) were included (19 retrospective cohorts, 3 case series, 2 randomized controlled trials). IH was reported in 10.2% (226/2200) and PSH in 19.2% (219/1143) of patients over a mean follow-up of 31 months (range: 12-66). Studies focused on prophylactic techniques included robotic harvesting (n = 1), fascia-sparing harvesting (n = 5), component separation (n = 6) and mesh-assisted closure (n = 16). Hernia repair involved mesh (n = 3) and primary suture (n = 1).</p><p><strong>Conclusion: </strong>Despite advances in prophylactic techniques for hernia prevention, significant challenges remain, including high heterogeneity in clinical diagnosis, follow-up duration, and surgical techniques. While some methods, such as fascia-sparing approaches, component separation, and mesh reinforcement show promising outcomes in reducing IH and PSH incidence, a lack of comparative studies prevents reaching a clear consensus. Future research should focus on larger scale studies and expert opinions to develop clinical recommendations for hernia prophylaxis and repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"251"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821341","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":"Comparison of laparoscopic iliopubic tract repair and transabdominal preperitoneal hernioplasty for contralateral occult inguinal hernia.","authors":"Sung Ryul Lee, Geon Young Byun","doi":"10.1007/s10029-025-03426-4","DOIUrl":"10.1007/s10029-025-03426-4","url":null,"abstract":"<p><strong>Purpose: </strong>Metachronous contralateral inguinal hernia (MCIH) following unilateral inguinal hernia repair is a common cause of reoperation. Contralateral occult inguinal hernia (OIH) may cause MCIH. Transabdominal preperitoneal hernioplasty (TAPP) might be overtreatment for OIH repair; laparoscopic iliopubic tract repair (IPTR) may be an effective alternative but has not been robustly studied. We compared laparoscopic IPTR and TAPP in treating OIH.</p><p><strong>Methods: </strong>This retrospective observational cohort study included 701 patients aged ≥ 18 years who received treatment for inguinal hernia between September 2012 and December 2023; 90 patients were excluded owing to loss during follow-up. Patients were divided into TAPP (54 patients; mesh implantation) and laparoscopic IPTR (647 patients; suture of the iliopubic tract and transversalis fascia arch without mesh implantation) groups.</p><p><strong>Results: </strong>MCIH from repaired OIH occurred in one patient in the TAPP group and six patients in the IPTR group [1.9% (1/54) vs. 0.9% (6/647), respectively]; this difference was not significant. The postoperative complication rate was higher in the TAPP group than in the IPTR group [5.6% (3/54) vs. 0.8% (5/647), p < 0.001]. Inguinodynia occurred in one patient in each group. Postoperative pain scores, duration of hospitalization, and time to return to normal daily life did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Laparoscopic IPTR is safe and effective for treating OIH and presents a viable alternative to TAPP.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"252"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821339","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":"Impact of different neurectomy techniques on managing chronic pain after inguinal hernia repair: a meta-analysis and systematic review.","authors":"Emmanouil Charitakis, Eyman Haj-Ali, Farah Al Hasani-Pfister, Baraa Saad, Niklas Ortlieb, Amanda Haberstroh, Florian Ponholzer, Stephanie Taha-Mehlitz, Lisa-Marie Schupp, Robert Christian Bauer, Sebastian Lamm, Daniel M Frey, Robert Rosenberg, Anas Taha","doi":"10.1007/s10029-025-03438-0","DOIUrl":"10.1007/s10029-025-03438-0","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to analyze the outcomes of neurectomy for treating chronic post herniorrhaphy pain (CPIP), with a focus on the efficacy of various surgical approaches (open, laparoscopic transabdominal, endoscopic retroperitoneal and combined approach), and types of neurectomy-single, double and triple.</p><p><strong>Methods: </strong>The research was registered with PROSPERO (CRD42023475401). A search in MEDLINE, Embase, Scopus, and Cochrane Central databases was conducted from the inception to November 2023. All participants aged 18 years and older who underwent neurectomy for treating CPIP were included. PRISMA guidelines were followed, selecting only randomized controlled trials, cohort studies and case series. A random-effects model was used for single-arm analyses, while the inverse variance and Mantel-Haenszel methods were employed for two-arm analyses.</p><p><strong>Results: </strong>The analysis includes fifteen studies involving 701 patients. Following neurectomy, 90% of the patients experienced an improvement in pain overall. Only 9.4% of the patients had postoperative complications. Among the surgical types, triple neurectomy demonstrated the highest overall pain improvement rate at 98.2%. Double neurectomy showed the highest rate of complete pain relief at 80.1%, but it also had a higher complication rate of 15.3%. In terms of surgical approach, the endoscopic retroperitoneal method not only had the highest overall improvement rate of 95.5% compared to other approaches but also the highest complication rate of 28.7%.</p><p><strong>Conclusion: </strong>Neurectomy was shown to be an effective treatment for neuropathic CPIP across various surgical techniques. Randomized controlled trials would be of vital importance to facilitate the evolution of surgical strategy and patient outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"249"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821340","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":"Minimally invasive Rives-Stoppa (MIRS) technique: a technique of retromuscular repair of ventral hernias preserving the posterior rectus sheath.","authors":"P Ngo, J-P Cossa, D Blum, J-F Gillion, Edouard Pélissier","doi":"10.1007/s10029-025-03425-5","DOIUrl":"https://doi.org/10.1007/s10029-025-03425-5","url":null,"abstract":"<p><strong>Purpose: </strong>Retromuscular techniques of ventral hernia (VH) repair involve division of the posterior rectus sheath, entailing a risk of suture line disruption when the gap is sutured or of abdominal swelling when it is not, or when any type of posterior releasing incision is performed. To prevent these drawbacks, we describe a technique of retromuscular repair preserving the posterior sheath integrity.</p><p><strong>Methods: </strong>The technique involved periumbilical skin incision, hernia reduction, suture of the orifice, bilateral incision of the anterior rectus sheath close to the midline, approximating the medial borders of these aponeurotic incisions by suture, retrorectus mesh deployment and approximation by suture of both lateral borders of the aponeurotic incisions over the mesh, thanks to anterior releasing incisions. Perioperative data were assessed on 177 consecutive patients and mid-term evaluation was carried out in the first 134 patients who had at least one year follow-up.</p><p><strong>Results: </strong>The mean hernia diameter was 2.6 cm (1-5), the operation duration was 76.4mn (50-120). Twenty-three (13%) uncomplicated seromas, 10 (5.6%) complicated seromas and 4 (2.3%) hematomas occurred. Introducing a quilting procedure amid the study reduced the incidence of complicated seromas from 9.6 to 2.1% (p = 0.031). On 134 patients with at-least 12 months follow-up, 128 (95.5%) were evaluated at a mean follow-up of 14.7 (12-32) months and 6 (4.5%) were lost to follow-up. There were neither recurrences, nor any case of swollen abdomen.  CONCLUSION: The MIRS technique provides effective repair of small VH and prevents the potential drawbacks linked to the division of the posterior sheath.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"250"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821342","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":"Comparison of short- and long-term efficacy and economic indicators between transabdominal preperitoneal and open tension-free repair for inguinal hernia in adults: a meta-analysis of randomized controlled trials.","authors":"Jianxin Chen, Yuanbiao Zheng, Chaoyang Lin","doi":"10.1007/s10029-025-03435-3","DOIUrl":"https://doi.org/10.1007/s10029-025-03435-3","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"248"},"PeriodicalIF":2.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794310","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":"Early outcomes of contaminated midline incisional hernia repair with mesh suture.","authors":"Megan M Perez, Taaha Hassan, Mehul Mittal, May Li, Kazimir Bagdady, Paige N Hackenberger, Gregory A Dumanian, Michael Shapiro","doi":"10.1007/s10029-025-03422-8","DOIUrl":"10.1007/s10029-025-03422-8","url":null,"abstract":"<p><strong>Purpose: </strong>Mesh suture is a novel reinforcement construct designed to provide enhanced mechanical support during midline fascial closure in comparison to conventional sutures while minimizing tissue dissection and foreign body burden in comparison to use of a planar mesh. Its use in contaminated fields remains understudied. This study evaluates the early clinical outcomes following mesh suture closure in clean-contaminated and contaminated incisional hernia repairs.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients undergoing incisional hernia repair with mesh suture closure between January 2023 and July 2024 across an academic health system. Eligible patients had clean-contaminated or contaminated wounds and underwent mesh suture implantation without planar mesh. Data included demographics, operative details, surgical site infections (SSI), surgical site occurrences (SSO), reoperations, readmissions, and hernia recurrence. Hernia recurrence-free survival was estimated using Kaplan-Meier analysis. Major complications were defined as surgical complication or reoperation within 90 days.</p><p><strong>Results: </strong>Fifty-one patients were included, with repairs performed by 22 surgeons. Most patients (62.7%) had clean-contaminated wounds. Anterior component separation was performed in 25.5% of cases. The 90-day SSI rate was 15.7%, with five patients requiring procedural intervention. The 90-day SSO rate was 23.5% and included one enterocutaneous fistula that resolved without surgical intervention. Readmission occurred in 27.4% of patients, and 9.8% underwent reoperation. Four hernia recurrences were observed (8.2%), with a 12-month recurrence-free survival of 91% and a mean recurrence-free survival of 17.3 months (95% CI: 16.5-18.1). Presence of a stoma was significantly associated with major complications (p = 0.041).</p><p><strong>Conclusion: </strong>Mesh suture closure was technically feasible across diverse surgical settings and demonstrated encouraging SSI and SSO rates as compared to conventional suture only and planar mesh-based repairs as reported in the literature. These findings support further investigation in prospective, comparative studies to assess long-term durability and comparative effectiveness.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"247"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784218","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":"Retraction Note: Comment to: the impact of smoking on ventral and inguinal hernia repair: a systematic review and meta-analysis.","authors":"Gang Wang, Zhichun Liu","doi":"10.1007/s10029-025-03449-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03449-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"244"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784220","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}