Hernia最新文献

{"title":"Long-term patient-reported outcomes after plication of rectus diastasis and simultaneous herniorrhaphy with HELP abdominoplasty.","authors":"Julia Saxen, Hilkka Peltoniemi, Tiina Jahkola, Jaana Vironen, Reetta Tuominen","doi":"10.1007/s10029-025-03408-6","DOIUrl":"10.1007/s10029-025-03408-6","url":null,"abstract":"<p><strong>Purpose: </strong>Midline hernias are common, and when associated with abdominal rectus diastasis, hernia guidelines recommend correction using mesh techniques. We present a retrospective series of patients with primary midline hernias and post-pregnancy moderate or severe abdominal rectus diastasis, who were operated using a comprehensive surgical approach without mesh.</p><p><strong>Methods: </strong>We previously described the HELP (Hydrodissection-Assisted Extended Lateral Plication) abdominoplasty technique for rectus diastasis repair, with or without a midline hernia. In this study, patient records from 2013 to 2018 were reviewed, and patients with a midline hernia who underwent the HELP abdominoplasty were recruited for a retrospective analysis.</p><p><strong>Results: </strong>Seventeen patients were successfully contacted. The mean diameter of the umbilical hernia defect was 13.6 mm (5-30 mm), and 7.7mm (5-20 mm) in epigastric hernias. The mean follow-up period was 5.2 years. None of the patients reported a recurrence of diastasis or of hernias. The overall complication rate was 11.8%.</p><p><strong>Conclusion: </strong>HELP abdominoplasty appears to be a reliable surgical treatment with a low complication rate for normal-weight women with post-pregnancy moderate to severe rectus diastasis and concomitant small primary hernias. In these cases, the entire damaged fascia should be repaired, and mesh correction is not always necessary.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"220"},"PeriodicalIF":2.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: A novel laparoscopic technique for closing the defect of direct inguinal hernia.","authors":"Junsheng Li","doi":"10.1007/s10029-025-03411-x","DOIUrl":"https://doi.org/10.1007/s10029-025-03411-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"218"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical COSMIN-informed scoping review of complex abdominal wall hernia quality of life tools: making a case for patient-driven tool development.","authors":"Catherine Oxley, Olivia Smith, Asim Abbas, Mark Mierzwinski, Christine Davey, Praminthra Chitsabesan, Srinivas Chintapatla","doi":"10.1007/s10029-025-03399-4","DOIUrl":"10.1007/s10029-025-03399-4","url":null,"abstract":"<p><strong>Background: </strong>Health-Related Quality of Life (HRQoL) is increasingly recognized as a key outcome measure in Complex Abdominal Wall Hernia (CAWH) surgery. However, selecting an appropriate HRQoL tool is challenging due to the variety of available instruments and their variable psychometric properties.</p><p><strong>Aim: </strong>This scoping review systematically reviews and evaluates the six CAWH-specific HRQoL tools using the Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) framework. The aim of this scoping review was to assess the clinical suitability and developmental robustness of CAWH-specific HRQoL instruments. This review does not assess post-operative HRQoL outcomes, but rather evaluates the design, content, and methodological quality of CAWH-specific tools themselves using the COSMIN framework.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with PRISMA-ScR and informed by COSMIN and Joanna Briggs Institute (JBI) scoping methodology. Four databases (MEDLINE, EMBASE, Cochrane CENTRAL, ClinicalTrials.gov) were searched (March 2024) to identify studies that used or evaluated CAWH-specific HRQoL tools. Tools were assessed across key COSMIN domains: conceptual framework, psychometric properties, respondent burden, and patient involvement in development.</p><p><strong>Results: </strong>Six CAWH-specific HRQoL instruments were identified: CCS, HerQLes, EuraHS-QoL, AAS/mAAS, AHQ, and HERQL. While these tools demonstrated utility, none fully integrated patient perspectives from initial domain development, and all exhibited gaps in content and structural validity. Comparative psychometric data across tools were limited, further complicating selection.</p><p><strong>Conclusion: </strong>Despite growing interest in measuring HRQoL in CAWH surgery, existing tools show important developmental limitations. While these tools demonstrate utility, none fully integrate patient perspectives throughout their development, and all exhibit gaps in content and structural validity. Additionally, comparative psychometric data remain limited, further complicating tool selection. Given these limitations, there is a clear need for further development-either by refining existing tools or creating a new, patient-informed HRQoL instrument that adheres to robust psychometric standards.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"219"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effectiveness and safety of the ultralight, non-resorbable Optomesh® ULTRALIGHT surgical meshes for surgical treatment of hernias based on open and laparoscopic techniques - a retrospective analysis.","authors":"Marcin Włodarczyk, Łukasz Dziki, Inez Bilińska, Jarosław Szpunar, Krzysztof Konopka, Piotr Kasprzak, Magdalena Tokarska, Agata Kraj, Paulina Łąpieś, Witold Sujka","doi":"10.1007/s10029-025-03398-5","DOIUrl":"10.1007/s10029-025-03398-5","url":null,"abstract":"<p><strong>Background: </strong>According to global data, hernia surgery is the most commonly performed elective surgical procedure. The primary factor that can lead to the development of a hernia is weakening of the abdominal wall. The only effective method of treating hernias, regardless of their type, is surgery. In the following clinical study, a retrospective - prospective analysis was performed. The aim of the study was to determine, based on open and laparoscopic techniques, the effectiveness and safety of Optomesh^® ULTRALIGHT surgical meshes made from cuts of stabilized monofilament polypropylene knit fabric recommended for reconstructive surgical procedures to fill and/or strengthen soft tissue defects in the treatment of various types of hernias.</p><p><strong>Methods: </strong>The study included 171 patients, aged 22 to 70 years, who met the inclusion and exclusion criteria specified in the clinical trial plan, including 20 women and 151 men. During surgery, the vast majority of hernias were operated using the Lichtenstein surgical technique (132 patients). The other operations were performed using the Rives-Stoppa technique (23) and laparoscopic TAPP, TEP technique (16).</p><p><strong>Results: </strong>The results were collected from intraoperative data and data collected during 2 follow-up visits after the procedure. The presented data collected during interviews with patients concern the frequency of recurrences, pain sensation in the first days after the procedure, discomfort associated with mesh implantation and pain sensation according to the VAS scale. These parameters will help to assess the therapeutic value of this type of implants intended for surgical treatment of hernias. Interviews at the second follow-up visit confirmed the patients' long-term, satisfactory reception in terms of comfort and average pain sensation.</p><p><strong>Conclusions: </strong>The Optomesh^® ULTRALIGHT implant is not only effective and safe but also imperceptible to the patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"216"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.","authors":"Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda","doi":"10.1007/s10029-025-03403-x","DOIUrl":"10.1007/s10029-025-03403-x","url":null,"abstract":"<p><strong>Purpose: </strong>Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.</p><p><strong>Methods: </strong>A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.</p><p><strong>Results: </strong>Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.</p><p><strong>Conclusion: </strong>This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"213"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors for recurrence of incisional hernia repair after liver transplantation: a retrospective cohort study.","authors":"Edouard Wasielewski, Thierry Pecot, Estelle Le Pabic, Mohamed Lakehal, Astrid Herrero, Fabien Robin, Karim Boudjema, Laurent Sulpice","doi":"10.1007/s10029-025-03400-0","DOIUrl":"10.1007/s10029-025-03400-0","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to evaluate the incidence and identify risk factors associated with the recurrence of incisional hernia (IH) following initial parietal repair in patients who had undergone liver transplantation. Liver transplantation (LT) is a complex procedure associated with numerous complications, particularly those affecting the abdominal wall, with incisional hernia (IH) being the most significant. To date, the risk factors contributing to IH recurrence in this population have not been systematically assessed.</p><p><strong>Methods: </strong>This retrospective, single-center study included all patients who underwent liver transplantation at Rennes University Hospital between January 1, 2012, and December 31, 2018. The list of eligible patients was provided by the French Biomedicine Agency.</p><p><strong>Results: </strong>A total of 803 liver transplant recipients were included. Among them, 282 patients (35.1%) developed an incisional hernia (IH) after a median follow-up of 75.87 months [54.7-97.2]. Of these, 50 patients (35.4%) experienced IH recurrence at a median interval of 8.8 months [5.2-34.2] following primary repair. Identified risk factors for recurrence included: length of hospital stay after the initial repair (HR: 1.09 [1.09-1.13], P = < 0.0001), type of repair (suture versus prosthetic) (HR: 2.48 [1.25-4.9], P = 0.009). Visceral obesity is considered a high-risk factor (HR: 2.21 [0.98-4.95], P = 0.055), although the association no longer reached the conventional threshold for statistical significance.\"</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study to assess body composition as a risk factor for incisional hernia recurrence in the liver transplant population. These findings highlight the importance of considering visceral obesity as a significant predictor of recurrence.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"217"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505561","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":"Do we have to rethink slit-mesh technique in endoscopic inguinal hernia repair? - A matched pair analysis.","authors":"Konstantinos Zarras, Jens Plambeck, Joseph Kankam, Martin Hukauf, Ferdinand Köckerling","doi":"10.1007/s10029-025-03394-9","DOIUrl":"10.1007/s10029-025-03394-9","url":null,"abstract":"<p><strong>Introduction: </strong>Due to a lack of evidence, the use of slit meshes in laparo-endoscopic hernia repair is a topic of controversial debate. Therefore, further studies are needed on this key question.</p><p><strong>Methods: </strong>This retrospective analysis of prospectively recorded data from the Herniamed Registry compared the perioperative and 1-year follow-up outcomes after laparo-endoscopic inguinal hernia repair with slit mesh versus non-slit mesh. Matching was performed for 1,028 pairs.</p><p><strong>Results: </strong>A significant difference was identified in the recurrence rate on 1-year follow-up in favor of the slit mesh (0.6% vs 1.8%; p = 0.023). No such systematic difference was found for any of the other outcome variables (intraoperative complications, general complications, postoperative complications, complication-related reoperations, pain at rest, pain on exertion, and pain requiring treatment on 1-year follow-up).</p><p><strong>Conclusion: </strong>The use of a slit mesh versus a non-slit mesh in laparo-endoscopic inguinal hernia repair is associated with a significantly lower recurrence rate. There is no relation with any other outcome criteria. Since the use of a slit mesh in laparo-endoscopic inguinal hernia repair seems to influence the outcome, this topic should be further investigated.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"214"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505559","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":"Similar recurrence rates among the 10 most used meshes for laparoscopic groin hernia repair: a nationwide register-based cohort study.","authors":"Kristoffer Andresen, Mette W Christoffersen, Jacob Rosenberg, Nadia Henriksen","doi":"10.1007/s10029-025-03397-6","DOIUrl":"10.1007/s10029-025-03397-6","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"215"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505562","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":"Rectus diastasis in males: a narrative review.","authors":"Simon Nienhuijs, Renske Wijgers, Elles Schipper, Tammo de Vries Reilingh, Johannes Wegdam","doi":"10.1007/s10029-025-03404-w","DOIUrl":"https://doi.org/10.1007/s10029-025-03404-w","url":null,"abstract":"<p><strong>Purpose: </strong>Rectus diastasis in male patients is underexposed in the literature. This review aims to list the available evidence and summarize recommendations for clinicians.</p><p><strong>Methods: </strong>A multidatabase literature search was performed with a focus on rectus diastasis (RD) in male patients. Studies were screened independently, after unblinding discrepancies discussed amongst the group. Quality of included studies was assessed and data was extracted using predefined criteria.</p><p><strong>Results: </strong>Twenty-one studies were included for qualitative syntheses. Prevalence of RD in males have been reported 25-30% and higher with concomitant findings such as other abdominal wall hernia (47%) and aortic aneurysm (67%). This outreached the portion of treated rectus diastasis, assumed to be between 4 and 14%. Quality of linea alba was described adversely affected by visceral obesity, less fibers, and smoking. Core stability was found to be related with RD in terms of low back pain in males, while body image was not encountered as a reported outcome. Limited number of studies shared algorithms for treatment of choice, showing a preference for mesh-based approach for male RD. This has also been suggested for hernia repair alongside RD to reduce the recurrence rate.</p><p><strong>Conclusion: </strong>Based on limited number of reports, the prevalence of RD in males is at least double the portion undergoing a repair. The community is asked to pay more attention for rectus diastasis in male patients; if present, inquire about the complaints and in case of a ventral hernia, check the inter recti distance.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"212"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496091","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":"Sandwich parastomal hernia repair, a prospective observational study.","authors":"T B Johnsen, T Stornes, B Ystgaard, T E Bernstein","doi":"10.1007/s10029-025-03335-6","DOIUrl":"10.1007/s10029-025-03335-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study is to evaluate the safety, feasibility and short and long term outcomes following the Sandwich repair for parastomal hernia.</p><p><strong>Methods: </strong>A prospective single center study including all patients operated with Sandwich repair at St. Olav hospital, Trondheim University hospital from 2018 to 2023.</p><p><strong>Results: </strong>Fifty four patients were treated with the Sandwich repair. All procedures were performed laparoscopically, with two conversions to open surgery due to adhesions. The median age was 67 years. 44% of the patients were females. Two thirds of the patients had a colostomy. Pain or discomfort was the most frequent indication for parastomal hernia repair, followed by leakage. Median operation time was 149 min. Eight patients were operated in an emergency setting. Six patients had a recurrence after previous surgery for parastomal hernia. Three patients had ClavienDindo complication rate 3b following the Sandwich repair and had their implants removed a few days after index surgery. The median in-hospital time was 5 (2-35) days and the median followup was 33 months (1-61). No recurrences were identified.</p><p><strong>Conclusion: </strong>The laparoscopic Sandwich repair is a safe methode for most of the parastomal hernia patients. Even with a reasonable long median follow-up, we did not observe any recurrences.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"211"},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336482","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}