Journal of abdominal wall surgery : JAWS最新文献

{"title":"Use of intraperitoneal fascial traction in robotic eTEP approach for complex ventral hernias: technique and outcomes.","authors":"Vivek Bindal, Dhananjay Pandey, Deepak Kumar, Shahiq Ahmed, Aakash Patel","doi":"10.3389/jaws.2026.16438","DOIUrl":"10.3389/jaws.2026.16438","url":null,"abstract":"<p><strong>Background: </strong>Tension-reduced midline closure remains a key challenge in the minimally invasive repair of large and complex ventral and incisional hernias. Commonly employed adjuncts, such as botulinum toxin A (BTA), progressive pneumoperitoneum (PPP), and component separation (CS), increase treatment complexity and may be associated with additional morbidity. Intraoperative fascial traction (IFT) has been described in open surgery to facilitate fascial medialisation; however, data related to its application in minimally invasive and robotic approaches supplementing IFT are scarce.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of six patients who underwent robotic-assisted enhanced-view totally extraperitoneal (eTEP) ventral hernia repair with adjunctive IFT between June 2024 and March 2025. A comprehensive preoperative workup was performed, which included clinical evaluation and computed tomography (CT) imaging. The width of the fascial defect was meticulously measured intraoperatively before and after traction. For patients with transverse defects exceeding 15 cm, preoperative BTA injections were administered.</p><p><strong>Results: </strong>The mean pre-traction defect width was 15.8 ± 5.4 cm and reduced to 8.9 ± 3.2 cm following traction, achieving a mean medialisation of 6.9 ± 1.8 cm. Tension-reduced midline closure was achieved in all patients, without the need for CS or conversion to open surgery. Postoperative recovery was uneventful, with low pain scores, early ambulation, and no surgical site complications or 30-day readmissions.</p><p><strong>Conclusion: </strong>IFT is a feasible and effective adjunct in robotic eTEP repair of large ventral hernias. When combined with robotic precision, it facilitates closure without undue fascial tension while preserving abdominal wall integrity and avoiding CS. Larger-scale studies are warranted to validate these findings.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16438"},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative and neutral results matter in abdominal wall surgery.","authors":"Manuel López-Cano, Josep M Garcia-Alamino","doi":"10.3389/jaws.2026.17443","DOIUrl":"10.3389/jaws.2026.17443","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"17443"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why LATI-H must enter the surgical lexicon.","authors":"Artur Zanellato, James Lucocq, Leo Brown, Thomas M Drake, Frederik Berrevoet, Stephen J Wigmore","doi":"10.3389/jaws.2026.16806","DOIUrl":"10.3389/jaws.2026.16806","url":null,"abstract":"<p><strong>Background: </strong>Millions of people undergo surgery with utilises a lower abdominal transverse incision (LATI). These incisions offer straightforward surgical access to the abdomen and pelvis and are ubiquitously used worldwide including for caesarean section. The incidence of hernia following these incisions have not been comprehensively studied and there are marked differences in abdominal entry across different LATI types. To address these hernias with a pivotal role in recognition and awareness, we propose a new term for hernias arising from these incisions: Lower Abdominal Transverse Interparietal/Incisional Hernias (LATI-H).</p><p><strong>Methods: </strong>A narrative review based on relevant literature was conducted to explore how LATI-H is described and reported. We searched the literature using MEDLINE and PubMed from inception to March 2025 to identify relevant studies. We retrieved relevant articles and included articles which described lower abdominal transverse incision complications including their hernias, with no limit on indication. Non-English articles were translated by medical translator for accurate understanding of the technique and literal transcription.</p><p><strong>Results: </strong>Lower abdominal transverse incisional hernias are poorly described and defined in the literature. They are frequently incorporated to large series of incisional hernias, but they are usually a mix of a large posterior defect with small incisional defects and have different features from other types of incisional hernia. This makes lower abdominal transverse interparietal hernias (LATI-H) a concern for general surgeons due to difficult diagnosis. LATI-H can progress and risk serious complications such as bowel obstruction and bowel ischemia.</p><p><strong>Conclusion: </strong>Lower abdominal transverse interparietal hernias (LATI-H) are poorly defined and are often erroneously termed Pfannenstiel or C-section hernias. The authors suggest the use of LATI-H to provide clear definition and provide a framework for future research to identify how these arise and find strategies to prevent and repair these hernias effectively.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16806"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of incisional hernia on quality of life after colorectal cancer surgery - results of the Rein4CeTo1 randomized clinical trial.","authors":"Charlotta L Wenzelberg, Carl-Fredrik Rönnow, Ulf Petersson, Peder Rogmark","doi":"10.3389/jaws.2026.17039","DOIUrl":"10.3389/jaws.2026.17039","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate quality of life (QoL), abdominal wall pain and discomfort 1 and 3 years after colorectal cancer (CRC) surgery in patients with and without incisional hernia (IH) and perform a risk factor analysis for impaired QoL.</p><p><strong>Methods: </strong>Longitudinal observational study with patients included in the randomized controlled trial, Rein4CeTo1, carried out 2017-2021. Patients underwent CT-scans 12 ± 3 and 36 ± 3 months after surgery, scrutinized for diagnosis of IH. General health was evaluated using the EQ-5D-5L questionnaire. For QoL related to IH and overall abdominal wall symptoms a slightly modified version of the Ventral Hernia Pain Questionnaire (VHPQ) was used. Potential risk factors of impaired QoL were investigated with multivariable linear regression analysis.</p><p><strong>Results: </strong>Of 160 randomized patients, 134 were eligible for 1-year follow-up and 119/134 (89%) answered the questionnaires. Corresponding numbers at 3 years was 81/101 (80%). The EQ-5D-5L results were similar at 1 and 3 years for patients with and without IH (p = 0.276 1 year, p = 0.404 3 years). The VHPQ concluded low frequency of pain, stiffness in the abdominal wall and other discomforting symptoms without differences between patients with and without IH. In multivariable linear regression stoma was an independent risk factor for impaired general QoL at 3 years, p < 0.005.</p><p><strong>Conclusion: </strong>In this study, comparing QoL 1 and 3 years after CRC surgery, we could not find a statistically significant difference in patients developing an IH compared to those who did not. The presence of a stoma was an independent risk factor for impaired general QoL after 3 years.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"17039"},"PeriodicalIF":0.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning in ventral hernia imaging: automated multi-structure CT segmentation for surgical planning.","authors":"Vinayak Rengan, Pravin Meenashi Sundaram, Eham Arora, Sabari Girieasen, Ashvind Bawa, Naveen Alexander, Rengan Ravanasamudram Sitaraman, Vimalakar Reddy, Vishakha Kalikar, Aman Arora, Lakshmi Kona, Rochita Venkataramanan, Devansh Lalwani, Dakshin Meenashi Sundaram, Rohit Kalla","doi":"10.3389/jaws.2026.15545","DOIUrl":"10.3389/jaws.2026.15545","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative assessment of ventral hernia defects remains time-intensive and subject to inter-observer variability. Current manual CT analysis for surgical planning is time-consuming, with inconsistent measurements affecting operative decision-making.</p><p><strong>Methods: </strong>215 CT scans of adults with ventral hernias were analyzed using TransUNet-inspired deep learning models. Expert annotations of anatomical landmarks and hernia features served as ground truth. Models were trained to automate segmentation of hernia defects and other critical anatomical structures.</p><p><strong>Results: </strong>Automated segmentation achieved IoU values of 0.85 for hernia defects, 0.89 for rectus abdominis muscles, 0.87 for lateral abdominal wall muscles, and 0.91 for psoas muscles.</p><p><strong>Conclusion: </strong>Deep learning automation provides rapid, standardized hernia assessment for surgical planning. The system delivers objective measurements with significant time savings, demonstrating technical feasibility as a proof-of-concept that warrants further prospective clinical validation before deployment in operative decision-making.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15545"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparison of robot-assisted enhanced-view totally extraperitoneal (eTEP) and transabdominal retromuscular (TARM aka TARUP) ventral hernia mesh repair: a systematic review and meta-analysis.","authors":"Francesco Brucchi, Annabelle De Troyer, Richard Sassun, Gianlorenzo Dionigi, Filip Muysoms","doi":"10.3389/jaws.2026.16656","DOIUrl":"https://doi.org/10.3389/jaws.2026.16656","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/jaws.2025.14723.].</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16656"},"PeriodicalIF":0.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic ventral TAPP versus IPOM for primary umbilical hernia repair: why use a sledgehammer to crack a nut?","authors":"Dimitrios Prassas, Omar Kreym, Wolfram Trudo Knoefel, Sascha Vaghiri","doi":"10.3389/jaws.2026.16805","DOIUrl":"https://doi.org/10.3389/jaws.2026.16805","url":null,"abstract":"<p><strong>Introduction: </strong>Intraperitoneal onlay mesh (IPOM) repair is the most commonly performed minimally invasive technique for ventral hernia repair, however, it is associated with increased postoperative discomfort and longer hospitalization. This study aimed to compare the efficacy and safety of the ventral transabdominal preperitoneal (V-TAPP) procedure and IPOM in primary umbilical hernia repair.</p><p><strong>Patients and methods: </strong>A retrospective review was conducted on 70 adult patients who underwent elective laparoscopic primary umbilical hernia repair between 2019 and 2026, using either the V-TAPP (n = 40) or IPOM (n = 30) technique. Short- and long-term comparative outcome analyses were performed.</p><p><strong>Results: </strong>Patient demographics, comorbidities and hernia characteristics were similar between the two groups. Surgery duration was significantly shorter in the IPOM group (time in minutes V-TAPP vs. IPOM: 98.1 ± 26.3 vs. 68.4 ± 24.5; p < 0.001). The effect of IPOM with regard to postoperative pain at 24 h was also pronounced (VAS Score min:0 max:10; V-TAPP vs. IPOM: 3 ± 1.3 vs. 4.8 ± 1.4; p < 0.001) Postoperative LOS was significantly longer in the IPOM group (LOS in days V-TAPP vs. IPOM: 1.3 ± 1 vs. 4.8 ± 1.4; p < 0.001). After adjusting for baseline clinical confounders via multivariable regression, the IPOM approach remained a significant independent predictor of both longer hospital stays (B = 2.69, p < 0.05) and higher 24-h postoperative pain (B = 1.81, p < 0.05). All other intra- and perioperative outcomes of interest were similar. No differences were noted at follow-up.</p><p><strong>Conclusion: </strong>With the exception of a longer operative time, V-TAPP was associated with significant advantages over IPOM in terms of patient recovery, while maintaining comparable safety and efficiency. While these findings are promising, larger prospective studies are warranted to confirm whether V-TAPP should be considered the preferred approach for small- and medium-sized primary umbilical hernias.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16805"},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesh reconstruction of the myopectineal region following wide local excision for inguinofemoral tumors.","authors":"Paul Yohan George, Paul Trinity Stephen, D K Titus, Beulah Roopavathana, Nitin Paul Ambrose, Prakash Joseph, Suchita Chase","doi":"10.3389/jaws.2026.16648","DOIUrl":"10.3389/jaws.2026.16648","url":null,"abstract":"<p><strong>Introduction: </strong>Appropriate reconstruction following radical resection of sarcomas in the inguinofemoral region and the pelvis is essential to prevent the subsequent development of an incisional hernia. Simple soft-tissue coverage may not suffice, as resection often involves the removal of the flat muscles and the inguinal ligament. We propose a technique of extraperitoneal mesh placement to reconstruct the myopectineal orifice (MPO).</p><p><strong>Methods: </strong>In this paper, we present a technique of extraperitoneal mesh reconstruction of the myopectineal region and inguinal ligament following radical resection for inguinofemoral tumours. The short-term surgical outcome, long-term oncological outcomes, and the development of an incisional hernia were also retrospectively reviewed.</p><p><strong>Results: </strong>A total of 13 patients were included in the study from May 2017 to February 2025. In 11/13 patients, primary closure of the soft tissue defect was possible. In two patients, a local rotational flap was required for soft tissue coverage. In 11/13 patients, a polypropylene mesh was used. In two patients, a titanium-coated polypropylene mesh was used. For all patients, the mesh was placed in the extra-peritoneal plane. Regarding short-term complications, 4 patients developed a surgical site infection, and 2 developed a seroma. In terms of long term outcomes, only one patient was confirmed to have developed an incisional hernia.</p><p><strong>Conclusion: </strong>This technique offers a simple, safe, cost-effective, and reproducible method for reconstructing the myopectineal orifice in patients undergoing radical resection of soft tissue tumors involving the inguinofemoral region, with the sacrifice of the inguinal ligament.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16648"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of large ventral hernias following damage control surgery: a retrospective comparison of laparoscopic IPOM plus and open repair techniques.","authors":"Marharyta Smirnova, Oleh Herasymenko, Mykhailo Koshikov, Yaroslav Haida, Alim Ulukhanov","doi":"10.3389/jaws.2026.16917","DOIUrl":"10.3389/jaws.2026.16917","url":null,"abstract":"<p><p>Damage control surgery (DCS) has become the standard of care in the management of severe abdominal trauma, particularly in military settings. Although this approach improves survival, it frequently results in significant disruption of the anterior abdominal wall and subsequent development of large ventral hernias. Reconstruction in this context is technically challenging due to adhesions, distorted anatomy, and loss of normal tissue planes. While open retromuscular repair is generally preferred, it is often not feasible following DCS. Laparoscopic intraperitoneal on-lay mesh repair with primary fascial closure (IPOM plus) may offer an alternative. However, evidence in post-traumatic populations remains limited. This study aimed to compare the feasibility, safety, and short-term outcomes of laparoscopic IPOM plus and open repair techniques in patients undergoing ventral hernia repair after DCS. A retrospective cohort study was conducted at a single military centre between June 2022 and December 2025. A total of 79 male patients with large ventral hernias following abdominal shrapnel injuries were included. Patients underwent either open repair (sub-lay or on-lay, n = 46) or laparoscopic IPOM plus repair (n = 33). Baseline characteristics were comparable between groups. Early postoperative outcomes within 90 days were analysed, including operative time, length of hospital stay, postoperative pain, time to recovery of bowel function, and complication rates. Laparoscopic IPOM plus repair was feasible in all cases, with successful primary fascial closure achieved in every patient. Operative time did not differ significantly between groups. The laparoscopic approach was associated with a significantly shorter hospital stay (p < 0.001), lower early postoperative pain on postoperative days 1 and 2 (p < 0.05), and earlier recovery of bowel function (p < 0.01). Rates of postoperative complications, including seroma formation, were lower following laparoscopic repair but did not reach statistical significance. No surgical site infections, reoperations, or readmissions were observed in either group. In patients with large ventral hernias following DCS, laparoscopic IPOM plus repair appears to be a feasible and safe alternative to open reconstruction. It is associated with improved early postoperative recovery without an increase in short-term complications. Further prospective studies with long-term follow-up are required to confirm these findings.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16917"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From online collaboration to clinical insight: identifying heterotopic ossification through a global hernia surgery network.","authors":"Vanessa Buie, Brian P Jacob","doi":"10.3389/jaws.2026.16362","DOIUrl":"10.3389/jaws.2026.16362","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16362"},"PeriodicalIF":0.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}