Journal of abdominal wall surgery : JAWS最新文献

{"title":"The current state of hernia surgery and Brazilian hernia congress 2025.","authors":"P H F Amaral, D L Lima, C M P Claus, M L Furtado, P H F Barros, L M Guimarães, P Trauczinsky, S Roll, L T Cavazzola, F Malcher, H M G Santos, G Soares","doi":"10.3389/jaws.2026.16500","DOIUrl":"10.3389/jaws.2026.16500","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16500"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393144","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":"Anthropometric measurements of the abdominal wall: toward standardization and difficulty grading in rTAPP inguinal.","authors":"U A Dietz, R Frey, A Lalos, U Pfefferkorn, M Ramser","doi":"10.3389/jaws.2026.16789","DOIUrl":"10.3389/jaws.2026.16789","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted procedures in hernia surgery are highly standardized, whereas the distance between the ports and the target organ is of critical importance. To date, anthropometric data regarding the distance from the umbilicus to the symphysis and the Abdominal Elevation Angle (AEA) are lacking, both of which may be relevant for preoperative estimation of procedural difficulty and for the standardization of the surgical technique. This study prospectively evaluated anthropometric abdominal wall parameters and their influence on procedural difficulty in robotic-assisted groin hernia repair.</p><p><strong>Methods: </strong>Abdominal wall elasticity was assessed by measuring xiphopubic, xiphoumbilical, umbilicopubic, and transversal distances before and after pneumoperitoneum at 12 mmHg. The abdominal elevation angle (AEA) was measured photographically and categorized as narrow (<23.8°), normal (23.9°-40.0°), or wide (>40.1°). Intraoperative anatomical features including intra-abdominal fat, peritoneal thickness, and adhesions were recorded using Likert scales.</p><p><strong>Results: </strong>Sixty-eight consecutive patients (61 male, 7 female; mean age 65 years, mean BMI 25.3 kg/m²) undergoing elective robotic-assisted groin hernia repair were included between July 2020 and April 2021. A total of 96 hernia sides were operated, including 28 bilateral and 8 recurrent cases. All distances increased significantly under pneumoperitoneum (p < 0.0001); the mean umbilicopubic distance with pneumoperitoneum was 16.35 cm. Mean longitudinal elasticity was 13.74% and transversal elasticity 11.73%, with no statistically significant difference between the two directions (p = 0.0844). Neither AEA nor BMI showed a statistically significant correlation with procedural difficulty. However, multiple linear regression analysis identified longitudinal abdominal wall elasticity as an independent predictor of procedural difficulty (p = 0.0139). Surgeon satisfaction with the procedural outcome was consistently high across all patient groups (mean score of 9.76/10), regardless of BMI or AEA.</p><p><strong>Conclusion: </strong>The mean umbilicopubic distance is less than the 20 cm proposed as distance-to-target in robot-assisted procedures; the umbilicus is not ideal for positioning of the endoscope port. Longitudinal abdominal wall elasticity appears to be a relevant factor influencing the difficulty of robot-assisted groin hernia repair, whereas BMI and AEA alone are insufficient predictors.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16789"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379313","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":"Introducing robotic surgery in a low-volume, community hospital: outcomes of the first 50 ventral hernia repairs (TARUP).","authors":"Jult Anton, Maertens Vicky, Melsens Elodie, Verrelst Lynn, Van Kerschaver Olivier, Fierens Kjell","doi":"10.3389/jaws.2026.15942","DOIUrl":"10.3389/jaws.2026.15942","url":null,"abstract":"<p><strong>Background: </strong>Robotic transabdominal retromuscular umbilical prosthetic repair (TARUP) is increasingly used for minimally invasive retromuscular ventral hernia repair, but data on implementation and learning curves in low-volume, non-tertiary community hospitals remain limited. We report early outcomes and operative efficiency during program initiation.</p><p><strong>Methods: </strong>Retrospective single-center cohort study in a non-specialist, non-tertiary community hospital. The first 50 consecutive robotic TARUP procedures (2022-2024) were screened; 43 patients were included after predefined exclusions. All hernias were primary midline ventral hernias (EHS width class W1). The primary outcome was operative time (skin-to-skin). Secondary outcomes included non-operative OR time, total OR time, mesh area, early postoperative pain (VAS at 2 h), length of stay (LOS), same-day discharge, and 30-day complications. Learning curves were assessed using chronological tertiles and CUSUM analysis.</p><p><strong>Results: </strong>Retrospective single-center cohort study in a non-specialist, non-tertiary community hospital. The first 50 consecutive robotic TARUP procedures (2022-2024) were screened; 43 patients were included after predefined exclusions. All hernias were primary midline ventral hernias (EHS width class W1). The primary outcome was operative time (skin-to-skin). Secondary outcomes included non-operative OR time, total OR time, mesh area, early postoperative pain (VAS at 2 h), length of stay (LOS), same-day discharge, and 30-day complications (Clavien-Dindo). Learning curves were assessed using chronological tertiles and CUSUM analysis.</p><p><strong>Conclusion: </strong>In a low-volume, non-tertiary community hospital, robotic TARUP showed a clear learning curve with improved operative efficiency over chronological experience and declining minor complications, alongside favorable 30-day recovery outcomes in selected smaller, primary midline ventral hernias. Longer follow-up and broader hernia complexity are needed to assess durability and generalizability.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15942"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298290","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":"Opportunities and obstacles in harnessing intraoperative data.","authors":"Amanda Hernandez, Jayson Marwaha","doi":"10.3389/jaws.2026.16301","DOIUrl":"10.3389/jaws.2026.16301","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16301"},"PeriodicalIF":0.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274498","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":"Editorial: Closure of abdominal wall - status Quo.","authors":"René H Fortelny, Nadia A Henriksen","doi":"10.3389/jaws.2026.16896","DOIUrl":"https://doi.org/10.3389/jaws.2026.16896","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16896"},"PeriodicalIF":0.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166385","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":"Health-related quality of life outcomes of bioabsorbable Phasix Mesh versus permanent synthetic mesh following open ventral hernia repair: a systematic literature review and narrative synthesis.","authors":"Mia Weiss, Hakan Gürcan, Elise Aronitz, Haytham Gareer, John P Fischer","doi":"10.3389/jaws.2026.16382","DOIUrl":"10.3389/jaws.2026.16382","url":null,"abstract":"<p><strong>Background: </strong>A hernia occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. The presence of a hernia, its surgical management, and the associated postoperative complications can substantially influence patient health-related quality of life (HRQoL). Ventral hernias often require mesh repair to reduce recurrence. While permanent synthetic meshes have historically been the standard of care, they have been associated with complications such as infection and chronic pain. As a result, patients are increasingly requesting alternatives, leading to growing interest in bioabsorbable meshes such as Phasix™ Mesh. This systematic literature review uses narrative synthesis to summarize reported HRQoL outcomes following open ventral hernia repair with Phasix™ Mesh or permanent synthetic mesh.</p><p><strong>Methods: </strong>Searches were conducted across multiple databases (i.e., MEDLINE®, Embase, Cochrane Central, and Cochrane Reviews) from 2013 to August 2024 using a peer-reviewed strategy. The primary outcome of the review was HRQoL, reported using the hernia-related quality of life survey (HerQLes).</p><p><strong>Results: </strong>Seven records of six independent studies met the inclusion criteria; four on Phasix™ Mesh and three on permanent synthetic mesh. Most studies were retrospective, with follow-up durations ranging from 12 to 66 months. A narrative synthesis was performed to summarize study design, patient characteristics, and HerQLes outcomes. Both mesh types showed improvements in HerQLes scores postoperatively. At the longest follow-up, the mean HerQLes postoperative scores were 75.25 for Phasix™ Mesh studies and 75.56 for permanent synthetic mesh studies. Quality of studies were moderate to high based on the Newcastle-Ottawa scale, supporting the reliability of findings.</p><p><strong>Conclusion: </strong>This study found that postoperative HerQLes scores improved with both Phasix™ Mesh and permanent synthetic meshes following open, ventral hernia repair. Single-arm studies of Phasix™ Mesh reported improvements in HerQLes scores up to 60 months post-surgery, including complex hernia cases. Early improvements in HerQLes scores were reported in permanent synthetic mesh studies, with reduced scores observed at the longest follow-up time points. Future large-scale, rigorously designed comparative studies are needed to confirm these findings, given no direct comparative studies are available.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16382"},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038944","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 extraperitoneal techniques in ventral hernia repair: a retrospective comparative study of TAPP and TEP.","authors":"R Croceri, A Tek, L Aragone, J P Medina, D E Pirchi","doi":"10.3389/jaws.2026.15676","DOIUrl":"10.3389/jaws.2026.15676","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia repair has traditionally been performed laparoscopically using the intraperitoneal onlay mesh (IPOM) technique, which is simple and widely available but carries the drawback of mesh-viscera contact. Extraperitoneal approaches such as transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair have emerged as alternatives that avoid this limitation, allowing the use of standard meshes without fixation. However, evidence comparing these techniques remains scarce.</p><p><strong>Methods: </strong>We conducted a retrospective comparative analysis of a prospectively collected database at a single centre between January 2023 and December 2024. Patients undergoing laparoscopic repair of primary ventral or W1 incisional hernias smaller than 4 cm, with or without rectus diastasis, were included. Demographic data, operative details, and postoperative outcomes were recorded. Pain was assessed using the visual analogue scale (VAS). Complications were graded according to Clavien-Dindo. Follow-up was at least 12 (twelve) months for all patients.</p><p><strong>Results: </strong>Thirty-three patients were analysed, 18 in the TEP group and 15 in the TAPP group. Baseline demographic and comorbidity characteristics were comparable. Operative time was significantly longer for TAPP (96.1 ± 14.8 vs. 84.7 ± 13.1 min, p=0.029). Mesh area was larger in TEP (242.9 ± 110.3 vs. 166.9 ± 49.9 cm², p=0.015). Rectus diastasis was present in a similar proportion of patients (55.6% vs. 53.3%), but correction was achieved only in TEP (11 of 18 cases, 61.1%). There was one conversion to IPOM in TAPP. Postoperative pain scores, hospital stay (18.2 vs. 15.3 h, p=0.119), and 30-day complication rates (13.3% vs. 22.2%, p = 0.665) were comparable, consisting mainly of minor seromas or haematomas. No recurrences were observed at 1 year.</p><p><strong>Conclusion: </strong>Both TAPP and TEP are safe and effective minimally invasive approaches for small ventral and W1 incisional hernia repair. TAPP is associated with longer operative times due to peritoneal flap creation, while TEP enables broader mesh placement and ergonomic correction of rectus diastasis. Despite the small sample size and retrospective design, our findings add to the growing evidence supporting extraperitoneal approaches as valuable alternatives to IPOM in abdominal wall surgery.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15676"},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019880","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":"Robotic parastomal hernia repair with reinforced tissue matrix; lessons learned from our 74-patient cohort.","authors":"J E Baart, T C van Smaalen, A L A Bloemendaal","doi":"10.3389/jaws.2026.16508","DOIUrl":"10.3389/jaws.2026.16508","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with a stoma often develop a parastomal hernia (PSH). Treatment of PSH is challenging and results are often disappointing, with many patients developing multiple recurrences. In this study we aim to describe our experiences with the treatment of PSH using our robot assisted operative technique, by exploring patient history and PSH repair outcome and giving in-depth description of failures and successes. We try to identify and better understand predicting factors for failure, postoperative complications and recurrence in an attempt to make a small step towards a more patient-tailored approach to parastomal hernia repair.</p><p><strong>Methods: </strong>All (robotic) PSH repairs performed in our centre from March 2022 to January 2026 were registered in a prospectively collected database.</p><p><strong>Results: </strong>In this period 74 patients underwent a robotic PSH repair. Almost half of these patients (46%) had undergone one or more previous attempts to PSH repair. Nine recurrences occurred (12%). Complication rate was 31% (9.5% severe complications). IPOM mesh <i>in situ</i>, ileostomy and amount of previous repair attempts may be related to recurrence and post-operative complications.</p><p><strong>Conclusion: </strong>This study highlights the complexity for PSH repair, becoming increasingly more complex in recurrent cases. More (comparative) research is needed to establish a more patient-tailored approach to PSH repair.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16508"},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019891","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":"Lessons Learned From AI-Assisted Guideline Generation in Parastomal Hernia Repair.","authors":"Maciej Śmietański, Mateusz Zamkowski, Krzysztof Tyszka","doi":"10.3389/jaws.2026.15992","DOIUrl":"10.3389/jaws.2026.15992","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) can analyse scientific literature and draft medical recommendations, but their role in formal clinical guideline development is unclear.</p><p><strong>Aim: </strong>To evaluate whether a publicly available GPT-based LLM can generate coherent, GRADE-based guidelines for parastomal hernia management from a predefined evidence base, and to compare these with the 2017 European Hernia Society (EHS) guidelines. A secondary aim was to explore implications for academic publishing and scientific authorship.</p><p><strong>Materials and methods: </strong>The 2017 EHS parastomal hernia guidelines (Antoniou et al.) were used as the reference framework. Within a closed session, the model was instructed to apply AGREE II and GRADE principles to 52 full-text clinical papers mirroring the original EHS reference set, and to formulate recommendations for nine key clinical questions (KQs). For each KQ, the model defined PICO, summarized the evidence, rated certainty, and stated direction and strength of recommendation. AI-derived guidance was then systematically compared with EHS statements. Divergences were classified as interpretative, threshold-based (handling of low-certainty evidence), or evidence-weighting.</p><p><strong>Results: </strong>AI-generated recommendations showed full or near-full alignment with EHS guidance in most domains, including diagnosis, prophylactic mesh for permanent end colostomy, rejection of suture-only repair, preference for non-keyhole laparoscopic repair, and favouring synthetic over biologic meshes. Differences arose primarily where evidence was very low quality: the model issued cautious, conditional recommendations (e.g., watchful waiting in asymptomatic hernias, consideration of laparoscopy in suitable patients, preference for retromuscular synthetic mesh and avoidance of cross-linked collagen onlay), whereas EHS opted for no recommendation.</p><p><strong>Conclusion: </strong>Within a closed evidence base, a GPT-based model can reproduce the logic and structure of expert guideline development with high fidelity. Discrepancies mainly reflect different thresholds for acting on low-certainty evidence, supporting a complementary role for AI as a structured methodological and drafting assistant rather than a replacement for human consensus.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15992"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848235","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 Are We Still Implanting Permanent Synthetic Mesh for Hernia Repair Into Young Patients?","authors":"Samuel G Parker, Steve Halligan, Alastair C J Windsor, Sarah Zhao, Lawrence Nip, Marja A Boermeester","doi":"10.3389/jaws.2026.16654","DOIUrl":"10.3389/jaws.2026.16654","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16654"},"PeriodicalIF":0.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794178","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}