Journal of abdominal wall surgery : JAWS最新文献

{"title":"InguinoScrotal Hernias: Comparison of Minimally Invasive Approaches and Open Surgical Repair (The SCAR Study).","authors":"Riccardo Caruso, Emilio Vicente, Yolanda Quijano, Jorge Zarate Gomez, Belen Porrero Guerrero, Álvaro Valdés de Anca, Maria Teresa Alonso Garcia, Álvaro Morales Taboada, Pablo Pastor Riquelme, Sergio Salido Fernandez, Javier Serrano Gonzalez, Ana Pilar Morante Perea, Valentina Ferri","doi":"10.3389/jaws.2026.15830","DOIUrl":"10.3389/jaws.2026.15830","url":null,"abstract":"<p><strong>Introduction: </strong>Inguinal hernia repair is one of the most common surgical procedures performed worldwide. Minimally invasive approaches (laparoscopic and robotic) are increasingly recommended owing to their favorable postoperative outcomes. However, their use in inguinoscrotal hernias remains limited. This study aims to evaluate and compare clinical outcomes of minimally invasive and open approaches in inguinoscrotal hernia repair.</p><p><strong>Methods and analysis: </strong>This national multicenter prospective observational cohort study will include patients undergoing elective or urgent repair of European Hernia Society-classified inguinoscrotal hernias (S1-S3) using open, laparoscopic, or robotic techniques. Adults (>18 years) from various hospitals in Madrid will be recruited. Data on patient demographics, intraoperative variables, postoperative complications, postoperative pain (Visual Analog Scale score), quality of life, and hernia recurrence over a 2-year follow-up will be collected. A minimum of 100 patients (50 per group) is required for detecting statistically significant differences, assuming 5% loss to follow-up.</p><p><strong>Ethics and dissemination: </strong>The HM Hospitales Ethics Committee has approved the study protocol. Written informed consent will be obtained from all participants. Results will be submitted to peer-reviewed journals and presented at national surgical conferences.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15830"},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794181","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: Use of Botox in Abdominal Wall Hernia Surgery.","authors":"Pilar Hernández Granados, Mette Willaume Christoffersen","doi":"10.3389/jaws.2026.16597","DOIUrl":"10.3389/jaws.2026.16597","url":null,"abstract":"","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16597"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794231","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":"How Reproducible Are Abdominal Wall Surgical Techniques? A Methodological Assessment of Technical Reporting in the Contemporary Literature.","authors":"Francesco Brucchi, Rita Stanco, Gianlorenzo Dionigi, Filip Muysoms","doi":"10.3389/jaws.2026.16371","DOIUrl":"10.3389/jaws.2026.16371","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the completeness and reproducibility of technical reporting in contemporary abdominal wall hernia literature, and to assess the risk of misinterpretation when surgical techniques are classified based solely on titles and abstracts.</p><p><strong>Methods: </strong>A descriptive methodological analysis was conducted on original studies published between 2000 and November 2025 reporting abdominal wall hernia repair techniques. The unit of analysis was the surgical technique (surgical arm). Each technique was assessed across five predefined technical domains essential for reproducibility: surgical approach, hernia type, mesh position, mesh type, and fixation method. Techniques were classified as fully reproducible only when all domains were explicitly reported. A secondary analysis evaluated immediate interpretability based on title and abstract information. Terminological variability was explored by identifying distinct acronyms used for identical technical configurations.</p><p><strong>Results: </strong>Two hundred articles comprising 290 surgical arms were analyzed. Surgical approach and hernia type were almost universally reported (≥99%). In contrast, mesh-related domains were inconsistently described, with mesh position and fixation reported in 81.4% and mesh type in 71.7% of arms. Overall, only 51.7% of techniques were fully reproducible based on full-text assessment. When limited to titles and abstracts, complete interpretability dropped to 3.4%, indicating a high risk of technical misclassification. Substantial terminological redundancy was observed, with up to 16 different acronyms used to describe identical technical configurations.</p><p><strong>Conclusion: </strong>Technical reporting in abdominal wall surgery is frequently incomplete, substantially limiting reproducibility, evidence synthesis, and reliable interpretation, particularly when relying on titles and abstracts. Excessive and inconsistent use of acronyms further amplifies ambiguity. The strict reliance on explicit reporting may overestimate non-reproducibility in real-world practice, and the study was not designed for exhaustive literature coverage. Adoption of structured, component-based reporting frameworks may represent a pragmatic pathway toward improving clarity, reproducibility, and methodological rigor in abdominal wall surgery.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16371"},"PeriodicalIF":0.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725453","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":"Prevention with Sublay Mesh of Trocar Site Hernia (PRESUME): Study Protocol for a Multicenter Randomized Controlled Trial.","authors":"Emma Sánchez-Sáez, Enric Sebastian-Valverde, Ramon Vilallonga Puy, Ana Ciscar Bellés","doi":"10.3389/jaws.2026.16067","DOIUrl":"10.3389/jaws.2026.16067","url":null,"abstract":"<p><strong>Background: </strong>Trocar Site Incisional Hernia (TSIH) is the most common postoperative complication after laparoscopic surgery, with incidences exceeding 30% in high-risk patients. Despite advances in minimally invasive approaches, optimal preventive strategies remain uncertain, and evidence comparing closure or reinforcement techniques is limited. Prophylactic mesh use shows benefits in open surgery, but its role in laparoscopy requires further clarification.</p><p><strong>Objective: </strong>The PRESUME study evaluates whether prophylactic sublay mesh placement at the umbilical trocar site reduces TSIH incidence in patients undergoing laparoscopic cholecystectomy who present at least one established risk factor. Secondary objectives include assessing mesh-related complications and short- and long-term postoperative outcomes.</p><p><strong>Methods: </strong>This prospective, multicentre, randomised controlled trial provides Level I evidence. Eligible participants are adults scheduled for laparoscopic cholecystectomy with diabetes mellitus, BMI ≥30 kg/m², age ≥65 years, or requiring umbilical incision enlargement. Patients will be randomised 1:1 to standard aponeurotic closure or intraperitoneal sublay mesh reinforcement (Ventralex™ ST). Follow-up visits are scheduled at 30 days, 6 months, 1 year-with ultrasound-and 2 years. The principal investigator will remain blinded during follow-up. The primary endpoint is TSIH incidence; secondary outcomes include surgical site events, postoperative pain, readmissions, and time to return to daily activities. Based on expected TSIH reduction from 35% to 10%, 42 patients per arm are required.</p><p><strong>Discussion: </strong>TSIH remains a significant postoperative issue with limited preventive evidence in laparoscopy. By assessing the efficacy and safety of prophylactic sublay mesh reinforcement, the PRESUME trial may support future recommendations and improve outcomes in high-risk patients.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16067"},"PeriodicalIF":0.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680110","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":"Large Language Models in Surgery: Promise, Pitfalls, and Practical Use.","authors":"Danette T Denham, Colin Y Wang, Emil Maric, Lucy R Hinton, B Todd Heniford","doi":"10.3389/jaws.2026.16349","DOIUrl":"10.3389/jaws.2026.16349","url":null,"abstract":"<p><strong>Background: </strong>Large Language Models (LLMs) represent a transformative advancement in artificial intelligence (AI) with rapidly expanding applications in medicine. While AI-related medical publications increased 36-fold between 2000-2022, practical guidance for surgeons remains limited. This mini-review delineates pragmatic applications of LLMs in surgical practice while addressing key limitations, implementation considerations, and ethical considerations.</p><p><strong>Methods: </strong>We reviewed contemporary LLM platforms and their integration into clinical workflows, patient communication, surgical research and academic writing, evaluating both benefits, constraints and risk mitigation relevant to practicing surgeons.</p><p><strong>Findings: </strong>LLMs demonstrate significant utility across multiple domains. In clinical workflows, ambient documentation and chart summarization may reduce documentation burden and support rapid synthesis of complex patient data. For patient communication, these tools can simplify complex medical information, tailor or translate patient instructions to appropriate reading levels or languages, and generate empathetic responses to patient messages with improved efficiency. In research, LLMs assist with literature summarization, study design optimization, and risk of bias assessment in RCT, allowing surgeons to focus on higher-level scientific reasoning. Despite promising applications, several constraints demand attention. Effective prompting requires specific techniques including clear clinical objectives, explicit instructions, and iterative refinement. LLM outputs require verification to prevent \"hallucinations\" - fabricated or inaccurate information. Protected health information (PHI) must never be entered into public LLM platforms to maintain HIPAA compliance. Liability frameworks for AI-generated errors remain ambiguous, with unclear responsibility deferred amongst providers, institutions, and developers.</p><p><strong>Conclusion: </strong>LLMs offer surgeons valuable tools for enhancing workflow efficiency and patient communication when deployed with appropriate oversight. Success requires understanding prompt engineering principles, maintaining rigorous fact-checking protocols, protecting patient privacy, and recognizing that human judgment remains irreplaceable in clinical decision-making.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16349"},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680120","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":"An Analysis of Biomechanical and Physiological Changes During Abdominal Wall Reconstruction.","authors":"S G Parker, A L A Bloemendaal, T Pampiglione, S Mallett, S Halligan, J McCullough, A C J Windsor, A A O Plumb","doi":"10.3389/jaws.2026.16437","DOIUrl":"10.3389/jaws.2026.16437","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal wall reconstruction (AWR) creates biomechanical and physiological changes, impacting the respiratory system. We assessed how dynamic lung compliance (LC) changed in response to intra-abdominal pressure (IAP) and closure forces. Secondarily, we investigated if patient, radiological, or biomechanical factors were identifying predictors of physiological changes.</p><p><strong>Materials and methods: </strong>We performed a prospective observational study in patients undergoing complex ventral hernia repair. LC was measured during 3 intra-operative stages after full muscle relaxation. Primary outcome was change in LC between completion of adhesiolysis and closure. Additionally, we measured force and distance required for midline closure.</p><p><strong>Results: </strong>Nineteen patients (median age 63) underwent AWR. Median hernia volume was 437 cm³ (IQR, 233-1,608). Mean LC change was -6.8 mL/cmH₂O (±6 SD). Mean IAP increase was 3 mmHg (±1.7 SD). LC reduced and IAP increased between adhesiolysis and skin closure, significantly (<i>P</i> < 0.001). Increased midline closure distance was positively associated with increased closure force (<i>P</i> = 0.03, 0.12N, 95% CI 0.21-4.0). There was no evidence that increased closure force reduced LC or raised final IAP. Preoperative FEV1 and BMI were associated with reduced final LC (<i>P</i> = 0.05, 6.23L 95% CI 0.05 to 12.4; <i>P</i> = 0.03, -0.74 kg/m2, 95% CI -1.4 to -0.07). There was no evidence of an association between radiological measurements and change of LC or IAP.</p><p><strong>Discussion: </strong>Reduced LC is positively associated with increased IAP. However, there is no evidence increased closure forces affect final LC or IAP. Pre-operative optimisation of BMI or pre-operative FEV1 may have more impact than hernia morphology on LC reduction.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16437"},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680075","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":"Improving Intraoperative Compliance With Critical View of the Myopectineal Orifice Criteria Using the V-M Pathway During Laparoscopic Inguinal Hernia Repair.","authors":"Kryspin Mitura, Laura Kacprzak, Marta Wojcik, Lidia Mitura, Michal Romanczuk, Bernard Mitura, Orest Lerchuk, Volodymyr Khomyak, Orest Chemerys, Piotr Niecikowski","doi":"10.3389/jaws.2026.16223","DOIUrl":"10.3389/jaws.2026.16223","url":null,"abstract":"<p><strong>Background: </strong>The CVMPO criteria were developed to standardize critical quality steps during laparoscopic inguinal hernia repair. However, consistent intraoperative compliance remains challenging, particularly during prolonged or technically difficult procedures, or under cognitive fatigue. Checklist-based approaches may be difficult to recall and apply in real time.</p><p><strong>Methods: </strong>A prospective observational study included 211 consecutive laparoscopic inguinal hernia repairs performed using a standardized technique. An original spatial cognitive framework, the V-M Pathway, mapping CVMPO criteria onto the laparoscopic view of the inguinal region, was applied as a deliberate intraoperative pause before mesh placement. Time required to verbally recall all nine CVMPO criteria was measured intraoperatively. All procedures were routinely recorded in full from the beginning to the end of the operation. Surgeon-identified corrective actions prompted by CVMPO recall were documented during the procedure. The time required to implement corrective actions was determined postoperatively based on independent review of the complete operative video recordings. All procedures underwent <i>post hoc</i> video verification to confirm objective adherence to the CVMPO criteria.</p><p><strong>Results: </strong>Complete recall of all nine CVMPO criteria using the V-M Pathway was achieved in all procedures, with a median recall time of 58 s (IQR 52-64). Intraoperative recall prompted corrective actions in 20.4% of cases. Among procedures requiring corrective actions, the median time required to complete all corrections was 46 s (IQR 38-81). Independent video review confirmed complete adherence to all CVMPO criteria in 97.2% of procedures. Mesh placement was performed only after CVMPO confirmation in all cases.</p><p><strong>Conclusion: </strong>The V-M Pathway supported rapid intraoperative recall of CVMPO criteria, prompted timely corrective actions, and was associated with high video-verified adherence to predefined quality criteria. Importantly, the additional time required for recall and corrective actions represented only a small fraction of total operative time, suggesting that integration of the pathway is feasible without major workflow disruption. This simple spatial cognitive aid may support intraoperative verification of quality criteria during laparoscopic inguinal hernia repair without disrupting operative workflow.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16223"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647970","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 and Laparoscopic Inguinal Hernia Repair in Africa: Current Adoption, Challenges, and Future Horizons.","authors":"Adebayo Falola, Murtaja Satea, Pedro Vega Guillen, Rodolfo J Oviedo","doi":"10.3389/jaws.2026.14775","DOIUrl":"10.3389/jaws.2026.14775","url":null,"abstract":"<p><p>Inguinal hernia repair is one of the most common surgical procedures performed globally. Laparoscopic inguinal hernia repair (LIHR) is recognized globally to be effective and safe, with advantages over open surgery, but its implementation across the African continent has been slow, with only 12 countries reporting implementation, and only 3.3% of inguinal hernia repairs in sub-Saharan Africa performed using laparoscopic techniques. Robotic surgery, although still emerging within the continent, with around 20 robots primarily used in urology across South Africa, Egypt, Morocco, Angola, and Tunisia, no reports of robotic inguinal hernia repair currently exist. Progress, however, is being observed with the growing interest from surgical societies, private-sector robotic expansion, and humanitarian missions introducing mesh-based and limited laparoscopic procedures. Limitations include the low global utilization of minimally invasive surgery (MIS) for hernia repair despite guideline recommendations. This has been attributed to training challenges, steep learning curve, and limited evidence of benefit for bilateral and recurrent hernias. African-specific challenges include costs, inadequate training opportunities, surgeon preference, ongoing debates regarding its necessity in low-resource settings, lack of institutional support, and resource prioritization for other MIS procedures such as cholecystectomy and prostatectomy. Despite ongoing challenges, investments in research, training and cost-effective equipment, increased availability of mesh, and integration of humanitarian hernia missions into national training systems, can enhance adoption and contribute to better surgical outcomes for patients. This narrative review presents the present state of robotic and laparoscopic inguinal hernia repair in Africa, as well as the current challenges, and recommendations to improve adoption.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"14775"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625366","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":"Advances in Intestinal Restoration and Abdominal Wall Reconstruction in Bogotá: A Two-Stage Approach During the Same Hospitalization.","authors":"Juan Pablo Ruiz, Neil Valentín Vega, Alejandro Lora Aguirre, Arnold José Barrios, Angie Carolina Riscanevo Bobadilla, Julián Orrego","doi":"10.3389/jaws.2026.15885","DOIUrl":"10.3389/jaws.2026.15885","url":null,"abstract":"<p><strong>Background: </strong>The available evidence regarding the sequential performance of gastrointestinal tract restoration and abdominal wall reconstruction in two surgical stages during a single hospitalization is limited and is based primarily on case series. In this study, we present our experience with the aim of describing the outcomes obtained in the repair of complex abdominal wall defects and the restoration of intestinal continuity using a two-stage approach within the same hospital stay.</p><p><strong>Methods: </strong>Case series of patients who underwent elective surgery for gastrointestinal tract restoration, followed by abdominal wall reconstruction in a second surgical stage during the same hospitalization. Medical records of procedures performed between 2018 and 2023 were reviewed. All interventions were carried out electively by a multidisciplinary team involving the abdominal wall surgery group and colorectal surgery.</p><p><strong>Results: </strong>A total of 30 patients were included. Both surgical procedures were completed in 73% of cases, with a mean interval of 6.3 days between the two surgeries. In 26% of patients, it was not possible to complete both procedures; the most frequent causes were anastomotic leakage and surgical site infection, each occurring in 9% of cases. The mean length of hospital stay was 14 days. The most common complications were postoperative ileus, anastomotic leakage, intestinal perforation, and deep surgical site infection.</p><p><strong>Conclusion: </strong>Although concomitant surgery is associated with a higher risk of complications particularly in the setting of complex hernias-in appropriately selected patients, sequential procedures performed during the same hospitalization can achieve favorable outcomes, especially in stoma reversal. The implementation of prehabilitation programs and the adoption of shared decision-making models are essential to optimize outcomes and reduce associated morbidity.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"15885"},"PeriodicalIF":0.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597317","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":"EHS Guidelines on the Management of Primary Ventral and Incisional Hernias Under Emergency Conditions.","authors":"Cesare Stabilini, Alexis Theodorou, Maciej Pawlak, Stavros Antoniou, Frederik Berrevoet, Heather Bougard, Umberto Bracale, Sara Capoccia Giovannini, René Fortelny, Christine Gaarder, Miguel Angel Garcia-Urena, Katie Gilmore, Sergio Alejandro Gomez-Ochoa, Ferdinand Köckerling, Elisa Mäkäräinen, Salvador Morales-Conde, Francesca Pecchini, José Antonio Pereira Rodríguez, Andrea Carolina Quiroga-Centeno, Yohann Renard, Benoit Romain, Elena Schembari, Eva Deerenberg","doi":"10.3389/jaws.2026.16228","DOIUrl":"10.3389/jaws.2026.16228","url":null,"abstract":"<p><strong>Introduction: </strong>Emergent primary ventral or incisional hernias (PVIHs) are a common cause of surgical admission, leading to significantly higher rates of morbidity and mortality compared to elective hernia repairs. Despite this, management varies widely due to a lack of evidence-based consensus. This article presents the new European Hernia Society (EHS) guidelines for the emergency treatment of adult patients with PVIH.</p><p><strong>Material and methods: </strong>This project was developed by the EHS Science Committee following AGREE-S, GRADE, and GIN standards. A guideline panel, composed of general and emergency surgeons along with patient partners, formulated seven key health questions addressing the surgical approach, mesh type and placement, and the management of defects of varying sizes and contamination levels to support general surgeons in their decision-making process. A systematic review was conducted, and recommendations were developed using a formal evidence-to-decision framework, ensuring consensus was reached on all recommendations.</p><p><strong>Results: </strong>The guidelines expert panel provides recommendations for several clinical scenarios. For defects amenable to direct closure, mesh-based repair is suggested over primary suture repair, regardless of the contamination grade. Furthermore, a laparoscopic approach with intraperitoneal mesh, an open approach with onlay mesh placement, and the use of large-pore synthetic meshes are recommended. For large defects, not amenable to closure, a staged approach that avoids immediate mesh-based repair is suggested.</p><p><strong>Conclusion: </strong>Adherence to these guidelines can help standardise the management of emergent PVIHs, potentially improving patient outcomes. The recommendations advocate for a \"damage control\" mindset, prioritising physiological stability over immediate definitive reconstruction. Further research is needed to address gaps in the current literature, particularly with regard to long-term recurrence rates and the specific protocols for managing these complex cases.</p>","PeriodicalId":516856,"journal":{"name":"Journal of abdominal wall surgery : JAWS","volume":"5 ","pages":"16228"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625373","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}