Hernias are a common medical condition characterized by the protrusion of organs or tissues through weakened muscle walls, affecting millions worldwide annually. Historically, from being treated with open surgeries using tension-free mesh repairs, the landscape of hernia repair has evolved significantly. This evolution has been marked by the advent and refinement of minimally invasive techniques, including laparoscopic and robotic-assisted approaches, which offer reduced postoperative pain, shorter recovery times, and improved patient outcomes compared to traditional methods. This comprehensive review aims to elucidate the evolution of hernia repair techniques, emphasizing the transition from conventional mesh repairs to advanced minimally invasive methodologies. By examining the historical progression and current state of hernia surgery, this review thoroughly analyzes the advancements in surgical techniques, materials, and technologies. Furthermore, it explores emerging trends such as biological meshes, ultrasound-guided procedures, and 3D printing applications in hernia repair. The clinical significance of these advancements lies in their potential to enhance the patient\'s quality of life, minimize complications, and optimize healthcare resource utilization. Insights gained from this review will inform clinicians and researchers about the efficacy, safety, and comparative effectiveness of various hernia repair approaches, guiding future directions in hernia management and fostering innovation in surgical practice.

Desmoid tumors, while generally benign histologically, can exhibit locally aggressive behavior, especially when located in the anterior abdominal wall. This case report explores the management of a rare giant desmoid tumor complicated by concurrent lymphedema, emphasizing the nuances of diagnosis, treatment decisions, and their impact on the patient\'s quality of life. The patient, a 55-year-old obese individual with a BMI of 47, presented with a 25 cm mass in the right paraumbilical region, alongside significant lymphedema in the right lower limb and associated inguinal lymphadenopathy. Abdominal CT revealed a well-defined soft tissue mass in the right paramedian hypogastric region, suggestive of a desmoid tumor. Surgical intervention involved a monobloc resection of the mass with a 5 cm lateral margin, including the right rectus abdominis muscle and associated aponeuroses, and subsequent reconstruction using a biface intraperitoneal synthetic mesh. Postoperative recovery was marked by the resolution of lymphedema and a return to full function of the affected limb. Histopathological examination confirmed the diagnosis of a desmoid tumor. This case underscores the importance of radical surgical resection with adequate margins and appropriate reconstruction to achieve favorable long-term outcomes. The report provides insights for future research and therapeutic advancements in the management of desmoid tumors.

An arcuate line hernia is a generally asymptomatic, ascending protrusion of intraperitoneal structures over the linea arcuata. Arcuate line herniae are scarcely reported in the literature. Only a few publications were found. No clear descriptions of the techniques for repair have been published either. We aim to provide diagnostic images and illustrate our method to repair this hernia.

Abdominal wall hernias are one of the most common surgical diseases present in both males and females nowadays. However, with only a few cases reported in the literature, hepatic round ligament hernias are a rare clinical manifestation. This case shows how a common symptom such as epigastric pain can be associated with this rare condition. In general, abdominal computed tomography (CT) images are the choice of study to evaluate complications and the involvement of different intestinal sections. Some laboratory tests can be performed to suspect intestinal ischemia secondary to strangulated hernias. Primary repair utilizing mesh is the preferred surgical treatment. This procedure can be performed through laparoscopic or open technique, depending on the surgeon\'s skills and patient preference.

Spigelian hernia is a rare type of abdominal wall hernia that accounts for only 0.12% of all abdominal hernias. A Spigelian hernia, also known as a spontaneous lateral ventral hernia or a hernia of the semilunar line, occurs when a part of the abdominal contents protrudes through the Spigelian fascia. Due to its anatomical location, Spigelian hernia can be difficult to diagnose through physical examination alone. Here we report a case of a 40-year-old female who experienced right abdominal pain and swelling, where ultrasonography imaging was crucial in the intraoperative diagnosis of Spigelian hernia. The patient underwent laparotomy mesh repair to address the condition. The lack of consistent physical findings and the rarity of the disease require a high level of clinical suspicion in the diagnosis of a Spigelian hernia. Its associated abdominal complaints are often vague and nonspecific, making it even more challenging. This case emphasizes the importance of utilizing imaging techniques to aid in the diagnosis of a Spigelian hernia and prompt surgical intervention to prevent complications associated with the hernia.

Transdiaphragmatic intercostal herniation is a rare injury that can be associated with blunt trauma. Since its first documentation within the literature in 1946, there have been less than 50 cases reported. We present a case involving a 56-year old female who presented to our Trauma Center with transdiaphragmatic intercostal herniation caused by blunt trauma from a high-velocity T-bone vehicular collision. Upon presentation, she exhibited bilateral breath sounds; however, with labored breathing, chest pain, and hypoxia. The initial chest radiograph interpretation indicated the presence of \"left lower lobe infiltrates\", and subsequent computed tomography imaging identified \"a small lateral hernia along the left mid abdomen\". After initial resuscitation, her condition deteriorated, exhibiting respiratory distress and becoming increasingly hypercarbic, requiring intubation. Review of the imaging showed disruption of the left hemidiaphragm with intrathoracic herniation of colon and stomach through the thoracic wall between the ninth and tenth ribs. Consequently, a thoracotomy was performed in the operating room, revealing a large defect between the two ribs with disruption of the intercostal muscles and inferior displacement of rib space. Lung and omentum had herniated through the disrupted rib space and the diaphragmatic rupture was attenuated anteriorly, measuring 11x6cm. After reduction of the herniated organs, a biologic porcine mesh was placed and an intermediate complex closure of the thoracic wall hernia was performed. The patient was later extubated, recovered from her injuries with no complications and was discharged. With the low incidence of transdiaphragmatic intercostal herniation, there is no standardized surgical management. Recent literature suggests that these injuries should be managed with mesh, rather than sutures only, due to high rates of recurrence. Furthermore, diaphragmatic injuries may suffer a delay in diagnosis. Therefore, a high index of suspicion should be maintained in patients with respiratory distress following a blunt trauma, with close review of computed tomography.

Aim: Women have the highest prevalence of epigastric hernia repair. Outcomes after epigastric hernia repair are rarely reported independently, although pathology and surgical techniques may be different than for other primary ventral hernias. The aim of this study was to evaluate long-term outcomes after epigastric hernia repairs in women on a nationwide basis. Methods: Nationwide cohort study from the Danish Hernia Database. Complete data from women undergoing elective epigastric hernia repair during a 12 years period (2007-2018) was extracted. A 100% follow-up was obtained by combining data from the National Civil Register. The primary outcome was operation for recurrence, secondary outcomes were readmission and operation for complications. Outcomes for open sutured repair, open mesh repair mesh, and laparoscopic repairs were compared. Results: In total, 3,031 women underwent elective epigastric hernia repair during the study period. Some 1,671 (55.1%) women underwent open sutured repair, 796 (26.3%) underwent open mesh repair, and 564 (18.6%) underwent laparoscopic repair. Follow-up was median 4.8 years. Operation for recurrence was higher after sutured repairs than after open mesh and laparoscopic repairs (7.7% vs. 3.3%, vs. 6.2%, p < 0.001). The risk of operation for complications was slightly higher after open mesh repair compared with sutured repair and laparoscopic repair (2.6% vs. 1.2%, vs. 2.0%, p = 0.032), with more operations for wound complications in the open mesh group (2.0%, p = 0.006). Conclusion: More than half of the women underwent a suture-based repair, although mesh repair reduces risk of recurrence. Open mesh repair had the lowest risk of recurrence, but on the expense of slightly increased risk of wound-related complications.

Abdominal wall reconstruction (AWR) is a surgical procedure performed to address various conditions such as hernias, incisional hernias, and complex abdominal wall defects. Mesh fixation plays a crucial role in providing mechanical reinforcement to the weakened abdominal wall during AWR. Traditionally, suturing has been the preferred method for mesh fixation; however, adhesion techniques using tissue adhesives or glues have gained attention as an alternative approach. This systematic review aims to compare suturing and adhesion techniques for mesh fixation in AWR and assess their effectiveness in preventing hernia recurrence. A comprehensive literature search was conducted across relevant databases, including PubMed, MEDLINE, Embase, and the Cochrane Library. Studies that fulfilled the predetermined eligibility criteria were included. The primary outcome measure of interest was hernia recurrence rates. Secondary outcomes included mesh-related complications, surgical site infections, patient-reported outcomes, and functional outcomes. A risk of bias assessment was performed for the included studies, and data were synthesized qualitatively. Overall, the results of the included studies suggest that atraumatic mesh fixation with glue may have the potential to reduce chronic groin pain (CGP). However, there were significant variations in patient selection criteria, glue administration techniques, and hernia repair methods among the trials, which limited the ability to draw definitive conclusions. Additionally, the definitions of CGP and measurement scales for postoperative pain varied across studies, making it challenging to compare outcomes. The limitations of the review include the small sample sizes in some trials, relatively short follow-up durations, and the lack of standardized criteria for assessing variables such as foreign body sensation and groin compliance. Furthermore, the economic implications of using glue fixation compared to traditional suture fixation need to be considered.

Incisional hernia (IH) is a frequent complication following abdominal surgery. The development of IH could be more sophisticated than a simple anatomical failure of the abdominal wall. Reported IH incidence varies among studies. This review presented an overview of definitions, molecular basis, risk factors, incidence, clinical presentation, surgical techniques, postoperative care, cost, risk prediction tools, and proposed preventative measures. A literature search of PubMed was conducted to include high-quality studies on IH. The incidence of IH depends on the primary surgical pathology, incision site and extent, associated medical comorbidities, and risk factors. The review highlighted inherent and modifiable risk factors. The disorganisation of the extracellular matrix, defective fibroblast functions, and ratio variations of different collagen types are implicated in molecular mechanisms. Elective repair of IH alleviates symptoms, prevents complications, and improves the quality of life (QOL). Recent studies introduced risk prediction tools to implement preventative measures, including suture line reinforcement or prophylactic mesh application in high-risk groups. Elective repair improves QOL and prevents sinister outcomes associated with emergency IH repair. The watchful wait strategy should be reviewed, and options should be discussed thoroughly during patients\' counselling. Risk stratification tools for predicting IH would help adopt prophylactic measures.

Background and objective Hernias of the abdominal wall were prevalent in people of all ages worldwide, with an overall prevalence of 1.7 percent. Recently, laparoscopic and Lichtenstein mesh repairs have become popular as they provide a rapid return to normal activities with low recurrence rates. There is a relatively high risk of complications following hernia repair, such as wound seroma/hematoma, urinary retention, and superficial incisional infection. As for complications that may develop after hernia repair, we discussed risk factors contributing to postoperative complications after hernia repair in this study. Methods This study was a retrospective descriptive study of all patients who underwent hernia repair. The cohort of patients data would be collected from patients using an interview-based questionnaire. The data obtained will be entered into a spreadsheet and analyzed using the Statistical Package for the Social Sciences (SPSS) 23.0 package (IBM Corp., Armonk, NY). Results In the current study, we collected data from 274 patients with hernia. The majority of participants were male (79.9%, n = 219), while (37.7%, n = 100) overweight, and (29.8%, n = 79) obese. Among the participants, (82.8%, n = 227) did not experience any complications, while (17.2%, n = 47) reported complications. The types of complications observed were as follows: seroma formation (2.9%, n = 8), wound infection (5.8%, n = 16), and mesh infection (1.8 %, n = 5). There were no significant associations between gender and the presence of complications. However, a significant association was found between BMI and complications (p < 0.001). Diabetes mellitus also showed a significant association with complications (p = 0.005), with a higher proportion of complications among participants with diabetes. Conclusion In the current study, we found a significant prevalence of postoperative complications with significant risk factors such as obesity and diabetic mellitus. Additional investigation is warranted to validate these correlations and investigate supplementary variables that could potentially contribute to postoperative problems in hernia surgery.