In recent years, the diagnosis and treatment of groin hernia have become more mature, and personalized treatment plans for different groin hernias have become more standardized. On the basis of the Guidelines for diagnosis and treatment on the adult groin hernia (2018 edition), more than 70 experts and scholars in China have discussed the consultation and modified the content of diagnosis and treatment of groin hernia in children and adolescents, diagnosis and treatment of scrotal hernia, management of hernia related complications, and postoperative education and follow-up in this new edition, combined with evidence-based medical evaluation standards. The relevant medical institutions and peers in China are requested to carry out the actual clinical reference.
Adolescent ; Adult ; Child ; Humans ; Hernia, Inguinal/therapy* ; Herniorrhaphy

Incisional hernia is a type of iatrogenic disease, and its clinical treatment is complicated. In recent years, there have been new advances in the diagnosis, surgical methods, and materials science of incisional hernias. On the basis of the Guidelines for diagnosis and treatment of abdominal wall incisional hernia (2018 edition), more than 70 experts and scholars over the country have discussed the consultation and modified the issues such as complex abdominal wall conditions, loss of domain, principles of incisional hernia treatment, techniques of abdominal wall hernia defects closure, perioperative management, and follow-up in this new edition, combined with evidence-based medical evaluation standards. The relevant medical institutions and peers in China are requested to carry out the actual clinical reference.
Humans ; Abdominal Wall/surgery* ; Incisional Hernia/therapy* ; Herniorrhaphy/methods* ; Practice Guidelines as Topic

Incisional hernia is a type of iatrogenic disease, and its clinical treatment is complicated. In recent years, there have been new advances in the diagnosis, surgical methods, and materials science of incisional hernias. Based on the Guidelines for Diagnosis and Treatment of Abdominal Wall Incisional Hernia (2018 Edition), more than 70 domestic experts have evaluated related publications using standards of evidenced-based medicine. Issues such as complex abdominal wall status, loss of domain, principles of incisional hernia treatment, techniques of abdominal wall hernia defects closure, perioperative management, and follow-up have been modified in the 2025 edition for the reference of clinicians.
Humans ; Incisional Hernia/surgery* ; Abdominal Wall/surgery* ; Hernia, Abdominal/therapy* ; Herniorrhaphy ; Practice Guidelines as Topic

In recent years, the diagnosis and treatment of inguinal hernia have become mature, and personalized treatment plans for different inguinal hernias have become more standardized. Based on the Guidelines for Diagnosis and Treatment on the Adult Inguinal Hernia (2012 & 2014 Edition), more than 70 domestic experts have evaluated related publications using standards of evidenced-based medicine. Major modifications include diagnosis and treatment of inguinal hernia in children and adolescents, diagnosis and treatment of scrotal hernia, management of hernia related complications, and postoperative education and follow-up in this new edition, for the reference of clinicians.
Humans ; Hernia, Inguinal/surgery* ; Practice Guidelines as Topic

Pneumothorax during pediatric laparoscopic surgery is a potentially fatal complication that may not be promptly recognized. It can occur due to congenital anatomical abnormalities, pre-existing pulmonary disease, or operative factors during laparoscopy. Clinical presentation may range from asymptomatic to acute respiratory distress, pleuritic chest pain, and even life-threatening circulatory collapse. Here, we report a case of sudden intraoperative pneumothorax accompanied by extensive subcutaneous emphysema of the neck and chest wall during laparoscopic high ligation of the hernial sac in a child. The child presented with a reducible left lower abdominal mass and mild pain 3 days prior but did not seek medical attention. Symptoms worsened 1 day prior to admission, with difficulty reducing the mass. On April 8, 2021, the patient was admitted to the Department of Anesthesiology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine of Central South University, with a diagnosis of "left inguinal hernia." On the second day of hospitalization, laparoscopic high ligation of the left inguinal hernia sac was performed under general anesthesia. During the procedure, the patient developed a sudden increase in airway pressure, marked hemodynamic fluctuations, crepitus in the neck and right anterior chest regions, and significantly diminished breath sounds in the right lung. Emergent bedside chest X-ray confirmed a right-sided pneumothorax. Immediate intervention including thoracic needle decompression, closed thoracic drainage, the lung re-expansion was performed. The patient was discharged on the 7th postoperative day with full recovery. This case highlights the need for clinicians to remain vigilant for iatrogenic pneumothorax during pediatric laparoscopic surgery. Close intraoperative monitoring of vital signs is crucial for early detection, recognition, and timely management of pneumothorax to ensure patient safety during minimally invasive procedures.
Humans ; Laparoscopy/methods* ; Pneumothorax/etiology* ; Ligation/methods* ; Hernia, Inguinal/surgery* ; Male ; Intraoperative Complications/etiology* ; Child ; Herniorrhaphy/methods* ; Female ; Subcutaneous Emphysema/etiology*

Hernia and abdominal wall surgery is a relatively new subspecialty in surgery. Although it started late in China, after 25 years of rapid development, it has made remarkable achievements and has become an important part of surgery, laying a solid foundation for the further development of the discipline. At the same time, one should also be soberly aware of the present deficiencies in this field. The development of the field should be more detailed and in-depth from the following aspects: correct understanding of new concepts of hernia and abdominal wall surgery, establishment of hernia patient registration and quality control system, technological innovation and development of technical equipment, especially the expansion of robot surgical systems, materials science progression to hernia and abdominal wall surgery. Faced with this challenge, China is expected to achieve high-quality development in the field of hernia and abdominal surgery.
Humans ; Abdominal Wall/surgery* ; Herniorrhaphy ; Hernia ; China ; Hernia, Ventral/surgery* ; Surgical Mesh

The incidence of parastomal hernia is substantially high, significantly affecting the quality of life of patients with stoma. How to effectively solve the problem of parastomal hernia is a long-term focus of hernia and abdominal wall surgery and colorectal surgery. The European Hernia Society guidelines on prevention and treatment of parastomal hernia published in 2018 has recommended the use of a prophylactic mesh to prevent parastomal hernia for the first time. In the following 5 years, more randomized controlled trials of multi-center, large-sample, double-blind, long-term follow-up have been published, and no significant effect of mesh prophylaxis has been observed on the incidence of parastomal hernia. However, whether mesh could decrease surgical intervention by limiting the symptoms of parastomal hernias would become a potential value of prophylaxis, which requires further research to elucidate.
Humans ; Hernia, Ventral/surgery* ; Surgical Mesh/adverse effects* ; Quality of Life ; Incisional Hernia/prevention & control* ; Surgical Stomas/adverse effects* ; Evidence-Based Medicine ; Colostomy/adverse effects* ; Randomized Controlled Trials as Topic

Complex ventral hernia refers to a large hernia that is complicated by a series of concurrent conditions. Change in intra-abdominal pressure is one of the main pathways through which various factors exert an impact on perioperative risk and postoperative recurrence. Taking abdominal pressure reconstruction as the core, the treatment strategy for complex abdominal hernia can be formulated from three aspects: improving patients' tolerance, expanding abdominal cavity volume, and reducing the volume of abdominal contents. Improving patients' tolerance includes abdominal wall compliance training and progressive preoperative pneumoperitoneum. To expand the volume of the abdominal cavity, implanting hernia repair materials, component separation technique, autologous tissue transplantation, component expend technique, and chemical component separation can be used. Initiative content reduction surgery and temporary abdominal closure may be performed to reduce the volume of abdominal contents. For different cases of complex ventral hernia, personalized treatment measures can be safely and feasibly adopted depending on the condition of the patients and the intra-abdominal pressure situation.
Humans ; Hernia, Ventral/surgery* ; Abdominal Wall/surgery* ; Plastic Surgery Procedures ; Herniorrhaphy/methods* ; Surgical Mesh ; Recurrence

With the development of modern surgery, the field of hernia and abdominal wall surgery is undergoing a transformative change, and new techniques, new concepts, and recent progress are being updated, which have motivated the high-quality development of the discipline. In the past two decades, the development of hernia and abdominal wall surgery in China has been recognized by international peers. Many young surgeons have gradually become the main force in the treatment of hernia and leaders in surgical technique. The innovation and development of discipline will never terminate; young surgeons as the main force should seriously think about how to improve their professional qualities. Young surgeons are interested in the innovation of surgical techniques and need to push for a traditional operation on the one hand and an innovative operation on the other. Updates to concepts and acquisition of new materials are more important, which can provide a solid foundation for technological innovation. Young surgeons should start with the basics and classics. Understanding the history and development of new techniques, new concepts and recent progress, and grasping indications of clinical application, is the important part of growing up for young surgeons, which can make surgical treatment more standardized, benefit patients, and promote the progress of Chinese specialized medical education.
Humans ; Abdominal Wall/surgery* ; Hernia ; Surgeons ; Herniorrhaphy/methods* ; China ; Surgical Mesh

Objective: To examine the preliminary effect of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis for the prevention of parastomal hernia after abdominoperineal resection for rectal cancer. Methods: This study is a prospective case series study. From June 2021 to June 2022, patients with low rectal cancer underwent laparoscopic abdominoperineal resection combined with extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis at the First Department of General Surgery, Shaanxi Provincial People's Hospital were enrolled. The clinical data and postoperative CT images of patients were collected to analyze the incidence of surgical complication and parastomal hernia. Results: Totally 6 cases of patient were enrolled, including 3 males and 3 females, aging 72.5 (19.5) years (M(IQR)) (range: 55 to 79 years). The operation time was 250 (48) minutes (range: 190 to 275 minutes), the stoma operation time was 27.5 (10.7) minutes (range: 21 to 37 minutes), the bleeding volume was 30 (35) ml (range: 15 to 80 ml). All patients were cured and discharged without surgery-related complications. The follow-up time was 136 (105) days (range: 98 to 279 days). After physical examination and abdominal CT follow-up, no parastomal hernia occurred in the 6 patients up to this article. Conclusions: A method of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis is established. Permanent stoma can be completed with this method safely. It may have a preventive effect on the occurrence of parastomal hernia, which is worthy of further study.
Male ; Female ; Humans ; Colostomy/methods* ; Rectus Abdominis ; Laparoscopy/methods* ; Incisional Hernia/surgery* ; Rectal Neoplasms/surgery* ; Hernia, Ventral/surgery* ; Surgical Mesh/adverse effects*