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

The incidence of hiatal hernia is on the rise due to population aging and improved awareness of the disease. Laparoscopic repair is the main treatment modality; however, there remains a lack of consensus on the selection of mesh materials and operative specifications. Based on high-level evidence, this expert consensus has formulated 11 recommendations regarding the indications for mesh application, material selection, and operative methods: For patients with giant hiatal hernias (defect area >10 cm², hiatal diameter ≥ 5 cm, or over 1/3 of the gastric body entering the thoracic cavity), complex hernias, recurrent hernias, or those with weak diaphragmatic crura, mesh-reinforced repair is recommended to reduce the risk of recurrence. Synthetic meshes are suitable for giant/complex hernias; biological meshes help reduce foreign body reactions; and bioabsorbable synthetic meshes combine mechanical strength with safety. The preferred shape of the mesh is U-shaped, and fixation methods (non-absorbable sutures, absorbable staplers, or medical adhesives) are selected based on hernia size and anatomical features. For suturing the diaphragmatic crura, non-absorbable sutures are recommended, with the choice between interrupted or continuous suturing techniques tailored to patient characteristics. The method of fundoplication is determined according to esophageal pH measurement and lower esophageal sphincter pressure, and non-absorbable sutures are recommended for plication.
Humans ; Hernia, Hiatal/surgery* ; Laparoscopy/methods* ; Surgical Mesh ; Herniorrhaphy/methods*

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*

Pantaloon hernias are a subset of abdominal hernias wherein both indirect and direct components of inguinal hernias are present on one side. Inguinoscrotal hernia of the urinary bladder is a rare condition involved in less than 4% of inguinal hernias and more so if they are part of a direct component of a pantaloon hernia. This is a case of a 65-year-old male who presented a non-reducible right inguinoscrotal mass. Inguinoscrotal herniation of the urinary bladder was preoperatively diagnosed through imaging. Intra-operatively a pantaloon hernia was noted with the herniated urinary bladder as the direct component and omentum as the indirect component. The patient underwent cystourethroscopy, inguinal exploration right, and mesh hernioplasty. The patient had an unremarkable post-operative course and was discharged with improved conditions. Awareness of this clinical condition will aid in the diagnosis, and proper management and prevent post-operative complications.
Herniorrhaphy

Objective: To analyze the short-term clinical effects of robot-assisted and laparoscopic repair of the hiatal hernia. Methods: The clinical data of 56 patients underwent minimally invasive hiatal hernia repair from January 2021 to January 2022 in the Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. There were 32 males and 24 females, aging (59.7±10.7) years (range: 28 to 75 years). All patients were divided into laparoscopy group (n=27) and robot group (n=29) according to surgical procedures. Perioperative conditions, hospital stay, and improvement in symptoms before and after surgery were compared between the two groups by the t test, Wilcoxon rank-sum test and χ² test. Results: All surgical procedures were successfully completed, without conversion to laparotomy or change in operation mode. There were no serious complications related to the operation. The intraoperative blood loss of the robot group was less than that of the laparoscopic group (M (IQR)): (20 (110) ml vs. 40 (80) ml, Z=-4.098, P<0.01). The operation time ((111.7±33.6) minutes vs. (120.4±35.0) minutes, t=-0.943, P=0.350) and hospitalization time ((3.9±1.4) days vs. (4.7±1.9) days, t=-1.980, P=0.053) of the robot group and the laparoscopic group were similar. Follow-up for 12 months after the operation showed no postoperative complications and recurrence. The score of the health-related quality of life questionnaire for gastroesophageal reflux disease in the robot group decreased from 10.8±2.8 before the operation to 6.5±0.6 after the operation, and that in the laparoscopic group decreased from 10.6±2.1 before the operation to 6.3±0.6 after the operation. There was no difference in the influence of different surgical methods on the change in score (t=0.030,P=0.976). Conclusion: Compared with laparoscopic repair of the hiatal hernia, robot-assisted hiatal hernia repair has the advantages of less bleeding, rapid postoperative recovery and good short-term effect.
Male ; Female ; Humans ; Hernia, Hiatal/complications* ; Retrospective Studies ; Robotics ; Herniorrhaphy/methods* ; Quality of Life ; Laparoscopy/methods* ; Recurrence ; Fundoplication/methods*

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

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