Laparoscopic hiatal hernia repair combined with fundoplication has become the standard surgical procedure for moderate to severe hiatal hernia, but intraoperative bleeding, postoperative dysphagia, hernia recurrence, and mesh-related complications remain significant concerns. This article summarizes the prevention and management strategies for these core complications based on the clinical data and surgical experience of 432 patients with moderate to severe hiatal hernia who underwent laparoscopic hiatal hernia repair combined with fundoplication at the Department of Hernia and Abdominal Wall Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, from 2018 to 2023. The overall complication rate in the 432 patients was 15.3% (66 cases). Among intraoperative complications, bleeding was the most common, occurring in 30 cases (6.9%). Among postoperative complications, dysphagia was the most frequent, occurring in 52 cases (12.0%). Hernia recurrence occurred in 8 cases (1.9%), and mesh-related complications in 3 cases (0.7%). Univariate analysis showed that age ≥50 years and Nissen fundoplication were associated factors for postoperative dysphagia (both P<0.05). By standardizing preoperative evaluation, optimizing surgical approach selection, strengthening intraoperative precise manipulation, and establishing stepwise management protocols, the incidence of complications can be effectively reduced. Individualized surgical strategies based on precise anatomy, standardized operative procedures, and stepwise management approaches are key to reducing complications and improving surgical safety.

To assess the intraoperative and postoperative safety and efficacy of robotic-assisted sleeve gastrectomy combined with fundoplication and hiatal hernia repair (SGFD+HHR).

This single-center retrospective cohort study included 76 patients with obesity and hiatal hernia who underwent either robotic-assisted or laparoscopic SGFD+HHR at the People's Hospital of Xinjiang Uygur Autonomous Region between January 2020 and July 2024. The patients were divided into a laparoscopic group (n=51) and a robotic group (n=25) based on the surgical approach. Perioperative parameters, postoperative weight loss efficacy, complication rates, Gastroesophageal Reflux Disease Questionnaire (GerdQ) scores, and reflux improvement were compared between the two groups.

There were no statistically significant differences between the two groups in baseline characteristics, operative duration, time to meeting discharge criteria, body weight and body mass index at baseline and 6 and 12 months postoperatively, percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL) at 6 and 12 months postoperatively, the incidence of early and long-term postoperative complications, GerdQ score, or reflux improvement at 12 months postoperatively (all P>0.05). However, the robotic group had less intraoperative blood loss than the laparoscopic group (Z=-3.913, P<0.001). In both groups, GerdQ scores at 12 months postoperatively were significantly lower than baseline scores (Z=-3.650 and -3.611, respectively; both P<0.001).

For patients with obesity and hiatal hernia, both robotic-assisted and laparoscopic SGFD+HHR achieved satisfactory weight loss and anti-reflux outcomes. No significant differences were observed between the two approaches in postoperative weight loss efficacy or complication rates, whereas robotic-assisted surgery was associated with reduced intraoperative blood loss.

To evaluate the clinical value and significance of the "3+2+1" anatomical dissection and suturing strategy in totally robotic hiatal hernia repair combined with fundoplication.

This is a single-center retrospective observational study. A total of 52 patients with gastroesophageal reflux disease (GERD) who underwent totally robotic hiatal hernia repair combined with fundoplication at the Department of General SurgeryⅡ, Yan'an Hospital Affiliated to Kunming Medical University, from January to December 2025 were enrolled. All procedures were performed using the "3+2+1" anatomical dissection and suturing strategy. Perioperative indicators, postoperative symptom improvement, and patient satisfaction were analyzed.

All surgeries were completed successfully without conversion to open surgery or complications, with 100% patient satisfaction. The mean robotic operating time was (82.03±32.91) minutes, intraoperative blood loss was 5 (5,5) ml, and postoperative hospital stay was (3.80±1.70) days. Gastroesophageal reflux disease questionnaire and gastroesophageal reflux disease-health related quality of life scores at 1, 3, 6, and 12 months postoperatively were significantly lower than preoperative values (all P<0.001).

Totally robotic hiatal hernia repair combined with fundoplication utilizing the "3+2+1" anatomical dissection and suturing strategy is safe and reliable, effectively alleviating reflux symptoms in patients with GERD, promoting rapid recovery, and achieving high patient satisfaction.

To share and discuss the surgical safety and clinical experience of the robotic "3+1" mode in hiatal hernia repair.

This study was a single-center retrospective case series. A total of 145 patients who underwent da Vinci robot-assisted laparoscopic hiatal hernia repair in the Department of Minimally Invasive, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, from January 2022 to January 2025 were included. All patients underwent trocar placement using the "3+1" mode, and the operations were completed accordingly. Postoperative improvement, hernia recurrence, and complications were followed up through outpatient appointments, online consultations, and telephone calls. The follow-up deadline was December 2025.

All 145 patients successfully underwent robot-assisted laparoscopic hiatal hernia repair combined with fundoplication, without conversion to open abdominal or thoracic surgery. Among them, 137 patients underwent Nissen fundoplication, 2 underwent Dor fundoplication, and 6 underwent Toupet fundoplication. The mean hernia defect area was (47.5±17.3) cm², the mean operative time was (67.5±18.8) min, the mean intraoperative blood loss was (15.0±5.0) ml, the mean postoperative hospital stay was (6.5±2.5) days, and the mean surgical cost was RMB (6.8±1.0)×10⁴ yuan. The mean postoperative follow-up duration was (30.5±7.5) months. Postoperative symptoms such as acid reflux, heartburn, and chest pain were markedly improved compared with those before surgery. During follow-up, no pleural effusion, pulmonary infection, wound infection, or recurrence was observed.

Robot-assisted hiatal hernia repair using the robotic "3+1" mode has high surgical safety. The trocar placement method is simple, standardized, highly reproducible, and highly operable.

To investigate the feasibility of preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication and its effect on postoperative gallbladder function.

This retrospective cohort study included 73 patients with gastroesophageal reflux disease complicated by hiatal hernia who underwent laparoscopic hiatal hernia repair in the Department of General Surgery, Shenzhen Hospital, Southern Medical University, from January 2019 to December 2023. Seventeen patients who underwent other concomitant procedures and two patients with recurrent hernia or type IV hernia were excluded. The remaining 54 patients were divided into the hepatic branch of the vagus nerve preservation group (n=17) and the hepatic branch of the vagus nerve resection group (n=37) according to whether the hepatic branch of the vagus nerve was preserved during surgery. Operative time, intraoperative blood loss, length of hospital stay, postoperative complications, and other indicators were compared between the two groups. All patients underwent routine outpatient follow-up at 1, 6, 12, and 36 months after surgery, and abdominal ultrasonography or computed tomography (CT) was performed to monitor gallbladder status. The incidence of gallstones was recorded.

There were no statistically significant differences between the hepatic branch of the vagus nerve preservation group and the resection group in operative time, intraoperative blood loss, length of hospital stay, or complications (P>0.05). In the hepatic branch of the vagus nerve resection group, two cases of asymptomatic gallstones were detected at the 6-month postoperative follow-up. With prolonged follow-up, the number of patients with gallstones increased. At the 3-year follow-up, gallstones were detected in nine patients (24.30%). No imaging evidence of gallstones or other gallbladder lesions was observed in the remaining patients. At 3 years after surgery, the incidence of gallstones in the hepatic branch of the vagus nerve resection group was significantly higher than that in the hepatic branch of the vagus nerve preservation group (24.30% vs. 0.0%), and the difference was statistically significant (P<0.05).

Preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication is feasible. In the short term, it may reduce the impact on gastrointestinal function and facilitate postoperative recovery. In the long term, it may help reduce the formation of gallstones; however, whether this effect is attributable to preservation of the hepatic branch of the vagus nerve requires further investigation.

To explore the mid-term efficacy of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia.

This study is a retrospective case series study. A total of 62 patients with typeⅢ hiatal hernia who underwent laparoscopic hiatal hernia repair with synthetic mesh in the Center for Obesity and Hernia Surgery , Department of General Surgery, Huashan Hospital, Fudan University from January 2017 to December 2023 were included. The perioperative conditions, postoperative complications, and follow-up results of the patients were analyzed.

All 62 patients successfully completed laparoscopic surgery without conversion to open surgery. The average operation time was (114.5±35.7) minutes, and the average postoperative hospital stay was 5.0(4.0, 6.0) days. The average follow-up period was (72±24.6) months. The GerdQ score after surgery was significantly lower than that before surgery [(6.4±1.0) points vs (8.6±2.1) points, P<0.05], and the number of patients requiring proton pump inhibitor treatment significantly decreased (7 vs 41). The postoperative anatomical recurrence rate was 8.2% (5/61), the symptom recurrence rate was 8.2% (5/61), and the incidence of dysphagia was 16.4% (10/61). Patient-related factors were not significantly correlated with recurrence or dysphagia.

Laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia is safe and feasible. It can effectively improve clinical symptoms, and reduce the risk of recurrence.

To investigate the influence of an intervention model based on Orem's self-care theory on postoperative self-efficacy, pain, and psychological status in patients with hiatal hernia (HH).

This study adopted a retrospective cohort design to select 96 HH patients who were admitted to Bainiaohu Hospital and Xinjiang Uygur Autonomous Region People's Hospital from July 2024 to June 2025 as the research subjects. These patients were divided into the control group and the experimental group, with 48 cases in each group, based on the different intervention methods. The control group received routine nursing care, while the experimental group was given an intervention model based on Orem's self-care theory for 1 week. Paired-sample and independent-sample t-tests were used to compare self-efficacy, pain intensity, psychological status, and self-care ability within and between the two groups before and after the intervention.

After 1 week of intervention, the experimental group had significantly higher general self-efficacy scale (GSES) score (28.48±4.14) points and exercise of self-care agency (ESCA) score (102.54±13.07) points than the control group GSES score (25.38±3.87) points, ESCA score (95.21±11.36) points (t=3.790, 2.933, both P<0.05). The changes in GSES and ESCA scores from baseline to post-intervention were compared between the two groups. The corresponding values were (5.02±3.02) vs (9.06±4.42) points and (7.67±5.78) vs (16.04±13.85) points, with statistically significant differences (t=5.229, 3.864; all P<0.001; Cohen's d≈1.07, 0.80). The scores of depression (8.98±0.67) points, anxiety (9.85±0.95) points, and stress (10.75±1.39) points in the depression-anxiety-stress scale (DASS-21) in the experimental group were significantly lower than those in the control group depression (9.44±0.77) points, anxiety (11.85±1.38) points, stress (12.58±1.47) points (t=3.082, 8.229, 6.233, all P<0.05). The visual analog scale (VAS) scores at 12 h (4.96±0.68) points, 24 h (3.92±0.58) points, and 48 h (2.73±0.45) points after operation in the experimental group were significantly lower than those in the control group at 12 h (5.38±0.76) points, 24 h (4.54±0.62) points, and 48 h (3.63±0.53) points after operation (t=2.853、5.059、8.968, P<0.05). Repeated-measures ANOVA revealed significant main effects of time, group, and time-group interaction on VAS scores (F_time=254.171, P_time<0.001; F_group=80.352, P_group=0.026; F_interaction=3.702, P_interaction= 0.026). In addition, the duration of pain in the experimental group was significantly shorter than that in the control group (t=7.093, P<0.001).

The nursing intervention based on Orem's self-care theory significantly enhances self-efficacy, strengthens self-care ability, alleviates negative emotional states, and improves pain control in postoperative HH patients, thereby providing scientific and high-quality psychological nursing support.

To explore the risk factors for hematoma formation after laparoscopic inguinal hernia repair (LIHR) and its preventive measures.

This study is a retrospective case-control study. The clinical data of 275 patients who received LIHR and were admitted to Tangdu Hospital, Air Force Medical University from January to December 2025, they were divided into the hematoma group (n=32) and the non-hematoma group (n=243) based on whether a hematoma formed after the operation. The clinical data of both groups were collected and a multivariate logistic regression analysis was performed to analyze the risk factors for hematoma formation after LIHR surgery, and corresponding preventive measures were proposed based on the identified risk factors.

There were statistically significant differences in age, body mass index, location of the hernia, diaphragm diameter, surgical type, and mesh type between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥65 years (OR 4.735, 95% CI 1.510-14.845), body mass index≥24 kg/m² (OR 3.445, 95% CI 1.363-8.707), bilateral hernia (OR 4.375, 95% CI 1.887-10.144), diaphragm diameter≥4 cm (OR 5.436, 95% CI 1.422-20.773), surgical type (total extraperitoneal hernia repair) (OR 3.105, 95% CI 1.158-8.322), and conventional mesh type (OR 4.088, 95% CI 1.266-13.198) were all independent risk factors for hematoma formation after LIHR (P<0.05).

The hematoma formation following LIHR are closely associated with age, body mass index, hernia location, diaphragm diameter, surgical type, and mesh type. The incidence of hematoma can be actively reduced through measures such as appropriate weight loss training, strict adherence to surgical operating standards, meticulous dissection using ultrasonic scalpel, preferential use of lightweight mesh, and compression care.

To evaluate the impact of laparoscopic preperitoneal mesh repair (LPPMR) on early postoperative pain and quality of life in adult patients undergoing umbilical hernia repair.

This is a retrospective cohort study. A retrospective analysis of the medical records of patients who underwent umbilical hernia repair at the First Affiliated Hospital of Xi 'an Jiaotong University between June 2023 and June 2025 was conducted. Patients were categorized into two groups based on surgical approach preference at admission and surgeon expertise: the LPPMR group (n=48), receiving laparoscopic preperitoneal mesh repair, and the IPOM group (n=48), receiving laparoscopic intraperitoneal onlay mesh repair. Comparative analyses were performed between the two groups on operative parameters, early postoperative pain levels, recovery of abdominal wall muscle function, postoperative quality of life, and follow-up outcomes.

Operative duration was significantly longer in the LPPMR group compared to the IPOM group. However, the LPPMR group demonstrated significantly shorter time to first flatus and lower overall surgical costs (P<0.05). Visual analog scale (VAS) pain scores assessed at 24, 48, 72 h, and 1 week postoperatively were lower in the LPPMR group than those in the IPOM group. Repeated- measures analysis of variance (ANOVA) indicated significant main effects for both time (F=334.600, P<0.001) and surgical group (F=16.932, P<0.001) on early postoperative pain, with no significant interaction (P>0.05). At 1 and 3 months after surgery, the LPPMR group exhibited superior performance in plank hold times, supine static crunch times, and number of bridge exercises than those in the IPOM group. The repeated measures ANOVA showed that the effects of time and group were significant for all the above three indicators (all P values<0.001), while the interaction effects were not significant (all P values>0.05). Furthermore, quality of life assessments at 1, 3, and 6 months after the surgery revealed significantly higher scores in both the physical and psychological domains for the LPPMR group than those of the IPOM group. Repeated-measures ANOVA showed significant time effects across all domains (P<0.001), with group effects significant only for the physical (F=17.948, P<0.001) and psychological (F=25.134, P<0.001) domains. The interaction effect had no significant effect on any of these four domains (all P>0.05). No hernia recurrences were reported in either group during follow-up. One month after the operation, the incidence of incision site pain (6.25% vs 20.83%) and foreign body sensation (4.17% vs 16.67%) was significantly lower in the LPPMR group than that in the IPOM group (P<0.05). The overall complication rates did not differ significantly between the two groups (P>0.05).

Both LPPMR and IPOM are safe and effective procedures for umbilical hernia repair. Although associated with a longer operative time, LPPMR offers distinct advantages, including reduced early postoperative pain, enhanced recovery of abdominal wall function, and improved short-term quality of life. LPPMR may serve as a preferred option for patients prioritizing rapid recovery and quality of life, though surgeon learning curve and operative time should be considered.

To investigate the clinical efficacy of transabdominal preperitoneal laparoscopic hernia repair (TAPP) versus totally extraperitoneal laparoscopic hernia repair (TEP) in elderly male patients with recurrent inguinal hernia, and their influences on respiratory function and testicular hemodynamic parameters.

A total of 104 elderly male patients with recurrent inguinal hernia admitted to the Second Hospital of Hebei Medical University from June 2021 to March 2024 were enrolled, and randomly divided into TAPP group and TEP group by the random number table method, with 52 cases in each group. The perioperative indicators, respiratory function indicators [airway pressure (Paw), end-tidal carbon dioxide partial pressure (P_ETCO₂)], trauma response indicators [tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6], testicular hemodynamic parameters [resistance index (RI), end-diastolic velocity (EDV), peak systolic velocity (PSV)], complication rates and postoperative recurrences of patients were compared between the two groups.

The operation duration and postoperative pain duration were shorter, and hospitalization costs were lower in the TEP group compared with the TAPP group, with statistically significant differences (all P<0.05). At 10 min and 30 min after pneumoperitoneum establishment, Paw and P_ETCO₂ values in the TEP group were significantly lower than those in the TAPP group (all P<0.001). Serum levels of TNF-α, IL-1β and IL-6 on postoperative day 1 and day 3 were markedly lower in the TEP group (all P<0.001). The TEP group had higher EDV and lower RI than the TAPP group (all P<0.001). No significant intergroup differences were found in the incidence of complications and 1year postoperative recurrence rate between the two groups (P>0.05).

TAPP and TEP are safe and effective treatment options for recurrent inguinal hernia in elderly males. However, TEP has a smaller impact on perioperative respiratory function, can alleviate pain and trauma stress, and reduces the economic burden on patients.

To evaluate the efficacy of biological mesh in laparoscopic trans- abdominal preperitoneal hernia repair (TAPP).

A retrospective analysis was conducted on clinical data of 185 patients who underwent TAPP hernia repair at Liupanshui People's Hospital between January 2018 and December 2023. Based on the type of mesh used during surgery, patients were divided into two groups: 90 cases receiving lightweight large-pole polypropylene mesh were assigned to the control group, while 95 cases receiving biological mesh were assigned to the observation group. Surgical indicators and postoperative complications were recorded; serum inflammatory markers were measured before and after surgery; postoperative pain was assessed; all patients were followed for 6 to 18 months, and post-discharge outcomes were documented.

No statistically significant differences were observed between the two groups in terms of operative time, intraoperative blood loss, or time to ambulation (P>0.05). The total incidence of postoperative complications was significantly lower in the observation group compared to the control group (P=0.025). Three days after surgery, levels of C-reactive protein (CRP) and white blood cell count (WBC) were significantly elevated in both groups compared to preoperative values (P<0.01). Postoperative pain scores were significantly lower in the observation group compared to the control group (P<0.001). No significant difference was found in the incidence of foreign body sensation at the surgical site between the two groups (P>0.05). The incidence of chronic postoperative pain in the surgical area was significantly lower in the observation group (P=0.003), and overall postoperative satisfaction was significantly higher compared to the control group (P<0.001).

The use of biological mesh in TAPP hernia repair in the treatment of adolescent inguinal hernia reduces the risk of postoperative complications and inflammatory responses, alleviates postoperative pain, decreases recurrence rates, and improves prognosis compared to conventional polypropylene mesh.

To compare the impacts of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) and transinguinal preperitoneal hernia repair (TIPP) on postoperative gastrointestinal function recovery and early rehabilitation in patients with unilateral inguinal hernia.

Data were collected from 120 patients with inguinal hernias who were admitted to Bayannur City Hospital and underwent surgical treatment from January 2023 to December 2024. Based on surgical technique, they were divided into a control group (TIPP procedure, 58 cases) and an observation group (TAPP procedure, 62 cases). The surgical-related indicators, recovery time of gastrointestinal function (resumption of bowel sounds, first flatus/ defecation), postoperative pain visual analogue scale (VAS), quality of life index for digestive diseases (GLQI), and complication rates were compared between the two groups of patients.

All patients completed follow-up with no dropouts. The operative times in the control group and observation group were (50.16±9.46) min and (46.33±8.02) min, respectively. The first ambulation time postoperatively was (7.86±1.15) h and (7.44±0.96) h, respectively. Postoperative hospitalization durations were (2.59±0.30) d and (1.94±0.22) d, respectively. The first passage of flatus time was (9.16±1.42) h and (8.58±1.25) h, respectively. The first defecation time was (25.21±3.23) h and (23.94±3.07) h, respectively. Bowel sound recovery time was (7.82±1.33) h and (7.25±1.24) h, respectively. Recovery time for oral intake was (8.34±1.21) h and (7.89±1.17) h, respectively. Postoperative VAS scores at day 1 were (3.89±0.92) points and (3.56±0.85) points, respectively. VAS scores at 1 week postoperatively were (1.97±0.43) points and (1.51±0.41) points, respectively. Postoperative GLQI scores at day 1 were (50.36±6.85) points and (53.17±6.94) points, respectively. GLQI scores at 1 week postoperatively were (58.31±8.27) points and (67.39±8.52) points, respectively. All these indicators showed significant differences between the two groups (P<0.05). The comparison of complication rates between the two groups showed no statistically significant difference (P>0.05). There was no incomplete intestinal obstruction nor recurrence of hernia in the two groups.

TAPP treatment for unilateral inguinal hernia demonstrates superior efficacy to TIPP repair in alleviating early postoperative pain and promoting gastrointestinal function recovery, without increasing the risk of complications. It represents a surgical approach that facilitates faster patient recovery.

To investigate the application of arcuate line approach in single incision laparoscopic totally extraperitoneal inguinal hernia repair (SIL-TEP).

A retrospective analysis was conducted on the clinical data of 90 adult patients with unilateral or bilateral inguinal hernias who underwent SIL-TEP at Qichun Peoples' Hospital from March 2020 to February 2024. Among them, 52 patients underwent SIL-TEP by arcuate line approach (arcuate line approach group) and 38 patients underwent SIL-TEP by umbilicus approach (umbilicus approach group). Compare the surgical duration, chopstick effect duration, bleeding volume, pain score, bed rest time, and intraoperative and postoperative complications between the two groups.

All patients completed the surgery successfully, and there was no case of incision infection or recurrence. There was no statistical difference between the two groups in complications such as intraoperative blood loss, postoperative bed rest time, postoperative serum swelling (P>0.05); There were statistically significant differences between the two groups in terms of surgical time, the duration of chopstick effect (interference between instruments), the number of cases of peritoneal damage during surgery, and postoperative pain scores (P<0.05).

The SIL-TEP hernia repair surgery via the arcuate line approach is more convenient than the umbilicus approach, reducing surgical difficulty and making the operation approach safe and feasible.

To compare the clinical efficacy of laparoscopic totally extraperitoneal hernia repair (TEP), transabdominal preperitoneal hernia repair (TAPP), and Lichtenstein tension-free repair in the treatment of adult inguinal hernia.

This retrospective cohort study included 135 adult patients with inguinal hernia who underwent treatment at the 985th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from February 2022 to April 2025. According to the surgical approach, the patients were divided into the TEP group, TAPP group, and Lichtenstein group, with 45 patients in each group. Surgery-related indicators, levels of inflammatory factors, incidence of complications, and early recurrence rates were compared among the three groups.

The TEP and TAPP groups were superior to the Lichtenstein group in terms of intraoperative blood loss, operative time, time to ambulation, and length of hospital stay (F=19.234, 6.725, 16.354, and 6.203, respectively; P<0.05). Postoperative levels of the inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) increased compared with preoperative levels in all three groups. The increase was most pronounced in the Lichtenstein group and lowest in the TEP group (F=4.215, 3.757, and 4.854, respectively; P<0.05). The overall incidence of complications in the Lichtenstein group was 20.00%, which was significantly higher than that in the TEP group, 4.44%, and the TAPP group, 6.67% (χ²=6.854, P<0.05). There was no statistically significant difference in the early recurrence rate among the three groups (P>0.05).

Compared with Lichtenstein repair, TEP and TAPP have the advantages of less surgical trauma, faster recovery, milder inflammatory response, and fewer complications. However, no significant difference was observed among the three procedures in preventing early recurrence.

To observe the application of needle grasper-assisted single-port laparoscopy in the treatment of pediatric incarcerated indirect inguinal hernia.

Clinical data of 117 children with incarcerated indirect inguinal hernia who received treatment at Ganzhou Maternal and Child Health Hospital from January 2023 to September 2025 were collected and analyzed. According to the surgical method, the children were divided into a conventional group with 55 cases and a study group with 62 cases. Children in the conventional group underwent transumbilical single-port laparoscopic surgery, while children in the study group underwent needle grasper-assisted transumbilical single-port laparoscopic surgery. Surgical-related indicators, postoperative pain and stress responses, inflammatory levels, surgical complications, and prognosis were observed and compared between the two groups.

The length of hospital stay, number of crying episodes, number of nocturnal awakenings, Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores on postoperative day 2 and day 3, and serum levels of serum amyloid A (SAA), C-reactive protein (CRP), and interleukin-6 (IL-6) in the study group were (3.24±0.14) d, (6.12±1.79) times, (3.02±0.59) times, (3.75±0.63) points, (2.76±0.38) points, (72.97±17.26) mg/L, (18.62±5.53) mg/L, and (12.79±3.77) pg/ml, respectively, which were all lower than those in the conventional group: (3.37±0.30) d, (6.74±1.41) times, (3.27±0.44) times, (3.98±0.52) points, (2.91±0.43) points, (82.85±19.04) mg/L, (22.25±7.74) mg/L, and (15.12±5.92) pg/ml, respectively, with statistically significant differences (all P<0.05). The incidence of scrotal hematoma in the study group was significantly lower than that in the conventional group (P<0.05). At 3 months after surgery, the incidence of abnormal imaging findings in the study group was lower than that in the conventional group (P<0.05).

Needle grasper-assisted single-port laparoscopy for the treatment of pediatric incarcerated indirect inguinal hernia can improve postoperative recovery-related indicators, alleviate postoperative pain and inflammatory responses, and reduce the incidence of complications, showing certain advantages in postoperative recovery and short-term prognosis..

To evaluate the impact of a novel hernia wearable device (HWD) on the early prognosis of patients following inguinal hernia repair.

This prospective, single-center, randomized controlled trial enrolled 261 patients with unilateral primary inguinal hernia who were admitted to Beijing Chao-Yang Hospital, Capital Medical University between March and August 2022. Participants were randomly assigned to three groups: the HWD group (n=89), the sandbag group (n=88), and the other hernia belt group (n=84). The primary outcomes included seroma incidence and area, pain intensity, patient comfort, and satisfaction at 30 days post-surgery.

At 30 days postoperatively, no significant difference was observed in the incidence of seroma among the three groups (P>0.05). However, the mean seroma area in the HWD group (1.90±0.84 cm²) was significantly smaller than that in the sandbag group (4.59±1.35 cm², P=0.048). The visual analogue scale (VAS) pain score in 3 groups showed no statistical difference (P=0.457). No significant differences were found in the Carolinas Comfort Scale (CCS) scores among the three groups (P>0.05). The comparison of patient satisfaction among the three groups showed a statistically significant difference (P=0.034). The HWD group reported significantly higher satisfaction score (9.3±1.6, P<0.05) than that of the sandbag group and the other hernia belt group (P=0.034). Notably, the "very satisfied" rate in the HWD group was significantly superior to both the sandbag and the other hernia belt groups (P=0.027).

The HWD demonstrates superior clinical efficacy compared to traditional compression methods following inguinal hernia repair. It significantly reduces the postoperative seroma area and enhances patient satisfaction without compromising overall comfort, making it an ideal alternative to traditional sandbag compression.

To explore the application effect of preoperative psychological care based on biofeedback theory in patients undergoing inguinal hernia repair surgery.

Patients with inguinal hernia repair admitted to the People's Hospital of Hai'an City from June 2020 to December 2022 were selected and randomly divided into experimental group and control group, with 60 cases in each group. The control group received routine preoperative nursing, and the experimental group received preoperative psychological nursing based on biofeedback theory on the basis of routine nursing. Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the preoperative anxiety and depression levels of patients. Visual analog scale (VAS) was used to evaluate postoperative pain. Postoperative discomfort and recovery time were recorded.

There were no significant differences in HAMA score and HAMD score between the experimental group and the control group on admission (P>0.05). After intervention, HAMA score and HAMD score of the experimental group were significantly lower than those of the control group before surgery (P<0.05). The postoperative VAS score of the experimental group was significantly lower than that of the control group (P<0.05). The number of postoperative nausea, vomiting, dizziness and other discomfort cases in the experimental group was significantly lower than that in the control group (P<0.05), and the recovery time of the experimental group was also significantly shorter than that in the control group (P<0.05).

Preoperative psychological care based on biofeedback theory has a significant effect on patients undergoing inguinal hernia repair surgery. It helps to reduce preoperative anxiety and depression levels, alleviate postoperative pain, improve postoperative discomfort, and shorten recovery time.

Dysphagia is an important and complex manifestation of hiatal hernia and is not always caused by simple mechanical obstruction. It may also be related to esophageal motility disorders, reflux-related inflammatory strictures, esophageal diverticula, and connective tissue diseases. Based on the relevant literature and clinical practice, this article reviews the etiological mechanisms of hiatal hernia complicated by dysphagia, mainly summarizes the roles of gastroscopy, upper gastrointestinal contrast study, high-resolution esophageal manometry, 24-hour pH-impedance monitoring, and esophagogastric junction filling ultrasound contrast imaging in the integrated assessment of structure and function, and outlines etiology-oriented treatment strategies. We believe that for such patients, individualized management should be guided by accurate identification of the dominant mechanism so as to reasonably optimize the indications for dilation, anti-reflux therapy, hiatal hernia repair, and related functional procedures, thereby improving dysphagia and overall prognosis.

To investigate the diagnostic features of pediatric pantaloon hernia and to evaluate the outcomes of laparoscopic surgical treatment.

The clinical data of four children diagnosed with pantaloon hernia and treated at Xiamen Children's Hospital (Xiamen Hospital of the Pediatric Hospital Affiliated to Fudan University) between March 2019 and April 2024 were retrospectively reviewed, and the relevant literature was analyzed.

All four patients were male, aged from 2 years and 1 month to 4 years and 5 months, with a mean age of 3 years and 3 months. Patient 1, aged 2 years and 1 month, experienced recurrence on the day of the initial operation for indirect inguinal hernia. During the second operation, the original indirect hernia sac was found to be completely ligated, and a direct hernia sac was identified on the same side after traction of the inguinal skin, leading to the diagnosis of pantaloon hernia. Laparoscopic high ligation of the direct hernia sac was performed, followed by coverage of the direct hernia triangle using the ipsilateral medial umbilical ligament. No recurrence was observed during 4 years of follow-up. Patient 2, aged 2 years and 3 months, developed recurrence 1 month after the initial operation performed at another hospital. At reoperation, the original indirect hernia sac was completely ligated, and a direct hernia sac was detected on the same side after traction of the inguinal skin. Pantaloon hernia was diagnosed intraoperatively. Laparoscopic high ligation of the direct hernia sac with coverage of the direct hernia triangle using the ipsilateral medial umbilical ligament was performed. No recurrence was observed during 3 years of follow-up. Patient 3, aged 4 years and 5 months, was diagnosed with pantaloon hernia during the initial operation. Laparoscopic high ligation of both the indirect and direct hernia sacs was performed, followed by coverage of the direct hernia triangle using the ipsilateral medial umbilical ligament. No recurrence was observed during 18 months of follow-up. Patient 4, aged 3 years and 1 month, was diagnosed with pantaloon hernia during the initial operation. Laparoscopic high ligation of both the indirect and direct hernia sacs was performed, with coverage of the direct hernia triangle using the ipsilateral medial umbilical ligament. No recurrence was observed during 6 months of follow-up.

Preoperative diagnosis of pantaloon hernia in children is challenging and the condition is prone to missed diagnosis. Laparoscopic high ligation of both indirect and direct hernia sacs combined with coverage of the direct hernia triangle using the ipsilateral medial umbilical ligament is a feasible and effective treatment for pediatric pantaloon hernia.