This article provides a comprehensive review of the historical development of treatments for gastroesophageal reflux and hiatal hernia， introduces various techniques used to repair hiatal defects， emphasizes the uncertainties in current management of hiatal hernia， and outlines potential directions for future research and advancements.
The application of hernia mesh has significantly reduced postoperative recurrence rates. However， mesh related complications （MRC） have gradually emerged as a clinically significant concern. MRC is characterized by complex pathogenic mechanisms， diverse clinical manifestations， and variable treatment outcomes. Surgeons should enhance their understanding of MRC， standardize surgical techniques， and rationally select surgical approaches and mesh materials to minimize the occurrence of MRC to the greatest extent.
To explore the predictive value of preoperative MRI parameters of the prostate and clinical factors for inguinal hernia （PIH） after robot-assisted radical prostatectomy （RARP）.
Methods
A retrospective case-control study was conducted to analyze the clinical data， preoperative prostate MRI and postoperative pathological reports of 469 patients who underwent RARP in the Department of Urology， the First Affiliated Hospital of Anhui Medical University from January 2020 to August 2024. According to the follow-up diagnosis results of hernia surgeons after surgery， they were divided into the case group （PIH group） and the control group （non-PIH group）. Kaplan-Meier plotted the PIH free survival curve after RARP and logistic regression analysis was used to analyze the risk factors of PIH.
Results
A total of 438 patients with RARP were included in this study. The median follow-up time was （19.3±8.6） months， and a total of 50 patients （11.4%） developed PIH. There were no statistically significant differences between the two groups in age， smoking history， alcohol consumption history， level of preoperative prostate-specific antigen， preoperative Gleason score， intraoperative pelvic lymph node dissection， duration of operation， and pathological N stage. Body mass index （BMI） and T stage of postoperative pathology were significantly different between the two groups （P＜0.05）. The 2-year PIH-free survival rates of BMI＜18.5 kg / m2 and BMI≥25.0 kg / m2 were 76.50 % and 92.22 %， respectively， and the difference was statistically significant （P=0.029）. The 2-year PIH-free survival rates of≤T2 and≥T3 were 91.01 % and 80.64 %， respectively， and the difference was statistically significant （P=0.037）. In prostate MRI parameters， Sag-H measured on sagittal T2-weighted images had significant differences （t=2.555， P=0.011）.Multivariate logistic analysis showed that T stage of postoperative pathology （≥T3） and Sag-H （＞5.46 cm）measured on sagittal T2-weighted images were independent risk factors for PIH （P＜0.05）. Adjusted OR values were 1.847 （95% CI 1.017-3.356） and 1.419 （95% CI 1.033-1.949）.
Conclusion
Low BMI， high T stage （≥T3） and Sag-H （＞5.46 cm） are risk factors for PIH after RARP. The results still require multi-center prospective studies for further verification in the future.
The feasibility of laparoscopic combined gastroscopy for Heller muscle incision， hiatal hernia repair and Dor fundoplication was discussed， and the surgical techniques and clinical efficacy of this combined operation were defined， so as to provide a standardized scheme for clinical functional repair and anatomical reconstruction.
Methods
A retrospective analysis was conducted on clinical data from 19 patients with achalasia and hiatal hernia treated in the Department of Minimally Invasive， Hernia and Abdominal Wall Surgery at Xinjiang Uygur Autonomous Region People's Hospital between June 2014 and October 2024. All patients underwent laparoscopic Heller myotomy combined with hiatal hernia repair and Dor fundoplication assisted by endoscopy. Operative time， intraoperative blood loss， complications， and recurrence were analyzed， with follow-up observations.
Results
All 19 patients were definitively diagnosed with achalasia via gastroscopy， upper gastrointestinal contrast， and high-resolution manometry. According to the Chicago Classification， 2 cases were typeI， 15 cases were type Ⅱ， and 2 cases were type Ⅲ. The surgeries were successful， with 1 case converted to thoracotomy. The median operative time was 82 （57-185） minutes， intraoperative blood loss was 20 （10-50） ml， and no gastroesophageal fistula occurred.The median postoperative hospital stay was 3.0 （2-6） days. During a median follow-up of 37 months （5-122 months）， 2 cases experienced transient dysphagia， but no recurrence or severe gastroesophageal reflux was observed.
Conclusion
Laparoscopic Heller myotomy combined with hiatal hernia repair and Dor fundoplication is safe and effective. However， larger sample sizes are required to validate long-term efficacy.
Based on the concept of enhanced recovery after surgery （ERAS）， to investigate the safety of laparoscopic inguinal hernia repair （LIHR） in elderly patients receiving antithrombotic therapy （ATT）.
Methods
This was a retrospective cohort study. Clinical data of 413 elderly patients who underwent inguinal hernia repair in the First Hospital of Lanzhou University from January 2021 to September 2024 were retrospectively analyzed. Patients were divided into two groups according to perioperative ATT use：124 patients who received ATT in the ATT group and 289 patients who did not receive ATT in the non-ATT group. The primary outcomes were postoperative bleeding complications， classification of complication intervention measures （Clavien-Dindo classification）， and postoperative thromboembolic complications. Secondary outcomes included non-bleeding complications，operation time， and postoperative hospital stay. Subgroup analyses were further conducted within the ATT group based on drug types， and postoperative outcomes between open and laparoscopic surgeries in the ATT group were compared.
Results
No significant intraoperative bleeding （＞10 ml） occurred in either group. There were no statistically significant differences in postoperative bleeding complications between the two groups：ecchymosis （1.6% vs. 0.0%， P=0.09） and bloody exudation on dressings （6.5% vs. 5.9%，P=0.824）， with no hematoma observed. The intervention measures required for complications（Clavien-Dindo grade I：5.6% vs. 4.5%） between the ATT group and the non-ATT group showed no significant difference （P=0.619）. No postoperative thromboembolic complications occurred within 30 days in either group， and there were no significant differences in non-bleeding complications， intraoperative blood loss， or operation duration between the two groups （P＞0.05）. The postoperative hospital stay was significantly longer in the ATT group than in the non-ATT group （P＜0.001）. Subgroup analysis showed that the postoperative hospital stay ［M （Q1， Q3）］was 1.5 （1.0， 2.0） days in both the aspirin group and other antiplatelet drug groups， 2.0 （1.5， 2.0） days in the anticoagulant group， and 1.8 （1.0， 2.1） days in the multiple antithrombotic drug group， with significant differences among different drug groups （P=0.021）.For bloody exudation on dressings， there were 2 cases （3.4%） in the aspirin monotherapy group， 0 cases（0%） in other antiplatelet drug groups， 1 case （4.0%） in the anticoagulant group， and 5 cases （22.7%） in the multiple antithrombotic drug group， with significant differences among different drug groups （P=0.019）.No significant differences were found in other outcome indicators among subgroups （all P＞0.05）.Comparison of surgical approaches showed that the postoperative hospital stay was 2.0 （1.5， 2.0） days for open surgery and 1.5 （1.0， 2.0） days for laparoscopic surgery， with a statistically significant difference（P＜0.001）， while other outcomes showed no significant differences between the two groups （P＞0.05）.
Conclusion
A considerable proportion of elderly patients undergoing inguinal hernia repair receive ATT.Based on ERAS， LIHR is safe for elderly patients on monotherapy antiplatelet agents， while those on dual/multiple antiplatelet or combined anticoagulant therapies require cautious management to avoid postoperative bleeding complications.
To evaluate the feasibility and safety of primary stoma reversal combined with giant incisional hernia repair in patients with abdominal wall giant incisional hernia and intestinal stoma， aiming to provide evidence-based guidance for clinical decision-making.
Methods
A retrospective analysis was conducted on the clinical data of 6 patients who underwent large ventral incisional hernia repair combined with stoma reversal at the Department of Gastrointestinal Surgery/Hernia and Abdominal Wall Surgery， the First Affiliated Hospital of Zhengzhou University， between January 2023 and December 2023.The surgical strategies， short-term complications， and operative outcomes were evaluated.
Results
All 6 patients successfully underwent stoma reversal combined with abdominal wall hernia repair. The average operative time was （289.2±112.4） minutes， with an average blood loss of （65.0±49.5） ml. The average hospital stay was （10.8±2.0） days. No severe postoperative complications such as anastomotic leakage，abdominal compartment syndrome， intestinal obstruction， or mesh infection occurred. Two patients developed postoperative subcutaneous seromas， which were cured after continuous drainage. During the 12-24 months of follow-up， there were no cases of incisional hernia recurrence.
Conclusion
Under strict adherence to aseptic techniques and with appropriate selection of abdominal wall reconstruction methods， the preliminary study demonstrates that single-stage stoma reversal combined with incisional hernia repair appears to be safe and feasible. Importantly， potentially contaminated surgical sites should not be considered an absolute contraindication for simultaneous hernia repair with mesh implantation.
To analyze the clinical outcomes of partially absorbable mesh versus standard polypropylene mesh in single-incision laparoscopic totally extraperitoneal hernia repair （TEP）.
Methods
A retrospective analysis was conducted on patients who underwent single-incision TEP at the Hernia and Abdominal Wall Surgery Department of Gansu Provincial People's Hospital between January 2020 and January 2021. Patients were categorized into an experimental group （partially absorbable mesh）and a control group （standard polypropylene mesh） based on the type of mesh used. Surgical time，intraoperative blood loss， length of hospital stay， seroma formation， foreign body sensation， chronic pain，mesh shrinkage diameter and shrinkage rate， and visual analogue scale （VAS） scores were evaluated and analyzed.
Results
There were no significant differences between the two groups in surgical time，intraoperative blood loss， length of hospital stay， or incidence of seroma （P＞0.05）. The average hospitalization cost in the experimental group was significantly higher （13 073.52±461.82） yuan than in the control group ［（10 518.20±473.62） yuan； P＜0.05］. Regarding postoperative complications， the experimental group had 2 cases of foreign body sensation （4.00%） and 3 cases of chronic pain （6.00%）， compared with 8 cases （16.00%） and 10 cases （20.00%）， respectively， in the control group. These differences were statistically significant （χ2=4.00， 4.33； P＜0.05 for both）. VAS scores decreased over time in both groups，with significantly lower scores in the experimental group on postoperative days 1 and 3 （P＜0.05）.Ultrasound measurements at 1， 3， 6， and 12 months postoperatively showed that the mesh shrinkage diameter and shrinkage rate were significantly better in the experimental group than in the control group（P＜0.05）.
Conclusion
Partially absorbable mesh demonstrates superior performance in single-incision TEP， with reduced mesh shrinkage diameter and shrinkage rate， as well as lower rates of postoperative foreign body sensation and chronic pain compared to standard polypropylene mesh. However， the cost is relatively higher， and its use should be prioritized in patients with adequate financial resources.
To investigate the clinical application value of 3D Slicer technology in preoperative planning and intraoperative guidance for desmoid tumors of the abdominal wall， and evaluate its effects in improving the total resection rate， shortening the surgical time， reducing the postoperative hospital stay， improving the quality of life of patients， and optimizing the treatment costs.
Methods
This study is a prospective non-randomized controlled trial. Due to the intervention characteristics of the surgical plan design， a single-blind non-randomized trial was adopted. A total of 37 patients with desmoid tumors of the abdominal wall who underwent surgery in the Department of General Surgery， First Affiliated Hospital of Anhui Medical University， from January 2012 to January 2025 were included. Patients were divided into two groups based on whether 3D Slicer technology was used for preoperative planning. The experimental group （n=20） used 3D Slicer for preoperative planning， while the control group （n=17） used traditional two-dimensional imaging planning methods. Surgical outcomes （total resection rate， postoperative hospital stay， surgical time）， postoperative quality of life （SF-36 score）， and hospitalization costs were compared between the two groups.
Results
The experimental group showed significantly better outcomes in total resection rate （100% vs 70.6%， P=0.014）， postoperative hospital stay ［1.0 （1.0， 2.0） days vs 2.0 （2.0， 6.5）days， P＜0.001］， surgical time ［42.5 （31.3， 50.0） minutes vs 100.0 （85.0， 139.5） minutes， P＜0.001］， and SF-36 score ［92.0 （90.0， 94.0） vs 88.0 （80.0， 93.5）， P=0.020］compared to the control group. There was no statistically significant difference in hospitalization costs between the two groups （P=0.330）.
Conclusion
3D Slicer software has significant advantages in preoperative planning for desmoid tumors of the abdominal wall. It can improve surgical precision and efficiency， enhance postoperative quality of life， and provide a reliable basis for clinical application.
To improve the early diagnosis rate of complete androgen insensitivity syndrome （CAIS） by examining internal genital organs during laparoscopic treatment of inguinal hernia in female pediatric patients.
Methods
A retrospective analysis was conducted on the clinical data of 536 female pediatric patients with inguinal hernia who underwent laparoscopic treatment during menstruation at Shanxi Children's Hospital from January 2012 to December 2021. During surgery， the condition of the pelvic cavity and bilateral internal inguinal rings was observed. If a normal uterus， fallopian tubes， and ovaries were present， standard purse-string closure of the patent internal ring was performed.
Results
In this group of cases， three patients had no normal internal genital organs in the pelvic cavity. If the gonads were located at the internal ring， they were pulled into the abdominal cavity， and the internal ring was closed with a purse-string suture. Among female pediatric patients undergoing laparoscopic surgery for inguinal hernia， three cases without internal genital organs were found. Further karyotype and genetic testing confirmed the diagnosis of CAIS in all three cases.
Conclusion
CAIS is a rare disease. The incidence of CAIS is relatively high in female pediatric patients with inguinal hernia. During laparoscopic treatment of inguinal hernia in female pediatric patients， routine intraoperative examination of internal genital organs is a simple and effective method for screening CAIS， which can achieve the goal of early diagnosis. During surgery， if gonads are found at the internal ring and no uterus or fallopian tubes are found in the pelvic cavity， CAIS should be considered， and further karyotype and genetic testing should be performed to confirm the diagnosis.
To investigate the efficacy of ultrasound-guided iliohypogastric and ilioinguinal nerve block （IH/IINB） with nalbuphine and ropivacaine for analgesia and early recovery in inguinal hernia.
Methods
This study employed a prospective randomized， triple-blind controlled trial.From December 2020 to December 2022， a total of 88 patients who underwent elective tension-free inguinal hernia repair （modified Kugel procedure） at Xuzhou Traditional Chinese Medicine Hospital were enrolled in the study. Using a random number table method， they were randomly divided into the Ropivacaine group （L group， receiving IH/IINB with ropivacaine hydrochloride and normal saline） and the Nalbuphine combined with Ropivacaine group （N group， receiving IH/IINB with nalbuphine hydrochloride， ropivacaine hydrochloride， and normal saline）， with 44 patients in each group. All patients received the ultrasound-guided IH/IINB before surgery with 30 ml for the ipsilateral side. The visual analog scale （VAS） scores for resting and exercise pain were asked and recorded at 6， 12， and 24 hours after surgery. The times of sleep disturbance by pain were counted on the night of surgery. The time of first postoperative administration of painkillers and the times of use of analgesics within 24 hours were counted，and the highest VAS scores within 24 hours were recorded. Postoperative anal exhaust time， first time of getting out of bed and occurrence of adverse reactions （urinary retention， nausea， vomiting， drowsiness，etc.） were recorded.
Results
Compared with the L group alone， combined nalbuphine could reduce the VAS scores for resting and exercise pain at 6， 12， and 24 h after surgery （Finteraction=10.28， Pinteraction＜0.001； Finteraction =18.19， Pinteraction ＜0.001）， reduce the need for additional analgesic drugs within 24 h，improve the sleep quality on the night of surgery， reduce the occurrence of nausea and vomiting， and promote the early recovery after surgery （P＜0.05）. There was no significant difference in other adverse reactions between the two groups （P＞0.05）.
Conclusion
For patients undergoing inguinal hernia repair，the analgesic effect of ultrasound-guided IH/IINB is satisfactory， and the compound nalbuphine can prolong the analgesic time of ropivacaine， improve sleep on the night of the operation， reduce the occurrence of adverse reactions， and accelerate postoperative recovery.
To explore the effect of ultrasound-guided transversus abdominis plane block combined with external oblique plane block anesthesia in elderly patients during hernia repair surgery.
Methods
Sixty elderly male patients with inguinal hernia who were admitted to the 901th Hospital of PLA from February 2022 to February 2023 were selected. They were randomly divided into experimental group （n=30） and control group （n=30） according to the random number table method. The experimental group underwent ultrasound-guided transversus abdominis plane block combined with external oblique muscle plane block anesthesia， and the control group underwent local infiltration anesthesia. The changes in heart rate and blood pressure during the operation， the amount of anesthetic liquid， the satisfaction of the patient and the surgeon， the number of additional anesthesia due to pain during the operation， the visual analogue scale （VAS） score during the operation and within 24 hours after the operation， and the adverse reactions after the operation were recorded.
Results
Both groups completed the operation successfully. In the experimental group， the number of patients with intraoperative VAS score ≥4 points， elevated blood pressure， increased heart rate， and additional anesthesia were less than that of the control group （P＜0.05）. There were no significant differences between two groups in the amount of anesthetic liquid， cases with VAS score ≥4 points within 24 hours after operation， and the incidence of postoperative incision fat liquefaction and scrotal edema （P＞0.05）. The number of skin bruising in the operation area of the experimental group was less than that of the control group （P＜0.05），and the satisfaction of patients and surgeons in the experimental group was also better than that of the control group （90.00% vs 66.67%； 85.67% vs 63.33%）， with statistically significant difference （P＜0.05）.
Conclusion
For elderly patients who underwent inguinal hernia repair， the ultrasound-guided transversus abdominis plane block combined with external oblique dual plane block anesthesia can obtain better analgesic effect， fewer intraoperative adverse reaction， and a higher degree of patients and surgeons' satisfaction.
To explore the impact of preoperative prehabilitation on postoperative recovery in patients undergoing abdominal incisional hernia repair.
Methods
A total of 108 patients who underwent abdominal incisional hernia repair under general anesthesia at Huadong Hospital Affiliated to Fudan University between February 2023 and March 2024 were enrolled in this study. Patients were randomly divided into two groups：the control group （n=56）， which received conventional care， and the experimental group （n=52）， which received a preoperative prehabilitation program in addition to conventional care. The quality of recovery-15 （QoR-15） scores， length of hospital stay， and incidences of postoperative pain and anxiety were compared between the two groups.
Results
On postoperative days 1， 3， and 7， the QoR-15 scores in the control group were （81.39±11.80）， （92.71±12.75）， and （107.59±14.07） points， respectively，whereas the scores in the experimental group were （92.42±13.10）， （109.15±11.74）， and （120.62±11.63） points，respectively. The differences were statistically significant （P＜0.001）. The postoperative self-rating anxiety scale （SAS） score in the experimental group ［39.38 （35.00， 43.75） points］was significantly lower than that in the control group ［52.52 （50.00， 56.25） points； （P＜0.001］. The median postoperative length of hospital stay in the experimental group ［6.0 （5.00， 8.00） days］was significantly shorter than that in the control group ［8.5（6.00， 10.00） days； P＜0.05］. The incidence of reported postoperative pain was significantly lower in the experimental group compared to the control group （P＜0.05）.
Conclusion
A preoperative prehabilitation program can effectively promote enhanced recovery after surgery in patients undergoing abdominal incisional hernia repair by reducing postoperative pain and anxiety and shortening the length of hospital stay.
To investigate the pathological changes of abdominal wall muscles after preperitoneal space mesh repair of incision hernia in SD rats.
Methods
Forty-eight SD rats were randomly divided into normal control group （8 rats）， incisional hernia model group （8 rats）， hernia mesh repair group ［1 week postoperative group （8 rats）， 4 weeks postoperative group （8 rats）， 8 weeks postoperative group （8 rats）， 12 weeks postoperative group （8 rats）］. In the control group， rat abdominal wall muscle specimens were taken. In the incision hernia model group， incision hernia modeling was performed， and abdominal wall muscle specimens were taken after 2 weeks. The incision hernia modeling was performed first in the hernia mesh repair group， and mesh repair was performed after successful modeling， and abdominal wall muscle samples were taken 1， 4， 8， 12 weeks after implantation of the mesh，to observe the inflammatory cell infiltration and fibrous tissue proliferation of abdominal wall muscles.
Results
After incision hernia anterior peritoneal space mesh repair， fibrous necrosis， inflammatory cell infiltration， and fibrous tissue hyperplasia occurred in the abdominal wall muscle tissue close to the peritoneum. （1） Degree of inflammatory cell infiltration：compared with the control group， the degree of inflammatory cell infiltration was increased in the incision hernia model group， and the difference was statistically significant （P＜0.05）； compared with the incision hernia model group， the degree of inflammatory cell infiltration was significantly increased in the hernia mesh repair group 1 week after surgery， and the difference was statistically significant （P＜0.05）， while there was no significant difference in the degree of inflammatory cell infiltration in the hernia mesh repair group at 4， 8 and 12 weeks after surgery （P＞0.05）. （2） Degree of fibrous tissue hyperplasia：Compared with the control group， the degree of fibrous tissue hyperplasia was increased in the incision hernia model group and the difference was statistically significant （P＜0.05）； compared with the incision hernia model group， the degree of fibrous tissue hyperplasia was increased in the hernia mesh repair group one week after surgery （P＜0.05）， while there was no significant difference in the hernia mesh repair group 4， 8 and 12 weeks after surgery（P＞0.05）.
Conclusion
After preperitoneal space mesh repair in rats， both surgical trauma and mesh stimulation can lead to muscle fiber necrosis， inflammatory cell infiltration， and fibrous tissue hyperplasia in the abdominal wall muscle tissue close to the peritoneum. This pathological change may be related to the clinical movement pain in the mesh area after preperitoneal space mesh repair.
To evaluate the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia by a meta-analysis of randomized controlled trials （RCTs）.
Methods
A comprehensive， systematic meta- analysis of RCTs on the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia was performed. Studies were identified by searching PUBMED， EMBASE， Science Direct， Cochrane registered controlled trials and China national knowledge infrastructure （CNKI）， Wanfang， and other major domestic and foreign databases （until December 30， 2021）. Summary odd ratios or weighted mean differences with 95% confidence intervals were adopted for the calculation of each outcome by fixed or random effects model.
Results
A total of 10 RCTs involving 1034 patients were included. No statistically significant difference were found between the two groups in the recurrent rate （P=0.07； OR=0.61， 95% CI 0.35-1.05）， hematoma （P=0.16； OR=0.45， 95%CI 0.14-1.38）， urinary retention （P=0.82； OR=0.92， 95% CI 0.43-1.96）， acute pain （P=0.07， OR=1.83， 95%CI 0.95-3.54）） and operation times （P=0.62， MD 5.92， 95% CI -17.22-29.07）. The laparoscopic group had lower rates of incision infection （P=0.03； OR=0.31， 95% CI 0.11-0.91）， less chronic pain （P=0.001；OR=0.36， 95% CI 0.19-0.67）， and shorter hospital stays （P=0.004； MD -1.30， 95% CI -2.19--0.42）.
Conclusion
In terms of incisional infection， postoperative chronic pain， and hospital stay， laparoscopic surgery for recurrent inguinal hernia is superior to open mesh repair. This provides reliable evidence for the objective evaluation of the difference between laparoscopic and open mesh repair for recurrent inguinal hernias， and for the management of recurrent inguinal hernias. In the future， high-quality research on laparoscopic and open mesh repair treatments for recurrent inguinal hernia should be conducted to enhance the reliability of the conclusions.
Inguinal hernia is a common surgical condition for which surgery remains the primary treatment modality. Laparoscopic inguinal hernia repair （LIHR） has become a leading surgical approach for treating inguinal hernias due to its advantages， such as minimal invasiveness and rapid recovery. The development and application of single-port laparoscopic techniques， robotic-assisted surgery， and various novel mesh materials have provided new possibilities for the advancement of LIHR. This article comprehensively reviews the historical development， current progress， and research hotspots in LIHR，including the latest research status of surgical methods such as totally extraperitoneal， transabdominal preperitoneal， and single-incision laparoscopic surgery， as well as recent advancements in the application of mesh materials.
Inguinal hernia is a common surgical disease. Tension-free hernia repair has been proven to be the most effective method for treating this disease， significantly reducing the recurrence rate of hernia. Meanwhile， postoperative patch infection， as one of the serious complications of tension-free repair， brings great psychological and physiological pain and economic burden to patients， and has become the focus of everyone's attention. At present， there is no consensus on the diagnosis and treatment of mesh infection after inguinal hernia surgery. Therefore， this article reviews the progress in the diagnosis and treatment of postoperative mesh infection in inguinal hernia， in order to provide reference for formulating reasonable treatment plans and improving treatment effectiveness.
Natural orifice transluminal endoscopic surgery （NOTES） refers to abdominal endoscopic surgical procedures performed through a natural orifice without any skin incision. As one of the most important conditions in abdominal surgery， abdominal wall hernias have become an increasingly common focus of NOTES application research. In recent years， a considerable number of studies and publications have described the use of NOTES in hernia repair. This article provides a systematic review of the progress， current status， advantages， limitations， and challenges associated with NOTES in the repair of abdominal wall hernias， aiming to serve as a reference for clinical practice and research.
Hernia mesh is an important repair material for abdominal wall tissue defect， which can replace the weak and damaged abdominal wall fascia tissue. It is a transition from biocompatible material to individual tissue engineering material， and its development has provided surgeons with many new thoughts and ideas. The appearance of biological mesh undoubtedly brings good news to the development of hernia repair technology. However， with the deepening of a large number of clinical studies， there are doubts about the long-term efficacy of biological mesh in inguinal hernia repair. In recent years， with the rapid development of materials science， synthetic absorbable mesh has gradually attracted the attention of surgeons because of its fewer side effects. However， the degradation and regeneration of synthetic absorbable mesh in vivo is still not well understood. In order to make better use of absorbable patches， the degradation and regeneration of four kinds of absorbable synthetic patches are summarized in this paper.
Abdominal wall hernias are a common condition that requires surgical intervention.Effective surgical repair relies on the development and testing of new materials and technologies， often based on animal models. Among these， rat animal models are widely used due to their physiological and genetic similarities to humans and their manageable size. This paper reviews the latest advancements in rat animal models concerning abdominal wall hernias and mesh innovations， aiming to provide references for future research on abdominal wall hernias.
