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 theGuidelines 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.

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.

This article discusses three key indicators for evaluating the quality and complications of hernia and abdominal wall surgery： Surgical Site Infection （SSI）， Surgical Site Occurrence （SSO）， and Surgical Site Occurrences Requiring Procedural Interventions （SSOPI）.SSI is categorized into superficial，deep， and organ cavity infections， providing an in-depth understanding different infections severity.SSO includes wound-related events such as seroma and incision dehiscence， which expanding the definition of complications， but not fully reflect surgical quality.SSOPI focuses on complications requiring intervention but does not encompass non-surgical management.The Clavien-Dindo classification system serves as a more comprehensive tool that addresses multiple facets of surgical complications.However， it is necessary to establish a scoring system for adverse surgical events tailored to the actual situation in China， to further optimize postoperative management and individualized treatment.

The innovation of implant materials， the evolution of repair concepts， and the iteration of laparoscopic platforms have continuously driven the development and advancement of abdominal wall incisional hernia repair techniques.Over 30 years of practice， certain classic procedures have stood the test of time and gained widespread adoption， while approaches that do not align with modern repair principles have gradually faded from use.Contemporary abdominal wall surgery emphasizes repair， structural reconstruction， and functional restoration.Any surgical approach must balance the principles of abdominal wall functional reconstruction with the advantages of minimally invasive techniques to achieve optimal clinical outcomes.It is anticipated that with the continuous optimization of intraperitoneal mesh and the exploration of extraperitoneal techniques， minimally invasive abdominal wall incisional hernia repair will see more refined solutions in the future.This article reviews the historical evolution of abdominal wall incisional hernia repair， discusses the current state of techniques， and explores future development trends.

As one of the common diseases in abdominal surgery， abdominal wall hernia often causes pain caused by the prolapse of the abdominal cavity organs， and even causes serious consequences such as organ necrosis， so more surgical treatment is needed.The fundamental reason for this is that a weak abdominal wall， collagen imbalance， or abnormal collagen fibers can lead to weakening and thinning of the connective tissue of the abdominal wall， which in turn can lead to the development and recurrence of hernias.Numerous studies have shown that the proportional dysregulation of type I / typeⅢ of collagen in the fascial tissue is the main factor involved in the inguinal hernia.It has been demonstrated that wound-healing collagen deposition is significantly affected by patch type ， however， to date， no studies have investigated the role of different graft materials on collagen deposition and tissue remodeling in the human fascia.This article summarizes the effects of 3 types of hernia patches （non-absorbable patches，biological patches， and synthetic absorbable patches） on collagen deposition.

Objective

To evaluate the lesion detection rate and completeness rate of the preoperative ultrasonic diagnosis in patients with external abdominal hernia， and to analyze the quality of preoperative ultrasonic reports， thereby exploring potential improvement measures.

Methods

We conducted a retrospective analysis of clinical data， ultrasonic examination results， and surgical records from patients with external abdominal hernias who underwent surgery at Peking Union Medical College Hospital from January to December 2023.With intraoperative diagnosis as the gold standard， the lesion detection rate were evaluated， and the quality of the reports was evaluated based on whether they indicated the type of inguinal hernia， the width of the neck of the hernia sac and its mobility.

Results

A total of 112 patients with surgically treated external abdominal hernias were included in the study， comprising 98 cases of inguinal hernia and 14 cases of abdominal wall hernia.The preoperative ultrasonic lesion detection rate of inguinal hernia was 95.9%， and the completeness rate of the ultrasound report of inguinal hernia was 14.3%.The preoperative ultrasonic lesion detection rate of ventral hernia was 100.0%， and the completeness rate of the ultrasound report of ventral hernia was 50.0%.

Conclusion

Ultrasound demonstrates a high detection rate for external abdominal hernias， effectively providing information regarding location， size， neck width of the hernia sac， mobility characteristics and relationships with surrounding tissues.Consequently， it is recommended that more comprehensive information be included in ultrasound reports to assist clinicians in making decisions and treatment.

Objective

To investigate the application of laparoscopic total visceral sac separation（TVS） in lumbar hernia.

Methods

A total of 12 cases of lumbar hernia were admitted to the Department of General Ⅱ Surgery， the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were statistically collected， including 11 cases of primary lumbar hernia and 1 case of acquired lumbar hernia （after renal cyst fenestration and drainage surgery）.General information， operation time， postoperative pain score， length of stay， the diameter of defect， postoperative complications， and postoperative recurrence rate were observed.

Results

All patients successfully underwent totally extraperitoneal （TEP） laparoscopic hernia repair.The operative time ranged from 45 to 112 minutes， with an average duration of 79 minutes.Postoperative pain， assessed using the visual analog scale （VAS）， ranged from 1 to 3， with a mean score of 2.3.The postoperative hospital stay ranged from 2 to 4 days， averaging 2.7 days.The defect diameter measured 1.6 to 3 cm， with a mean of 2.3 cm.Two patients developed seromas， which were managed conservatively and resolved spontaneously within three months of follow-up.No cases of wound infection， hematoma， or chronic pain were observed.During a follow-up period of 5 to 15 months， no hernia recurrence was reported.

Conclusion

Laparoscopic TVS is safe，reliable and less traumatic in the treatment of lumbar hernia.

Objective

To investigate the application value of hernia wearable device in laparoscopic inguinal hernia day surgery.

Methods

A retrospective cohort study was conducted，including 180 patients who underwent inguinal hernia day surgery in the Hernia and Abdominal Wall Surgery Department of The Sixth Affiliated Hospital of Sun Yat-sen University from March 2021 to March 2023.Patients were divided into groups based on their willingness to wear a hernia support device postoperatively.A total of 114 patients who wore the device were assigned to the observation group， while 66 patients who received standard postoperative care were assigned to the control group.Follow-up assessments were conducted on postoperative day 1， day 7， 1 month， and 6 months via outpatient visits and telephone interviews.The postoperative quality of life， pain levels， and complications were compared between the two groups.

Results

Among the 180 patients， 174 were male and 6 were female， with an age range of 18.0 to 80.0 years and a median age of 52.0 years.Regarding postoperative quality of life， the Carolina Comfort Scale （CCS） scores in the observation group at postoperative day 7 and 1 month were significantly lower than those in the control group （z=-2.348 and -3.302， P=0.019 and 0.001， respectively），indicating an improved quality of life.Similarly， the Visual Analog Scale （VAS） scores for pain were significantly lower in the observation group at both postoperative day 7 and 1 month （z=-2.073 and -2.606，P=0.033 and 0.005， respectively）， and a positive correlation was noted between the CCS scores and VAS-H.Furthermore， on postoperative day 7， the Generalized Anxiety Disorder-7 （GAD-7） scores in the observation group were significantly lower than those in the control group （t=-3.165， P=0.002），demonstrating reduced anxiety levels.In terms of complications， the incidence of seroma within 6 months was 6.1% （7/114） in the observation group， which was significantly lower than the 9.1% （6/66） observed in the control group （χ²=4.239， P=0.039）.No cases of hernia recurrence were noted in either group during the 6-month follow-up period.

Conclusion

The use of hernia wearable device can significantly improve the postoperative quality of life and reduce postoperative pain and the incidence of seroma in patients with inguinal hernia day surgery.

Objective

To explore the feasibility and efficacy of robot-assisted laparoscopic parastomal hernia repair （Sugarbaker）.

Methods

A retrospective analysis was conducted on the clinical data of 7 cases of robot-assisted laparoscopic parastomal hernia repair completed in Union Medicine Center in Tianjin from March 2024 to July 2024.The method of All patients repaired was Sugarbaker.Observe and record the surgical situation， including operation time， intraoperative complications （intraoperative hemorrhage， intestinal injury）， and the occurrence of robotic system failure； postoperative recovery，including postoperative water intake， eating time， postoperative exhaust and defecation time， pain level on the first day after surgery， and postoperative hospital stay.Follow up the post-discharge complications，including stoma infections， intestinal obstruction， and hernia recurrence.

Results

All seven patients successfully underwent surgery without intraoperative complications or robotic system malfunctions.The operative time ranged from 150 to 240 minutes， with an intraoperative blood loss of 10 to 50 ml， and no intraoperative transfusions were required.Postoperatively， all patients were allowed oral water intake at 6 hours after surgery， followed by a liquid diet on postoperative day 1.The time to first flatus ranged from 1 to 3 days， with an average of 1.57 days， while the time to first bowel movement was 2 to 4 days， averaging 2.86 days.Postoperative pain was mild， with Numeric Rating Scale （NRS） scores on postoperative day 1 ranging from 2 to 4， with a mean of 2.71.The postoperative hospital stay ranged from 4 to 5 days， with an average of 4.29 days.During the 1-to 4-month follow-up period， one patient developed postoperative intestinal obstruction， which resolved with conservative treatment.No cases of stoma infection or hernia recurrence were observed.

Conclusion

Robot-assisted laparoscopic parastomal hernia repair is safe and effective， with a relatively low complication rate and short term recurrence rate， but the long-term effect needs to be further observed.

Objective

To evaluate the therapeutic effects of totally endoscopic sublay repair（TES） compared to laparoscopic intraperitoneal onlay mesh repair （IPOM） in treating umbilical hernias and their influence on patients' short-term postoperative quality of life.

Methods

This study retrospectively analyzed clinical data of 48 patients with umbilical hernias who underwent surgical treatment in Beijing Chaoyang Hospital， Capital Medical University， between June 2023 and February 2024.Patients were categorized into two groups based on the surgical method： the TES group （11 cases）and the IPOM group （37 cases）.Surgical data， length of hospital stay， hospitalization costs， and perioperative complications were compared between the two groups to evaluate surgical outcomes， with a focus on visual analogue scale （VAS） and the Short-Form 36 （SF-36） scores to assess the short-term postoperative quality of life.

Results

No statistically significant differences were observed between the two groups in terms of age， sex， body mass index， disease duration， comorbidities， or the use of anticoagulant and antiplatelet medications （P＞0.05）.No significant differences were found in surgical time， blood loss， hospital stay length， complications， or recurrence rates between the two groups（P＞0.05）.The hospitalization cost for the TES group was （19 133.36±4277.28） yuan， significantly lower than that of the IPOM group （38 596.68±16 764.63 yuan）， with a statistically significant difference（P＜0.001）.Regarding postoperative pain， 30 （81.1%） patients in the IPOM group had a VAS score ≥3 at discharge， compared to 2 （18.2%） patients in the TES group， with a statistically significant difference（P＜0.001）.Postoperative SF-36 scores indicated significant quality-of-life improvements in both groups，but with no statistically significant difference between groups （P＞0.05）.

Conclusion

Both TES and IPOM surgeries exhibit good effect for umbilical hernias and enhance the short-term postoperative quality of life in patients.TES offers benefits in reducing postoperative pain and lowering hospitalization costs.

Objective

To investigate the safety and efficacy of the multi-disciplinary team combined with enhanced recovery after surgery model （MDT-ERAS model） in the diagnosis and treatment of hiatal hernia.

Methods

This study retrospectively analyzed the clinical data of 100 patients with hiatal hernia who underwent laparoscopic hiatal hernia repair+ fundoplication at the Chengdu Fifth People's Hospital from January 2021 to January 2024.According to whether the patients were managed under the MDT-ERAS mode， they were divided into the MDT-ERAS group with 49 cases and the conventional group with 51 cases.Two groups of patients were compared in terms of general condition， intraoperative indicators， postoperative recovery， postoperative complications （including intestinal obstruction，gastrointestinal leakage， urinary retention， incision infection， abdominal infection， pulmonary infection，urinary system infection， postoperative adverse reactions， length of stay， pain score， and satisfaction score.

Results

There were no significant differences between the two groups in terms of blood loss （15.6±6.5 ml vs.15.8±6.5 ml； t=-0.194， P=0.846）， operation time （62.6±5.7 min vs.62.5±5.8 min； t=0.054， P=0.957）， and drainage tube retention rate （1/49 vs.2/51； χ²=0.000， P＞0.999）.In terms of intraoperative fluid infusion volume， the MDT-ERAS group was lower （1353.1±295.2 ml vs.1721.6±330.6 ml； t=-5.871， P＜0.001）.The time of first postoperative exhaust （17.6±4.2 h vs.25.5±3.0 h； t=-10.823， P＜0.001）， the time of first liquid diet （6.6±1.2 h vs.18.8±4.8 h； Z=-8.762， P＜0.001）， the time of first semi-liquid diet （24.9±1.3 h vs.48.8±3.5 h； Z=-8.750， P＜0.001）， the time of first getting out of bed （6.7±1.3 h vs.25.1±3.1 h； Z=-8.821，P＜0.001）， and the time of urinary catheter indwelling （1.2±0.6 d vs.1.8±0.7 d； Z=-5.239， P＜0.001） in the MDT-ERAS group were shorter than those in the conventional group.There was no statistically significant difference in the incidence of postoperative complications between the two groups.The incidence of postoperative abdominal distention （1/49 vs.8/51； χ²=4.137， P=0.042）， nausea and vomiting （2/49 vs.10/51； χ²=4.329， P=0.037） in the MDT-ERAS group was lower than those in the conventional group， and the difference was statistically significant.There was no statistically significant difference in non-infectious fever and dysphagia between the two groups.The pain score of patients in the MDT-ERAS group was lower （3.2±1.2 vs.5.2±1.4； Z=-6.175， P＜0.001）， and the average length of stay in the MDT-ERAS group was shorter （3.3±0.7 d vs.3.8±0.8 d； Z=-3.222， P=0.001） than those in the conventional group.The satisfaction score of patients in the MDT-ERAS group was higher （4.4±0.7 vs.3.6±0.8； Z=-4.384，P＜0.001）， with statistically significant difference.The average follow-up months were 20.6±7.2 in the MDT-ERAS group and 20.1±7.1 in the conventional group.One patient in each of the two groups had a recurrence.One patient in the conventional group developed dysphagia one month after surgery， and the symptoms disappeared after conservative treatment.

Conclusion

The multi-disciplinary team combined with enhanced recovery after surgery mode is safe and effective in the diagnosis and treatment of hiatal hernia.

Objective

Exploring the characteristics of mesh infection after tension-free repair of groin hernia and the selection of a surgical approach for removing infected meshes.

Methods

A retrospective analysis was conducted on the clinical and follow-up data of 38 surgical patients who underwent mesh removal due to mesh infection at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2020 to October 2023.Based on the initial surgical method and the level of mesh placement during the initial surgery， they were divided into Group A （laparoscopic hernia surgery group）， Group B（Lichtenstein surgery group）， and Group C （mesh plug+ flat mesh surgery group）， summarize the characteristics of mesh infection after tension-free repair of groin hernia， as well as the selection of surgical approach for removing infected meshes.

Results

Mesh infection occurred 3 days to 10 years postoperatively， with 17 cases within 6 months postoperatively and 21 cases over 6 months.38 patients underwent infection mesh removal surgery， with a surgical time of 119 （84， 170） minutes； A postoperative hospital stay of 7 （6， 12） days； 19 cases underwent postoperative vacuum sealing drainage （VSD） and secondary wound closure.Out of 38 patients， 35 were followed up for 2-42 months， with a median follow-up time of 22 months； 4 cases of recurrent infection in the inguinal region after surgery （reinfection rate 11.4%）； 5 cases underwent postoperative recurrence of groin hernia （recurrence rate 14.3%）； Of the 5 recurrence patients， 2 had undergone TAPP surgery， 1 had undergone TAPE surgery， and 2 cases had not undergone surgical treatment yet.Among the 12 patients in Group A， 2 cases underwent an open anterior approach for mesh retrieval， and 10 cases underwent a laparoscopic posterior approach for mesh retrieval；15 cases in Group B were all treated with patch removal through an open anterior approach； among the 11 patients in Group C， 8 used a hybrid approach to remove infected meshes， and 3 used an open anterior approach to remove infected meshes.

Conclusion

The removal of infected meshes is an effective method for treating postoperative meshes infections in groin hernias.The method of initial hernia surgery and the placement level of the mesh are important influencing factors for the surgical approach of mesh removal.

Objective

To explore the application of general anesthesia combined with ultrasound-guided transverse abdominal plane （TAP） block anesthesia in elderly inguinal hernia repair.

Methods

The clinical data of 100 elderly patients undergoing laparoscopic inguinal hernia repair in Jianhu County People's Hospital of Jiangsu Province from January 2020 to March 2023 were retrospectively analyzed.They were divided into observation group and control group according to anesthesia method， with 50 patients in each group.The control group underwent simple general anesthesia，while observation group underwent general anesthesia combined with ultrasound-guided TAP block anesthesia.Heart rate （HR） and mean arterial pressure （MAP） before anesthesia （T0）， before incision （T1），10min after incision （T2）， and immediately after surgery （T3）； visual analogue scale scores （VAS） after recovery （T4）， 6 h （T5）， 24 h （T6）， and 48 h （T7） after surgery； simple Mental State Assessment Scale（MMSE） scores at T0， T6 and 7 days after surgery （T8）； intraoperative analgesics addition， recovery time，Cravero score were compared between the two groups.

Results

At T4， there was no significant difference in VAS scores between the two groups （P＞0.05）.At T5， T6 and T7， VAS scores in observation group were significantly lower than those in control group， with statistically significant difference （P＜0.05）.At T0 and T1， there was no significant difference in HR and MAP levels between the two groups （P＞0.05）.At T2 and T3， levels of HR and MAP in observation group were significantly lower than those in control group， with statistically significant difference （P＜0.05）.At T0， there was no significant difference in MMSE scores between 2 groups （P＞0.05）.At T6 and T8， MMSE scores in observation group were significantly higher than those in control group （P＜0.05）.The postoperative additional dosages of propofol and sufentanil in observation group were significantly lower than those in control group （P＜0.05）.The recovery time in observation group was significantly shorter than that in control group， and Cravero score was significantly lower than that in control group （P＜0.05）.

Conclusion

General anesthesia combined with ultrasound-guided TAP block anesthesia has a good anesthetic effect on elderly patients undergoing laparoscopic inguinal hernia repair， which can effectively relieve postoperative pain， reduce intraoperative analgesics addition and improve recovery quality， with less influences on hemodynamics and cognitive function.

Objective

To explore the application of transcutaneous electrical acupoint stimulation（TEAS） combined with transverse abdominis plane block （TAP） in laparoscopic transabdominal preperitoneal hernia repair （TAPP）.

Methods

Sixty patients with TAPP under general anesthesia were randomly divided into the TAP group and the TEAS+TAP group， with 30 patients in each group.After TAP group anesthesia induction， bilateral TAP was performed under ultrasound guidance.TEAS+TAP group stimulated the Hegu-Zusanli point 30 minutes before anesthesia induction， and bilateral TAP was performed after anesthesia induction.The dosage of propofol and remifentanil during operation and the time of tracheal extubation after operation were recorded.Hemodynamic indexes before anesthesia （T1），operation （T2）， and extubation （T3）； pain visual analogue scale （VAS） score， Ramsay sedation score at 4， 8，12 and 24 hours after operation， Pittsburgh sleep quality index （PSQI） score at 48 hours after operation，time to remove catheter， time to get out of bed after operation， time to recover intestinal function and days of hospitalization.

Results

The dosage of propofol and remifentanil during operation and the extubation time after operation in the TEAS+TAP group were significantly shorter than that in the TAP group（P＜0.05）.Hemodynamic indexes in the TEAS+TAP group were significantly better than those in the TAP group at T2 and T3 （P＜0.05）.The VAS scores， Ramsay sedation score of patients in the TEAS+TAP group were lower than those in the TAP group at 4， 8， 12 and 24 hours after the operation （P＜0.05）， and 48 hours after the operation，the PSQI score ≤7 points was higher than those in the TAP group （P＜0.05）.Compared with the TAP group， the time of getting out of bed after the operation， recovery time of intestinal function and the days of hospitalization in the TEAS+TAP group were significantly shortened.

Conclusion

TEAS combined with TAP is helpful to reduce the dosage of anesthetic during operation， shorten the recovery time， reduce postoperative complications and accelerate the rapid recovery of patients.

Objective

To analyze and compare the therapeutic effects and recurrence rates of laparoscopic hernia repair and traditional hernia repair in the treatment of inguinal hernia.

Methods

The clinical data of 83 patients with inguinal hernia treated at the First People's Hospital of Suzhou from May 2019 to May 2023 were collected for retrospective analysis.The patients treated with the traditional open tension-free hernia repair （Lichtenstein procedure） were assigned to the control group， with a total of 40 cases； the patients treated with laparoscopic transabdominal preperitoneal hernia repair （TAPP） or laparoscopic totally extraperitoneal hernia repair （TEP） were assigned to the observation group， with a total of 43 cases.The operation time， intraoperative blood loss， postoperative pain duration， average hospital stay， the expression levels of serum C- reactive protein （CRP） and tumor necrosis factor-α （TNF-α）， and the complications of all patients were analyzed.

Results

The operation time， intraoperative blood loss，postoperative pain duration， and average hospital stay in the observation group were all shorter than those in the control group， and the differences were statistically significant （P＜0.05）； the expression levels of CRP and TNF-α after operation in the observation group were lower than those in the control group， and the differences were statistically significant （P＜0.05）； the incidence of postoperative complications and recurrence rate in the observation group were lower than those in the control group， and the differences were statistically significant （P＜0.05）.

Conclusion

Compared with traditional hernia repair， TAPP and TEP show better therapeutic effects.These two surgical procedures have a lower incidence of complications and recurrence rate， which helps to relieve patients' pain， reduce the risk of incision infection， improve patients' physical condition， and increase patients' satisfaction.

Objective

To compare the clinical efficacy of laparoscopic transabdominal preperitoneal repair （TAPP group） and open preperitoneal repair with Ultrapro Hernia System （UHS group）in the treatment of adult patients with groin hernia， and to explore the significance of membrane anatomy principle in guiding the surgical procedure.

Methods

The clinical data of 163 adult patients with groin hernia from January 2022 to October 2023 treated by general surgery in Anting Hospital， Jiading District，Shanghai were analyzed retrospectively.According to the surgical method， patients were divided into TAPP group （laparoscopic TAPP surgery， 92 cases） and UHS group （open preperitoneal repair， 71 cases）.The baseline data， operative data， postoperative visual analogue scale（VAS） scores， length of hospital stay，total cost， postoperative complications and recurrence of the two groups was compared.

Results

The age，ASA grade of the patients in UHS group were higher than those in TAPP group.There were significant differences in hernia classification and type between the two groups （P＜0.001）.No significant difference in operation time were observed between two groups.Compared with the UHS group， the TAPP group had lower postoperative pain VAS scores and shorter hospital stays， but higher hospitalization costs， with statistically significant differences （P＜0.001， P=0.001， P＜0.001）.There was no significant difference in the overall postoperative complications between the two groups.There was no Clavien-Dindo grade I or above complications in the TAPP group， and 2 cases of Clavien-Dindo grade Ⅱ and 1 case of grade Ⅲcomplications in UHS group.

Conclusion

Both TAPP and open preperitoneal repair with UHS guided by the concept of membrane anatomy are safe and effective in the treatment of adult patients with groin hernia.TAPP has the advantages of better visual field with endoscopy， less trauma， less postoperative pain and faster recovery.The advantage of open preperitoneal surgery is that it provides a variety of anesthesia options， which means it can be performed for a wider range of patients.

Objective

To analyze the application of absorbable mesh in open inguinal hernia repair in elderly patients.

Methods

We collected the data of 105 elderly patients who were admitted to Taiyuan Central Hospital for inguinal hernia and accepted open Lichtenstein repair from December 2020 to December 2022.Patients were divided into absorbable mesh group （absorbable group） and synthetic mesh group （synthetic group） based on the intraoperative type of mesh.The clinical data and postoperative follow-up outcomes of the two groups were compared.

Results

All 105 patients successfully completed open Lichtenstein surgery under local anesthesia， with 55 cases in the absorbable group， and 50 cases in the synthetic group.There were no statistically significant differences between the two groups in terms of sex，age， body mass index， onset time， hernia location， hernia type， operation time， and hospital stay （P＞0.05）.There were 23 cases （41.82%） of postoperative seroma in the absorbable group and 11 cases （22.00%） in the synthetic group， and the difference between the two groups was statistically significant （P＜0.05）.All patients with postoperative seroma were healed and absorbed after conservative observation.The visual analogue scale （VAS） score at discharge was （2.27±1.13） points in the absorbable group and （2.24±1.10）points in the synthetic group at discharge， with no significant difference （P＞0.05）.The three-month postoperative pain VAS score of the absorbable group was （0.82±0.58） points and that in the synthetic group was （1.26±0.72） points， with a statistically significant difference （P＜0.05）.There was no recurrence，no other postoperative complications such as foreign body sensation and infection in the two groups during 1-2 years of follow-up.

Conclusion

The effect of absorbable mesh in open inguinal hernia repair for elderly patients is comparable to that of synthetic mesh.The incidence of postoperative seroma with absorbable mesh is higher， but the pain level in the medium and long term is mild.

Objective

To analyze the risk factors for the occurrence of esophageal hiatal hernia.

Methods

A total of 200 patients who underwent gastroscopy in Beijing Chaoyang Hospital， Capital Medical University from January 2021 to December 2023 were selected.Among them， 100 patients diagnosed with esophageal hiatal hernia under endoscopy were selected as the case group， and 100 patients without esophageal hiatal hernia under endoscopy were selected as the control group.Questionnaire was used to analyze the general situation， lifestyle， and occupational status of two groups of patients.Univariate and multivariate logistic regression analysis were used to explore the risk factors for esophageal hiatal hernia.

Results

Univariate analysis showed that the proportion of males， age， obese individuals， smokers，drinkers， constipated individuals， postprandial exercise participants， high-fat diet participants， eating too fast， overeating， spicy eating habits， sitting for long time， and depression in the case group were higher than those in the control group （P＜0.05）.Multivariate logistic regression analysis showed that advanced age，obesity， and a preference for spicy food were high risk factors for esophageal hiatal hernia （OR=16.498，12.891，3.718，all P＜0.001）.

Conclusion

Advanced age， obesity， and a preference for spicy food are high risk factors for esophageal hiatal hernia.For high-risk individuals， it is important to encourage them to develop good lifestyle and dietary habits， which can help prevent the occurrence of hiatal hernia and control its progression.

Objective

This study aimed to analyze the risk factors for postoperative complications following transabdominal preperitoneal hernia repair （TAPP） in elderly patients.

Methods

A total of 300 elderly inguinal hernia patients treated at Chuiyangliu Hospital in Beijing from January 2021 to December 2023 were included.Postoperative complications were followed up over a period of 12 to 24 months.Univariate and logistic regression analyses were used to identify independent risk factors for postoperative complications.

Results

Out of the initial 300 patients， 18 were lost to follow-up， resulting in a final cohort of 282 patients.Among these， 46 patients （16.31%） experienced postoperative complications.Univariate analysis revealed significant differences in body mass index （BMI）， age， degree of adhesion，presence of comorbidities preoperatively， choice of mesh， and hernia type （P＜0.05）.Multivariate logistic regression analysis identified BMI， age， degree of adhesion， hernia type， and the presence of preoperative comorbidities as independent risk factors for the development of postoperative complications （P＜0.05）.

Conclusion

The incidence of postoperative complications in elderly patients undergoing transabdominal preperitoneal hernia repair （TAPP） is considerable.Factors such as BMI， age， degree of adhesion， presence of preoperative comorbidities， and hernia type significantly increase the risk of complications.It is crucial to develop effective diagnostic， therapeutic， and nursing strategies that specifically address these risk factors during the perioperative period for this patient population.

Objective

To evaluate the application outcomes of the enhanced recovery after surgery （ERAS） philosophy in the nursing care of elderly patients following inguinal hernia repair.

Methods

A total of 150 elderly patients who underwent inguinal hernia repair at the First Affiliated Hospital of Guangdong Pharmaceutical University between May 2022 and May 2023 were selected and randomly assigned to either the control group or the observation group， with 75 patients in each group.The control group received routine nursing care， while the observation group received nursing care based on the ERAS concept.Postoperative pain levels， hemodynamic parameters， recovery status， quality of life， and nursing satisfaction were assessed and compared between the two groups.

Results

The visual analog scale （VAS） pain scores at 12， 24， and 48 hours postoperatively were significantly lower in the observation group than in the control group， and the duration of pain was shorter in the observation group （P＜0.05）.Additionally， postoperative heart rate， diastolic blood pressure， and systolic blood pressure were lower in the observation group compared to the control group.The time to first ambulation， bowel sound recovery，and hospital length of stay were all significantly shorter in the observation group.Furthermore， the short-form- 36 health survey （SF-36） quality of life questionnaire scores at one month postoperatively were higher in the observation group， while the incidence of postoperative complications was lower.Nursing satisfaction was also significantly higher in the observation group， with all differences being statistically significant （P＜0.05）.

Conclusion

The application of the ERAS philosophy in the nursing care of elderly inguinal hernia repair patients postoperatively can significantly enhance postoperative recovery quality， reduce pain， shorten hospital stay， and increase patient satisfaction， holding significant clinical application value.

Objective

To investigate the application of strategy optimization management mode under the intelligent health education platform in adult patients undergoing inguinal hernia surgery.

Methods

152 patients who underwent inguinal hernia surgery in Nanjing Gaochun People's Hospital from January 2021 to December 2022 were selected， and were divided into the control group （n=76，routine management） and the observation group （n=76， intelligent health education platform combined with strategy optimization management） by random number table method.The two groups were compared in terms of surgical indicators （surgical time， length of hospital stay， intraoperative blood loss and time to out-of-bed activities）， postoperative pain， serum 5-hydroxytryptamine （5-HT） and prostaglandin E2 （PGE2）levels， complications， and satisfaction.

Results

Surgical time， length of hospital stay， and time to out-of-bed activities in the observation group were shorter than those in the control group （P＜0.05）.There was no significant difference in intraoperative blood loss between the two groups （P＞0.05）.Repeated measures analysis of variance found that there were statistically significant differences in terms of time effect， inter-group effect， and interaction effect （P＜0.05）.Visual analogue scale （VAS） scores of the observation group at 12， 24 h after surgery were lower than those of the control group （P＜0.05）， but there was no significant difference in the VAS scores of the two groups at 2， 36， 48 h after surgery （P＞0.05）.After intervention， serum 5-HT and PGE2 levels in the two groups decreased， and levels in the observation group were lower than those in the control group （P＜0.05）.The postoperative complications of the two groups included venous thrombosis， seroma， subcutaneous emphysema and urinary retention.The incidence of complications was lower in the observation group than in the control group （P＜0.05）， and satisfaction rate was higher in the observation group than in the control group （P＜0.05）.

Conclusion

Applying intelligent health education platform combined with strategy optimization management mode in the intervention of patients undergoing inguinal hernia surgery can improve surgical indicators， alleviate pain， reduce the incidence of complications， and improve satisfaction， which is worthy of clinical promotion.

Objective

To investigate the application effect of comfort and fine dual track intervention patients with inguinal hernia.

Methods

A total of 94 patients with inguinal hernia admitted to Xuancheng People's Hospital from July 2021 to May 2023 were selected by convenience sampling method.They were divided into the observation group and the control group according to the random number table method， with 47 patients in each group.The control group received routine intervention，while the observation group received comfort and fine dual track intervention during the perioperative period.Postoperative recovery， postoperative complications， acute pain， anxiety， and depression in the two groups were compared.

Results

After intervention， the first eating time， pain duration and hospital stay of the observation group were shorter than those of the control group （P＜0.05）.At 6 h and on day 1 and day 3 after surgery， the Visual Analogue Scale （VAS） scores of the observation group were lower than those of the control group （P＜0.05）.The Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS）scores of the observation group before anesthesia and on day 3 after surgery were lower than those of the control group （P＜0.05）.The incidence of complications in the observation group was lower than that in the control group （P＜0.05）.

Conclusion

Comfort and fine dual track intervention is more effective than routine nursing for patients in the perioperative period of inguinal hernia repair.The former can shorten postoperative recovery time， relieve perioperative pain， reduce the incidence of complications， and alleviate postoperative negative emotions.

Objective

To evaluate the application and effect of a self-education method combined with a checklist evaluation system in laparoscopic transabdominal preperitoneal （TAPP） hernia repair surgical teaching.

Methods

A total of 30 surgeons who participated in TAPP surgical training at Peking University People's Hospital from October 2022 to December 2023 were enrolled in the study.Based on different teaching methods， they were divided into a control group and a self-lecture group， with 15 participants in each.The control group received traditional lectures， whereas the self-lecture group underwent self-lecture teaching in addition to traditional lectures.Both groups were assessed using the checklist evaluation system and a theoretical examination， which included surgical video assessments and written tests.

Results

The self-lecture group achieved an average assessment score of 90.00±3.18.In the theoretical examination， the self-lecture group scored significantly higher than the control group （88.40±4.63 vs.82.27±5.28， P=0.002）.Similarly， in the surgical video assessment， the self-lecture group outperformed the control group （19.93±1.94 vs.18.40±2.06， P=0.045）， with both differences being statistically significant.

Conclusion

The self-education method combined with the checklist evaluation system can improve students' active learning awareness and accurately evaluate students' surgical performance， thereby improving the theoretical and practical abilities of TAPP surgery.