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> Disorders > Anatomical Abnormality > Hernia

Hernia

Hernias are a common medical condition where organs or tissues protrude through a weak spot in the abdominal wall.
This can lead to pain, discomfort, and potentially serious complications if left untreated.
PubCompare.ai's AI-driven platform helps researchers optimize hernia research by identifying the most accurate and reproducible protocols from literature, pre-prints, and patents.
Leveraging advanced AI comparisons, the platform pinpoint the best protocols and products to enhance the hernia research process, promoting enhanced reproducibility and accuarcy.

Most cited protocols related to «Hernia»

1
Incisional Hernia Classification Proposals
Chevrel and Rath [3 (link)] proposed a classification for incisional hernias in 2000. This classification is attractive, because it is simple, and the data required to reach the classification are readily obtained. Three parameters were utilised. Firstly, the localisation of the hernia of the abdominal wall: divided into median (M1–M4) and lateral (L1–L4) hernias. Secondly, the size of the hernia: it was postulated that the width of the hernia defect is the most important parameter (greater than hernia defect surface, length of the hernia or size of the hernia sac), which was divided into four groups (W1–W4). As a third parameter of this classification, subgroups were made for incisional hernias and recurrences: the number of previous hernia repairs was recorded as (R0, R1, R2, R3,…). Although apparently easy to use, this classification has not been commonly used in the literature.
In his book on hernia surgery, “Hernien”, Schumpelick described a classification that divided incisional hernias into five classes [2 ]. The size of the defect, the clinical aspect of the hernia in lying and standing position, the localisation of the incision and the number of previous repairs were used for this classification.
Korenkov et al. [4 (link)] reported on the results of an expert meeting on classification and surgical treatment of incisional hernia, but no detailed classification proposal resulted from this meeting.
Ammaturo and Bassi [6 (link)] suggested an additional parameter to the Chevrel classification. The ratio between the anterior abdominal wall surface and the wall defect surface predicts a strong abdominal wall tension when closing the defect, with possible abdominal compartment syndrome development, and thus might influence the choice of surgical technique.
Recently, Dietz et al. [5 (link)] proposed another alternative classification of incisional hernias in which variables like body type, hernia morphology and risk factors for recurrence were included and recommendations made for surgical repair based on the different types. It is based on a self-explanatory taxonomy and is intended to tailor the repair to the body type and risk factors of the individual patient.
The Swedish Abdominal Wall Hernia Registry presented their data collection sheet for incisional and ventral hernias at the EAES congress in Stockholm in June 2008, which forms the basis for a classification and includes many prognostic relevant variables. For this reason Agneta Montgomery was invited to the consensus meeting to present the method of classification used in Sweden.
Muysoms F.E., Miserez M., Berrevoet F., Campanelli G., Champault G.G., Chelala E., Dietz U.A., Eker H.H., El Nakadi I., Hauters P., Hidalgo Pascual M., Hoeferlin A., Klinge U., Montgomery A., Simmermacher R.K., Simons M.P., Śmietański M., Sommeling C., Tollens T., Vierendeels T, & Kingsnorth A. (2009). Classification of primary and incisional abdominal wall hernias. Hernia, 13(4), 407-414.
Publication 2009
Abdominal Compartment Syndrome Experimental Autoimmune Encephalomyelitis Hernia Hernia, Abdominal Herniorrhaphy Incisional Hernia Operative Surgical Procedures Patients Recurrence Somatotype Ventral Hernia Wall, Abdominal Wound Healing
2
Comprehensive Analysis of Surgical Complications at a University Hospital
Over the 6‑month period covering April 2010 to September 2010, all patients admitted to one of our patient wards at the Division of General Surgery, Department of Surgery, Medical University of Vienna were included in this study.
The Division of General Surgery in our university hospital consists of the following teams and specializations: colorectal surgery, hepatobiliary surgery, endocrine surgery, upper gastrointestinal (GI) surgery (esophageal and stomach surgery), bariatric surgery, breast surgery, and pancreatic surgery.
The patient data were extracted by reviewing all discharge letters from that period taken from the digital archives.
Overall, 517 patients were admitted over this period, some repeatedly, leading to a total of 817 admissions. These 517 patients underwent 463 operations. The complications of these operations were then rated according to the Clavien-Dindo classification (Table 1). For easier use, the suffix “d” for permanent disability was not drawn upon.

Clavien-Dindo classification

GradeDefinition
Grade IAny deviation from the normal postoperative course without the need for pharmacological treatment, or surgical, endoscopic, and radiological interventions.Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics and electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside
Grade IIRequiring pharmacological treatment with drugs other than such allowed for grade I complications.Blood transfusions and total parenteral nutrition are also included
Grade IIIRequiring surgical, endoscopic, or radiological intervention
Grade IIIaIntervention not under general anesthesia
Grade IIIbIntervention under general anesthesia
Grade IVLife-threatening complication (including central nervous system complications) requiring IC/ICU management
Grade IVaSingle organ dysfunction (including dialysis)
Grade IVbMultiorgan dysfunction
Grade VDeath of a patient

According to Dindo et al. [6 (link)]

IC intermediate care, ICU intensive care unit

The operations were sorted according to the complexity ranking (eight groups) in the accounting system of the Austrian Chamber of Physicians (Table 2; [8 ]).

Operation groups (complexity according to the Austrian Chamber of Physicians)

Operation groupExamples
IAbscess incisions, secondary sutures, proctoscopy, skin biopsy
IIExcisions of atheromas, fibromas, lipomas, incisions of anal abscesses
IIIToe amputation, small lymph node extirpation, thoracic drainage, colonoscopy
IVTracheotomy, appendectomy, hernia operation, colostomy, gastrostomy, ERCP
VGastroenterostomy, interventions for recurrent hernia, Cimino fistula, radical varicose vein stripping
VIStrumectomy, cholecystectomy, splenectomy, hemicolectomy, reduction mammoplasty
VIIPartial pancreatectomy, subtotal colectomy, subsegmental and large liver resections
VIIIEsophageal resection, open surgery of aortic aneurysms, organ transplantation
Bolliger M., Kroehnert J.A., Molineus F., Kandioler D., Schindl M, & Riss P. (2018). Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. European Surgery, 50(6), 256-261.
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Publication 2018
Amputation Antiemetics Antipyretics Anus Aortic Aneurysm Appendectomy Atheroma Bariatric Surgery Blood Transfusion Central Nervous System Cholecystectomy Colectomy Colostomy Dialysis Disabled Persons Diuretics Drainage Electrolytes Endocrine Surgical Procedures Fibroma Fingers Fistula Gastrointestinal Surgical Procedure Gastrostomy Hemicolectomy Hepatectomy Hernia Intensive Care Lipoma Lymph Node Excision Operative Surgical Procedures Organ Transplantation Pancreas Pancreatectomy Parenteral Nutrition, Total Patient Discharge Patients Pharmaceutical Preparations Pharmacotherapy Physicians Proctoscopy Skin Splenectomy Stomach Surgical Endoscopy Surgical Wound Sutures Therapeutics Therapy, Physical Thoracic Surgical Procedures Treatment Protocols Upper Gastrointestinal Tract Varices Wound Infection X-Rays, Diagnostic
3
EHS Hernias Classification and Registry
Several members of the EHS board and some invitees gathered at the initiative of the Belgian Section for Abdominal Wall Surgery (BSAWS) and the Dutch Hernia Society (DHS) for 2 days to discuss the development of an EHS classification for primary and incisional abdominal wall hernias.1During an initial discussion, the existing proposals were briefly presented by one of the participants.
Thereafter, a decision was taken concerning the purpose of a classification and the scope of this consensus meeting. Some of the participants saw it mainly as a search for a simple classification. Because it was supported by and originated from the EHS, this classification could have a greater application in hospitals and in the surgical literature than the previous proposals published originating from one centre. Others were more in favour of an open structured approach, in which “scientists” would gather a maximum number of data sets in a prospective registry. With this registry, it was hoped to discover the most valuable and important risks factors for recurrence in order to direct future guidelines and therapeutic choices. It was decided to focus first on a simple, reproducible classification, because getting results out of the registry may take many years. A classification was proposed as such, including localisation of the hernia and the size of the hernia defect as decisive for the outcome, not going into its use to direct therapeutic choices for the present time. During the last session of the meeting, the development of a large, broad and open structured European registry was initiated.
Muysoms F.E., Miserez M., Berrevoet F., Campanelli G., Champault G.G., Chelala E., Dietz U.A., Eker H.H., El Nakadi I., Hauters P., Hidalgo Pascual M., Hoeferlin A., Klinge U., Montgomery A., Simmermacher R.K., Simons M.P., Śmietański M., Sommeling C., Tollens T., Vierendeels T, & Kingsnorth A. (2009). Classification of primary and incisional abdominal wall hernias. Hernia, 13(4), 407-414.
Publication 2009
Europeans Hernia Hernia, Abdominal Operative Surgical Procedures Recurrence Therapeutics Wall, Abdominal
4
Prenatal Surgery for Myelomeningocele
We conducted the trial at three maternal–fetal surgery centers — the Children's Hospital of Philadelphia, Vanderbilt University, and the University of California, San Francisco — together with an independent data-coordinating center at George Washington University and with the Eunice Kennedy Shriver National Institute of Child Health and Human Development. All other fetalintervention centers in the United States agreed not to perform prenatal surgery for myelomeningocele while the trial was ongoing. The trial was approved by the institutional review board at each center. The study protocol, including the statistical analysis plan and full inclusion and exclusion criteria, is available with the full text of this article at NEJM.org.
Inclusion criteria were a singleton pregnancy, myelomeningocele with the upper boundary located between T1 and S1, evidence of hindbrain herniation, a gestational age of 19.0 to 25.9 weeks at randomization, a normal karyotype, U.S. residency, and maternal age of at least 18 years. Major exclusion criteria were a fetal anomaly unrelated to myelomeningocele, severe kyphosis, risk of preterm birth (including short cervix and previous preterm birth), placental abruption, a body-mass index (the weight in kilograms divided by the square of the height in meters) of 35 or more, and contraindication to surgery, including previous hysterotomy in the active uterine segment.
Adzick N.S., Thom E.A., Spong C.Y., Brock JW I.I.I., Burrows P.K., Johnson M.P., Howell L.J., Farrell J.A., Dabrowiak M.E., Sutton L.N., Gupta N., Tulipan N.B., D'Alton M.E, & Farmer D.L. (2011). A Randomized Trial of Prenatal versus Postnatal Repair of Myelomeningocele. The New England journal of medicine, 364(11), 993-1004.
Publication 2011
Abruptio Placentae Care, Prenatal Cervix Uteri Ethics Committees, Research Fetal Anomalies Gestational Age Hernia Hindbrain Hysterotomy Index, Body Mass Karyotyping Kyphosis Meningomyelocele Operative Surgical Procedures Pregnancy Premature Birth Residency Uterus
5
Opioid Prescription Indication Analysis
Indication for prescription was not available on pharmacy records. At Group Health in 2001–2003 we determined indication through ICD-9 codes recorded on visit encounters to the prescribing physician that occurred within 90 days of the initial prescription (N=151,314 episodes of opioid use). It was possible to link a preceding encounter within 90 days to an initial opioid prescription for 74.4% of the episodes. The most common diagnostic groups observed on the linked encounters were: extremity pain (13.4%); back pain (13.3%); fractures, contusions, injury (7.1%); abdominal pain/hernia (5.1%); osteoarthritis (3.8%); neck pain (3.6 %); headache (2.6 %); kidney stones/gall stones (1.9%); and menstrual/reproductive pain (1.0%).
Von Korff M., Saunders K., Ray G.T., Boudreau D., Campbell C., Merrill J., Sullivan M.D., Rutter C., Silverberg M., Banta-Green C, & Weisner C. (2008). Defacto Long-term Opioid Therapy for Non-Cancer Pain. The Clinical Journal of Pain, 24(6), 521-527.
Publication 2008
Abdominal Pain Back Pain Calculi, Biliary Contusions Degenerative Arthritides Diagnosis Dysmenorrhea Fracture, Bone Headache Hernia Hernia, Abdominal Injuries Kidney Calculi Neck Pain Opioids Pain Physicians Reproduction

Most recents protocols related to «Hernia»

1
Robotic Inguinal Hernia Repair Outcomes
This study was approved by the Institutional Review Board of the Catholic University of Korea, St. Vincent Hospital (No. VC21RASI0194). The need for informed consent was waived because of the retrospective design. The analysis used anonymous clinical data and involved no additional procedure besides routine practices in a clinical setting, presenting no risk of harming the patients.
The patients who underwent robotic inguinal hernia repair by 2 different surgeons from April 2021 to April 2022 were retrospectively analyzed. Two surgeons exhibit a difference in the experience of hernia surgeries; one with over 1,000 cases of inguinal hernia repair (surgeon A) and the other with over 100 cases of inguinal hernia repair (surgeon B). Patient data were collected and constructed from patient medical records. All operations were conducted by the 2 surgeons who had finished the robot platform training program.
Patient demographics, operation variables, and postoperative outcomes were extracted from the electronic medical record. Patient demographics include age, sex, body mass index (kg/m2), American Society of Anesthesiologists physical status classification, Charlson comorbidity index score, previous operation history, laterality of the hernia, and its size. Operation variables include the laterality of the inguinal hernia and the time from skin incision to skin closure. The mean operation time was calculated for patients who underwent surgery solely for hernia repair. Patients who received other surgical procedures, such as prostatectomy, nephrectomy, or adrenalectomy, were excluded in order to get an accurate operation time. Postoperative outcomes were assessed by a visual analog scale assessing postoperative pain, episodes of urinary difficulty, postoperative wound complications, and other postoperative 30-day morbidities.
Yoo R.N., Mun J.Y., Cho H.M, & Kye B.H. (2023). One-year experience of robotic transabdominal preperitoneal approach in a single institute: 2 different surgeons with different levels of experience. Annals of Surgical Treatment and Research, 104(3), 176-181.
Publication 2023
Adrenalectomy Anesthesiologist Ethics Committees, Research Functional Laterality Groin Hernia Hernia, Inguinal Herniorrhaphy Index, Body Mass Nephrectomy Operative Surgical Procedures Pain, Postoperative Patients Physical Examination Postoperative Complications Prostatectomy Roman Catholics Skin Surgeons Training Programs Urine Visual Analog Pain Scale Wounds
2
Emergent Small Bowel Resection for Acute Mesenteric Ischemia
Between January 2007 and December 2019, we retrospectively reviewed patients who underwent emergent small bowel resection for nonmalignant lesions, by operative notes as well as by pathology results. We aimed to identify patients with AMI and intestinal gangrene. Patients who experienced intestinal gangrene and resection were included. The preoperative diagnosis of AMI was determined by contrast computed tomography (CT) scan. Gangrene of the bowel was confirmed by pathological findings. Patients without intestinal resection, intestinal gangrene, or preoperative contrast CT scans were all excluded. Patients with isolated ischemic colitis were also excluded. Patients with intestinal gangrene resulting from adhesion, abdominal wall hernia, internal herniation, or concurrent active malignancy were all excluded.
Liu H.T., Lai C.Y., Liao J.J., Chen Y.J., Cheng S.B, & Wu C.C. (2023). Immediate postoperative parenteral anticoagulant therapy in patients with mesenteric ischemia after intestinal resection: a retrospective cohort study at a single institute. BMC Gastroenterology, 23, 56.
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Publication 2023
Colitis, Ischemic Diagnosis Gangrene Hernia Hernia, Abdominal Intestines Intestines, Small Malignant Neoplasms Patient Isolation Patients Radionuclide Imaging X-Ray Computed Tomography
3
Analyzing Hernia Recurrence Outcomes
Descriptive statistics were used to summarize continuous variables and frequencies and percentages for categorical variables. A chi-squared test or Fisher exact test was used to compare the difference in the categorical variables among study groups. A t test or Wilcoxon rank sum test was used to test the difference of continuous variables. The time to hernia recurrence was defined as the time interval between the date of AWR and the date of hernia recurrence or the last follow-up, whichever occurred first. Patients who did not have hernia recurrence at the last follow-up date were censored in the analysis. Cumulative hernia recurrence-free probabilities were estimated using Kaplan-Meier product-limit method. A log-rank test was used to compare the distribution of hernia recurrence-free probability among various patient groups. Multilevel models were designed with patients nested within fellows. Multivariable hierarchical logistic regression models were used to evaluate the effect of the fellowship pathway on SSO, SSI, readmission within 30 days, and re-operation. A multivariable hierarchical frailty model was used to assess the impact of training pathways on time to hernia recurrence. A multivariable hierarchical mixed linear regression model was fitted for length of hospital stay. The logarithm transformation of length of stays was applied for better model fit. Patient-level covariates included patient demographics, and clinical and surgical characteristics. Results are presented using hazards ratio (HR), odds ratio (OR), and beta (β) coefficients. Two-tailed P values less than 0.05 were considered significant; all statistical analyses were performed using SAS Enterprise Guide software (version 9.4; SAS Institute Inc., Cary, N.C.) by a senior biostatistician (J.L.).
Hassan A.M., Egro F.M., Talanker M.M., Shah N.R., Liu J., Maricevich R.S., Chang E.I., Hanasono M.M., Selber J.C, & Butler C.E. (2023). Comparison of Long-term Surgical Outcomes and Microsurgical Skills between Independent and Integrated Plastic Surgery Trainees. Plastic and Reconstructive Surgery Global Open, 11(3), e4709.
Publication 2023
Fellowships Hernia Operative Surgical Procedures Patients Recurrence Repeat Surgery Thirty Day Readmission
4
Autonomous Abdominal Wall Reconstruction by Trainees
We conducted a comprehensive retrospective review of consecutive patients who underwent AWR performed independently by microsurgical fellows to repair abdominal wall hernias or oncologic resection defects. The surgical technique employed in this study was consistent across all patients, as previously described.10 (link)–16 (link) We performed anterior component separation with release of the external oblique aponeurosis in almost all cases. Regardless of the level of contamination, the intention in all cases was to perform a single staged reconstruction. Regardless of prior experience with AWR, fellows were generally trained on the AWR techniques that were consistently performed at the authors’ institution.10 (link)–12 (link) Patient selection was based on patient availability and did not follow any selection criteria. A trainee had to have complete autonomy in preoperative, intraoperative, and postoperative care and decision-making to be considered the operative surgeon for a case. Direct and indirect supervision was available if requested by the trainee.
Surgical outcomes included hernia recurrence rate, surgical site occurrence (SSO), surgical site infection (SSI), 30-day readmission, return to operating room rates, and length of hospital stay. Hernia recurrence was defined as a contour abnormality with associated fascial defect diagnosed via physical examination and/or abdominal imaging with either computed tomography or magnetic resonance imaging. An SSO was defined as skin necrosis, fat necrosis, wound dehiscence, infection, hematoma, seroma, or enterocutaneous fistula. SSIs consisted of infectious processes, either abscesses or cellulitis, requiring treatment with antibiotics with or without drainage. Rectus muscle violation was defined as an existing or new ostomy, gastrostomy/jejunostomy tube placement, transversely divided rectus abdominis muscle, and/or resected rectus abdominis muscle.
Hassan A.M., Egro F.M., Talanker M.M., Shah N.R., Liu J., Maricevich R.S., Chang E.I., Hanasono M.M., Selber J.C, & Butler C.E. (2023). Comparison of Long-term Surgical Outcomes and Microsurgical Skills between Independent and Integrated Plastic Surgery Trainees. Plastic and Reconstructive Surgery Global Open, 11(3), e4709.
Publication 2023
Abdomen Abscess Antibiotics Aponeurosis Cellulitis Drainage Enterocutaneous Fistula External Abdominal Oblique Muscle Fascia Gastrostomy Hematoma Hernia Hernia, Abdominal Infection Jejunostomy Necrosis Necrosis, Fat Neoplasms Operative Surgical Procedures Ostomy Patients Physical Examination Postoperative Care Reconstructive Surgical Procedures Rectus Abdominis Rectus Muscle, Extraocular Recurrence Seroma Skin Supervision Surgeons Surgical Wound Infection Thirty Day Readmission Wounds
5
Radiographic Evaluation of Vertebral Fracture Reduction
Plain radiographs and computed tomography (CT) scans were obtained before surgery, immediately after surgery, at the removal of the implants, and during the final follow-up. The segmental kyphotic angle (SKA) and anterior vertebral body height ratio (AVBHR) were measured as radiographic parameters to evaluate the indirect reduction of the vertebral body and local kyphosis. SKA was defined as the Cobb angle calculated between the cranial vertebra’s upper endplate and the caudal vertebra’s lower endplate. AVBHR was defined as the percentage of the anterior vertebral height of the fractured vertebra to the average anterior height of the two adjacent vertebrae (Fig. 1) [17 (link)].

Schematic diagrams of radiographic parameters. Segmental kyphotic angle (SKA) = θ, Anterior vertebral body height ratio (AVBHR) = c/(a + b)/2

The indirect reduction of fractured vertebrae and correction loss during observation were evaluated using SKA and AVBHR. In this study, correction loss was considered present if the ΔSKA was ≥10° immediately after surgery to the final examination [4 (link), 6 ].
We evaluated the degree of vertebral body involvement using the load sharing classification (LSC) scoring system [18 (link)]. The vertebral fractures were classified according to the AO classification system [19 (link)]. The severity of intervertebral disc and vertebral endplate injury were assessed using the preoperative Sander’s TIDL classification based on T2-weighted MRI (Table 1) [10 (link), 13 (link)]. In this study, TIDL was considered grade 3 when CT showed an apparent vertebral endplate fracture (Fig. 2). If both the upper and lower discs were damaged, a more severe TIDL grade was adopted.

Classification of TIDL

GradeT2-weighted MRIEndplate fractureCharacteristic finding
0NoneIntact
1HyperintenseNoneEdema
2Hypointense with perifocal hyperintenseNone or mildDisc rupture with intradiscal bleeding
3Hypointense with perifocal hyperintenseModerate or severeInfraction of the disc into vertebral body, annular tears, or infraction without herniation into endplate

TIDL Traumatic intervertebral disc lesion

Classification of traumatic intervertebral disc lesion (TIDL). A case of AO type A3 fracture at L3. CT shows a fracture of the cranial endplate and MRI shows infraction of the disc into the vertebral body (white triangles) which means a TIDL grade 3. The caudal disc showed a TIDL grade 2

A case with a depression of 5 mm or more on the sagittal CT slice with the greatest depression was defined to have residual endplate deformity to assess the degree of endplate deformity at follow-up (Fig. 3E).

A 39-year-old woman with L2 burst fracture (AO A3). CT (A) and MRI (B) showed severe damage of the cranial endplate and infraction of the disc into the vertebral body (TIDL grade 3). The fractured vertebra was reduced after surgery (C). At follow up, fractured vertebra showed bony union, however disruption of the vertebral endplate and degeneration of intervertebral disc resulted in correction loss and breakage of the pedicle screw (D, E). Panel E shows residual endplate deformity

Hashimura T., Onishi E., Ota S., Tsukamoto Y., Yamashita S, & Yasuda T. (2023). Correction loss following short-segment posterior fixation for traumatic thoracolumbar burst fractures related to endplate and intervertebral disc destruction. BMC Musculoskeletal Disorders, 24, 174.
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Publication 2023
Bones Caudal Vertebrae Congenital Abnormality Cranium Fracture, Bone Fracture Fixation Hernia Intervertebral Disc Intervertebral Disc Degeneration Kyphosis Operative Surgical Procedures Pedicle Screws Radionuclide Imaging Spinal Fractures Spinal Injuries Tears Vertebra Vertebral Body Woman X-Ray Computed Tomography X-Rays, Diagnostic

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