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        <title>Journal of Abdominal Wall Surgery | New and Recent Articles</title>
        <link>https://www.frontierspartnerships.org/journals/journal-of-abdominal-wall-surgery</link>
        <description>RSS Feed for Journal of Abdominal Wall Surgery | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-11-11T00:11:43.293+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17970</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17970</link>
        <title><![CDATA[Incisional hernia repair after abdominal organ transplantation: current evidence, controversies and research gaps]]></title>
        <pubdate>2026-11-10T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Kavyesh Vivek</author><author>Michael Paß</author><author>Ferdinand Köckerling</author><author>Vassilios Papalois</author>
        <description><![CDATA[Incisional hernia is a common late complication of abdominal organ transplantation, with reported frequency ranging from a pooled 4% after kidney transplantation to a prevalence of 43% on clinical examination after liver transplantation. Immunosuppression places recipients at least in Ventral Hernia Working Group grade 2, and concern about wound failure, mesh infection and recurrence often delays repair. This mini review synthesises evidence on elective repair in adult liver, kidney and pancreas recipients around three questions: whether transplant status independently predicts adverse outcome, how immunosuppression relates to outcome, and how operative access, reconstruction, mesh plane, material and fascial closure should be chosen. In most registry and matched comparisons, 30-day wound morbidity and length of stay were similar to those of non-transplant patients, although one matched laparoscopic series found more surgical site occurrences. Study-specific recurrence ranges from 0% in selected specialist series to 37%, with differing follow-up and ascertainment, and observational comparisons do not establish whether transplantation independently increases recurrence. A randomised trial showed more wound complications with de novo sirolimus after kidney transplantation; the association between maintenance sirolimus and recurrence after later repair rests on small, conflicting series, and perioperative conversion is untested. Recent series of transversus abdominis release report recurrence of 0%–25%, depending on incision, defect size, follow-up and comparator. Diaphragmatic tack fixation should be avoided. Two randomised trials of prophylactic mesh at transplant closure are registered, without published results. Research priorities include transplant-specific registry fields, standardised recurrence ascertainment, longer post-repair follow-up and graft-related outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17385</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17385</link>
        <title><![CDATA[Prophylactic mesh augmentation in midline laparotomy in elective or emergency settings: a systematic review and network meta-analysis of randomized trials]]></title>
        <pubdate>2026-11-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Timothée Girardin</author><author>Marc-Olivier Sauvain</author>
        <description><![CDATA[IntroductionIncisional hernia (IH) remains a common complication after midline laparotomy. Prophylactic mesh reinforcement reduces IH risk, but the optimal anatomical plane for mesh placement remains uncertain. This systematic review and network meta-analysis (NMA) compared mesh positions for IH prevention while assessing postoperative morbidity.MethodsA systematic search of PubMed, Embase, and Cochrane databases identified randomized controlled trials (RCTs) comparing prophylactic mesh reinforcement with suture-only fascial closure after laparotomy. The primary outcome was the IH rate. Secondary outcomes were surgical site infection (SSI), surgical site occurrence (SSO), seroma, and hematoma. Pairwise random-effects meta-analysis and frequentist random-effects NMA were performed using risk ratios (RR) with 95% confidence intervals (CI). Treatments were ranked using P-scores.Results27 RCTs, including 4327 patients, were analyzed. The control group was suture-only closure (1891 patients). Mesh positions were onlay (38%), retromuscular/preperitoneal (37%), intraperitoneal (18%), and inlay-strip (7%). Overall, prophylactic mesh reinforcement significantly reduced IH compared with suture-only closure (RR 0.41, 95% CI 0.27–0.62). In the NMA, compared with suture-only closure, onlay mesh reinforcement was associated with the largest relative reduction in IH (RR 0.27, 95% CI 0.17–0.45), followed by retromuscular/preperitoneal (RR 0.42, 95% CI 0.27–0.67). Inlay-strip and intraperitoneal meshes were not significantly superior to suture-only closure. Onlay mesh ranked highest for IH prevention (P-score 0.976). Findings were consistent in the elective and emergency subgroup analyses. For SSI, no mesh position significantly increased the risk compared with the suture-only group. For SSO, onlay mesh reinforcement was associated with a significantly increased risk (RR 1.46, 95% CI 1.03–2.06), whereas retromuscular/preperitoneal was not. Similar results were found for seroma. No mesh position significantly increased the risk of hematoma in the NMA analyses.ConclusionProphylactic mesh reinforcement reduces IH after laparotomy. Both onlay and retromuscular/preperitoneal placement significantly reduced IH. Onlay achieved the highest treatment ranking, without increasing SSI, but at the cost of higher wound morbidity, especially seroma. Further high-quality trials are needed to define the optimal mesh plane, as limited direct evidence between mesh planes precludes firm conclusions of superiority.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17799</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17799</link>
        <title><![CDATA[Incidence of incisional hernia after closure of burst abdomen - a single-center, retrospective cohort study]]></title>
        <pubdate>2026-11-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mohammed Ibrahim</author><author>Simon A. Schippmann</author><author>Gabriel Zaremba</author><author>Pia Rath</author><author>Josephine Berger</author><author>Can Yurttas</author><author>André L. Mihaljevic</author><author>Jonel Ngjelina</author>
        <description><![CDATA[IntroductionBurst abdomen is a severe postoperative complication associated with high morbidity and a substantial risk of subsequent incisional hernia. Evidence regarding the optimal fascial closure technique following surgical repair remains limited.MethodsThis retrospective single-center cohort study included adult patients undergoing surgical repair of burst abdomen after midline laparotomy between 2017 and 2024. Patients with complete fascial closure and at least 30 days of follow-up were included. The primary objective was the development of incisional hernia within 6 years after the operation. Two closure strategies, interrupted polyglactin 910 and predominantly continuous polydioxanone, were compared in an exploratory analysis. Univariable and multivariable analyses were performed to identify independent risk factors. Death was treated as a competing event in a sensitivity analysis.ResultsA total of 104 patients were included. Median follow-up was 18.1 months. The cumulative incidence of incisional hernia was 26.3% at 12 months, 39.6% at 24 months and 45.1% at 36 months (24.0%, 34.7% and 38.9% when death was treated as a competing event). Hernia incidence did not differ significantly between interrupted polyglactin 910 closure (n = 85) and polydioxanone closure (n = 19, hazard ratio 1.21, 95% CI 0.49–2.97). Recurrent burst abdomen was more frequent after polydioxanone closure (26.3% versus 5.9%, p = 0.02). Increasing age was associated with incisional hernia formation (hazard ratio 1.05 per year, 95% CI 1.02–1.08, p = 0.003), consistently across alternative models. Its effect was not constant over time and was mainly apparent after the first year.DiscussionAlmost half of the patients developed an incisional hernia within 3 years of burst abdomen repair. The two closure strategies did not differ significantly in hernia incidence, but the small polydioxanone group and the confounding of suture material and technique preclude conclusions on the optimal closure. Increasing age was associated with abdominal wall failure. Prospective studies with a standardized and documented closure technique are needed to define optimal reconstructive strategies in this high-risk population.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17125</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17125</link>
        <title><![CDATA[Surgical skill retention among surgery trainees following standard surgery skills acquisition workshops model early preliminary findings, a mixed method study]]></title>
        <pubdate>2026-11-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Moses Taremwa</author><author>Francis Basimbe</author><author>Isaac Mubezi</author><author>Francis Kakooza</author><author>Chris Oppong</author><author>Jacob Akoh</author>
        <description><![CDATA[BackgroundIn resource-limited settings, postgraduate surgical training often faces constraints such as limited supervision, inconsistent operative exposure despite the high patient loads that presents a paradox. To address these gaps, surgical training Workshops have emerged as a supplemental strategy to enhance hands-on procedural competence. However, the extent to which surgical skills are retained following such intensive interventions remains unclear. We aimed to investigates the medium-term retention of surgical competence in standard hernia repair among surgical residents in Uganda who participated in a structured surgical skills transfer program.Methodswe employed a longitudinal mixed-methods design. A purposive sample of 8 surgical residents, membership and fellowship of surgery candidates who were recruited to surgical skills transfer program and where followed up at three assessment points: pre-Training (D0), immediate post-training (D1), 1.5 months post-training (FU). Quantitative data collection will utilize College Of Surgeons of East Central and Southern Africa (COSECSA) -validated tools, including self-assessments, trainer assessments, structured OSCEs, and surgical logbooks. Qualitative data was gathered through in-depth interviews and focus group discussions with a sub-sample of doctors and faculty mentors. Quantitative data was analyzed using descriptive statistics, paired and multivariate analyses, while thematic analysis was applied to qualitative narratives. Data triangulation was used to support a comprehensive understanding of skill retention trajectories and influencing factors.ResultsThe study reported improvements in self-assessed and trainer-assessed surgical competence immediately post-training, with measurable retention in the short-term. Qualitative insights highlighted enablers such as mentorship and procedural frequency, as well as barriers like institutional workload and limited access to operative cases.ConclusionThis study generated important evidence on the effectiveness of surgical training Workshops in fostering sustainable surgical skills among surgery residents, this presents promising preliminary findings of a small residents cohort.Recommendationshort-term surgical intensive skills workshops should be integrated into formal residency programs in Uganda and similar low-resource settings, enhancing both skill acquisition and long-term competence.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17632</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17632</link>
        <title><![CDATA[Single-port robotic totally extraperitoneal inguinal hernia repair using a floating docking technique with the da Vinci SP system: feasibility across a spectrum of hernia complexity]]></title>
        <pubdate>2026-10-22T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Junhyung Park</author><author>Seong-Taek Oh</author><author>Jaeim Lee</author>
        <description><![CDATA[The da Vinci SP system is applied to totally extraperitoneal (TEP) inguinal hernia repair, but clinical data remain limited. Full wrist articulation requires the instruments to extend beyond the cannula tip, which the preperitoneal space is too shallow to accommodate intracorporeally. We report a single-surgeon series using a floating docking configuration. We retrospectively reviewed 12 consecutive patients undergoing SP TEP repair. After a 2.5-cm infraumbilical incision and entry into the retrorectus space, the cannula was docked suspended approximately 9–10 cm above the skin, so that the instruments reached the operative field already articulating. Mesh reinforcement was performed in all patients. Patients were 11 men and 1 woman (91.7% male; mean age 57.2 ± 10.7 years), evenly split between sides; 10 primary and 2 (16.7%) recurrent, 8 indirect, 4 direct. Median operative and console times were 42.5 (IQR 38.8–46.8) and 40.0 min (IQR 33.8–42.2). All procedures were completed via a single port without conversion or additional trocars, including an incarcerated scrotal hernia and a recurrent hernia with dense adhesions requiring intracorporeal peritoneal closure. Mean hospital stay was 1.1 ± 0.5 days. Complications occurred in 3 patients (25.0%): fluid collection in all, urinary retention in one, managed conservatively. No recurrence occurred over a median follow-up of 6.9 months (IQR 4.1–8.7). SP TEP repair with floating docking was feasible across a range of hernia types and complexities, with no major early complications. Larger cohorts with longer follow-up are needed to assess recurrence and chronic pain.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17808</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17808</link>
        <title><![CDATA[The fixation paradox: when less is more in laparo-endoscopic inguinal hernia repair]]></title>
        <pubdate>2026-10-20T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>Mateusz Zamkowski</author><author>Maciej Śmietański</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16944</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16944</link>
        <title><![CDATA[A European algorithm and strategy for management of chronic postoperative inguinal pain (EurA-CPIP)]]></title>
        <pubdate>2026-10-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>K. G. Andersen</author><author>T. W. K. van der Meer</author><author>N. van Veenendaal</author><author>N. B. Foss</author><author>M. J. A. Loos</author><author>M. Miserez</author><author>M. Pawlak</author><author>R. M. H. Roumen</author><author>T. Naddaf</author><author>M. Togsverd-Bo</author><author>M. W. Stadeager</author><author>E. K. Aasvang</author><author>W. A. R. Zwaans</author>
        <description><![CDATA[BackgroundChronic postoperative inguinal pain (CPIP) is a disabling complication affecting 8%–17% of all patients after inguinal hernia repair. It is a complex pain condition with several pathophysiological mechanisms involved, including neuropathic pain, inflammation, and mechanical effects (e.g., mesh or scar tissue). Management remains inconsistent, probably due to limited high-quality evidence, heterogeneous approach, and insufficient standardisation of outcomes. This study aimed to develop EurA-CPIP, a multidisciplinary treatment algorithm and prospective data-collection platform designed to support consistent phenotyping, step-up management, and standardised outcomes across centres, creating an iterative platform for future hypothesis-driven research and multicentre trials.MethodsAn international multidisciplinary working group from European tertiary referral centres developed the European Algorithm and Strategy for Management of Chronic Postoperative Inguinal Pain (EurA-CPIP). Development was informed by the evidence synthesis underpinning the updated international HerniaSurge guidelines and a critical appraisal of previously published CPIP algorithms. A pragmatic step-up algorithm was designed, integrating pharmacological, interventional, surgical and supportive treatments, with prospective outcome registration and planned data-driven revision on a regular basis.ResultsEurA-CPIP provides a multidisciplinary algorithm with entry at multiple levels depending on prior treatment attempts. The concept is to begin and, if needed, advance from conservative measures such as systemic medication and topical therapy, to more invasive treatments such as trigger point injections, and ultrasound-guided nerve blocks; predefined investigational add-ons (radiofrequency, cryoneurolysis, botulinum toxin A) are embedded after documented block response. Multidisciplinary team review precedes escalation to more invasive interventions such as surgery. A supportive and rehabilitative coping trajectory is integrated early on. Standardised outcomes include patient-reported pain outcomes, functional impairment, psychological factors, analgesic use, and patient global impression of improvement.ConclusionEurA-CPIP is a pragmatic consensus-based strategy intended to harmonise and improve specialised CPIP care while utilising existing and developing emerging therapies. Future research should investigate pathophysiology and intervention effects within this step-up algorithm.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17986</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17986</link>
        <title><![CDATA[Posterior rectus sheath reattachment after eTEP rives: are we solving the right problem?]]></title>
        <pubdate>2026-10-13T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Jorge Daes</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17051</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17051</link>
        <title><![CDATA[Radiologic recurrence after minimally invasive ventral hernia repair in patients with class III obesity: a single-center retrospective cohort study]]></title>
        <pubdate>2026-10-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ahsan Ahmed</author><author>Faizan Khalid</author><author>Ali Sadeghi</author><author>Marlon Rodriguez Valladares</author><author>Marlen Flores</author><author>Valeria Loja Pauta</author><author>Cesar Alas-Pineda</author><author>Cosman Camilo Mandujano</author>
        <description><![CDATA[BackgroundObesity is a known risk factor for complications and recurrence after ventral hernia repair (VHR). Many surgeons defer elective repair in patients with class III obesity based on body mass index (BMI) thresholds. We evaluated postoperative outcomes and factors associated with recurrence after minimally invasive VHR in this high-risk population.MethodsThis single-center retrospective cohort study included consecutive adult patients with BMI ≥40 kg/m2 who underwent predominantly minimally invasive VHR between January 1, 2012, and December 31, 2024, and had postoperative radiologic follow-up by computed tomography (CT). The primary outcome was radiologic hernia recurrence. Secondary outcomes included 30-day complications and postoperative weight trajectory. Between-group comparisons used Fisher’s exact or χ2 tests for categorical variables and Welch t-test or Mann-Whitney U test for continuous variables, as appropriate; two-sided p < 0.05 was considered significant.ResultsFifty-two patients (mean BMI 45.0 ± 5.4 kg/m2), 80.8% female, met the inclusion criteria. Radiologic recurrence occurred in 9 patients (17.3%; CI 9.4%–29.7%) at a median imaging follow-up of 793 days (IQR 412–1381) in the overall cohort. Recurrence was observed exclusively in incisional (2/16, 12.5%) or recurrent incisional hernias (7/21, 33.3%) (p = 0.028), with no recurrences in primary hernias (0/15). 30-day complications occurred in 11.5% of patients. Patients with recurrence experienced significantly greater postoperative weight loss than those without (15.6% vs. 4.6% of total body weight; p = 0.015). Operative technique and mesh-related variables were not significantly associated with recurrence (all p > 0.25), although the study was underpowered to detect such associations.ConclusionMinimally invasive VHR in patients with class III obesity was associated with low short-term morbidity, but the mid-term radiologic recurrence rate of 17.3% is on the higher end of published estimates and should not be characterized as low. Recurrence occurred exclusively in incisional and recurrent incisional hernias, reaching 24.3% when primary hernias were excluded; associations with technical factors and BMI were not statistically significant in this small sample. Greater postoperative weight loss was associated with recurrence, though reverse causation and ascertainment bias cannot be excluded. Given the small sample size, these findings are hypothesis-generating and warrant confirmation in larger, prospective studies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17525</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17525</link>
        <title><![CDATA[Inguinoscrotal hernia repair: analysis of the national EVEREG registry]]></title>
        <pubdate>2026-10-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>M. Verdaguer-Tremolosa</author><author>V. Rodrigues-Gonçalves</author><author>M. P. Martínez-López</author><author>M. López-Cano</author><author>in representation of EVEREG group </author>
        <description><![CDATA[PurposeInguinoscrotal hernia repair has been associated with worse outcomes compared to conventional repairs. Its optimal technique and prognostic factors remain unclear. We aimed to evaluate factors related to complications and recurrence in these repairs based on the EVEREG registry.MethodsAdult males who underwent elective unilateral inguinoscrotal hernia repair from 2021 to 2024 from the EVEREG registry were included. The primary outcome was postoperative complications. The secondary outcomes were to describe recurrence within 30 days and at latest available follow-up.ResultsA total of 748 patients were included. Most patients (83.4%) underwent open repair, and the preferred mesh position was anterior in 70.8% of cases. Postoperative complications occurred in 6.95% of cases, mostly grade I-II of the Clavien-Dindo classification. Advanced age, diabetes, chronic obstructive pulmonary disease, higher ASA grade, H4-type hernia, open surgical approach, intraoperative complications, and longer operative times were identified as factors associated with postoperative complications (P < 0.001, P = 0.018, P = 0.035, P < 0.001, P = 0.007, P = 0.002, P = 0.039, and P < 0.001). Ambulatory surgery and the involvement of a surgeon with experience in abdominal wall repair were associated with better outcomes (P < 0.001, P = 0.029). Multivariate analysis yielded consistent results regarding protective factors. At maximum follow-up, the presence of a surgeon experienced in abdominal wall repair was the only factor linked to lower recurrence risk.ConclusionAccording to the EVEREG registry, the most common approach for inguinoscrotal hernia repair was open surgery with anterior mesh placement. Postoperative complications occurred mainly in patients with greater comorbidity and hernia complexity and were mostly low-grade. Surgery performed by a surgeon experienced in abdominal wall surgery was associated with fewer postoperative complications, supporting individualised management and consideration of referral for complex cases. The available data do not allow conclusions regarding the superiority of a specific technique or long-term recurrence.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17201</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17201</link>
        <title><![CDATA[Incisional hernia prevention in high-risk midline laparotomy using onlay PVDF mesh: multicenter prospective observational study]]></title>
        <pubdate>2026-09-28T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jose Luis Rodicio Miravalles</author><author>Javier López Monclús</author><author>Sonia Amoza Pais</author><author>María Moreno Gijón</author><author>Antonio López López</author><author>Natalia Gutiérrez Corral</author><author>Luis Alberto Blázquez Hernando</author><author>Rafael Menéndez de Llano Ortega</author><author>María Isabel Diez Pérez de las Vacas</author><author>Lourdes Sanz Álvarez</author><author>Miguel Angel Garcia-Urena</author>
        <description><![CDATA[IntroductionProphylactic mesh reinforcement reduces the risk of incisional hernia after midline laparotomy in high-risk patients, although concerns regarding complications and implementation limit its routine use. This multicentre prospective observational study evaluated long-term outcomes after onlay polyvinylidene fluoride (PVDF) mesh reinforcement in high-risk patients undergoing midline laparotomy in elective and emergency settings.Materials and methodsA prospective multicentre observational cohort study was conducted in tertiary and secondary hospitals within the Spanish National Health Service between July 2016 and June 2022. Adult patients undergoing midline laparotomy with more than one risk factor for incisional hernia were included. Abdominal wall closure was reinforced with an onlay PVDF mesh visible on MRI. The primary outcome was incisional hernia at 2 years. Secondary outcomes included mesh-related complications and factors associated with incisional hernia.ResultsA total of 180 patients were analysed. Mean age was 64.6 years and mean BMI was 27.4 kg/m2. Most procedures were performed for oncological disease (72.8%), 32.8% were emergency operations, and 23.9% were performed in contaminated or dirty surgical fields. Surgical-site infection occurred in 12.8% and seroma in 9.4% during index admission. Mesh removal was required in four patients (2.2%). Two-year follow-up among surviving patients reached 96.1%. In the intention-to-treat analysis, incisional hernia developed in 21 patients (11.3%), compared with 16 patients (8.9%) in the per-protocol analysis. BMI (OR 1.19, 95% c.i. 1.05 to 1.33; P = 0.008) and stoma formation (OR 5.77, 95% c.i. 1.75 to 19.30; P = 0.004) were independently associated with incisional hernia. MRI demonstrated no significant mesh contraction.ConclusionIn this prospective multicentre observational study, prophylactic onlay PVDF mesh reinforcement in high-risk midline laparotomy, including emergency and contaminated procedures, was feasible and associated with a low incidence of incisional hernia and acceptable mesh-related morbidity. These findings are hypothesis-generating and warrant further evaluation in controlled studies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17323</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17323</link>
        <title><![CDATA[Selective use of reinforced tissue matrix in complex abdominal wall reconstruction: a multicenter consensus analysis]]></title>
        <pubdate>2026-09-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sebastian Schaaf</author><author>Thomas Mones</author><author>Peter Mai</author><author>Niels-Torsten Hoedt</author><author>Markus Götz</author><author>Arnulf Willms</author><author>Guido Woeste</author>
        <description><![CDATA[BackgroundOptimal mesh selection in complex abdominal wall reconstruction remains controversial, particularly in contaminated fields or in patients with extensive tissue loss. Reinforced tissue matrix (RTM) meshes combine biologic material with permanent synthetic reinforcement and may represent a potential option in selected cases. This study aimed to analyze clinical use patterns of RTM meshes and identify potential indication niches through structured expert consensus.MethodsA multicenter expert panel collected cases of abdominal wall reconstruction using RTM mesh (OviTex). Patient characteristics, hernia features, operative strategies, and postoperative outcomes were recorded in a standardized database. Cases were evaluated according to established complexity criteria. Seven abdominal wall surgeons independently rated the appropriateness of RTM use. Consensus was defined as ≥70% agreement, and interrater reliability was assessed using Fleiss’ kappa.ResultsSeventy-four patients were included (mean age 63.9 ± 12.0 years; median BMI 30.2 kg/m2). Most patients presented with incisional hernias and large fascial defects. Contaminated or potentially contaminated operative fields were present in approximately one-third of cases. Surgical site infection occurred in 20.3%, mesh infection in 7.8%, and hernia recurrence in 12.3%. Expert consensus supporting RTM implantation was reached in 50% of cases, particularly in scenarios combining contamination with large fascial defects. Interrater agreement was fair (κ = 0.34).ConclusionRoutine use of RTM meshes in abdominal wall reconstruction is not supported. However, RTM may represent a potential option in selected high-complexity scenarios involving contamination and large fascial defects where permanent synthetic meshes may be unsuitable. These findings are exploratory and hypothesis-generating and may support future Delphi-based indication consensus development.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17526</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17526</link>
        <title><![CDATA[Large registries, rare outcomes and neutral/inconclusive machine learning results in abdominal wall surgery]]></title>
        <pubdate>2026-09-21T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>M. Verdaguer-Tremolosa</author><author>Sergi Mojal</author><author>V. Rodrigues-Gonçalves</author><author>M. P. Martínez-López</author><author>M. López-Cano</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17325</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17325</link>
        <title><![CDATA[The ORION study protocol: impact of prior intraperitoneal versus extraperitoneal mesh placement on subsequent minimally invasive abdominal reoperations]]></title>
        <pubdate>2026-09-18T00:00:00Z</pubdate>
        <category>Protocol</category>
        <author>Elisa Pelfini</author><author>Sara Lauricella</author><author>Antonella Nisi</author><author>Gianlorenzo Dionigi</author><author>Francesco Brucchi</author>
        <description><![CDATA[BackgroundVentral hernia repair is among the most common surgical operations worldwide. Mesh can be positioned in different anatomical planes; extraperitoneal placement is gaining popularity, whereas intraperitoneal placement is linked to long-term complications. Evidence comparing the long-term outcomes of intraperitoneal versus extraperitoneal placement remains limited.ObjectiveThis study addresses that gap, also examining the management of recurrences and the potential neurological sequelae of surgery.MethodsThe ORION study is a prospective, multicentre, observational study involving surgical centres across Europe. The study is addressed to patients who have previously undergone minimally invasive mesh-based ventral hernia repair, with either intraperitoneal or extraperitoneal mesh placement, and who are now undergoing minimally invasive abdominal surgery—either in an elective or emergency setting—for a hernia recurrence (Cohort B) or for other indications (Cohort A). Data will be collected between 1 March 2026 and 28 February 2027. Follow-up assessments at 30 and 90 days are planned only for patients enrolled in Cohort B.DiscussionThe ORION study will provide data on the intraoperative consequences of prior intraperitoneal versus extraperitoneal mesh placement at subsequent minimally invasive abdominal surgery, and will describe recurrence patterns and management among patients reoperated for recurrent ventral/incisional hernia.Clinical Trial RegistrationIdentifier NCT07384962.]]></description>
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        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17401</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17401</link>
        <title><![CDATA[Impact of an AI workshop on knowledge and attitudes toward AI in scientific publishing among surgeons at an international abdominal wall surgery congress]]></title>
        <pubdate>2026-09-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mireia Verdaguer-Tremolosa</author><author>Georgia Kotoreni</author><author>Simon Hoggart</author><author>Manuel López-Cano</author>
        <description><![CDATA[BackgroundGenerative artificial intelligence (AI) tools are increasingly used for scientific writing, literature synthesis, and peer-review, yet their responsible use requires awareness of hallucinations, fabricated references, confidentiality risks, authorship limitations, and disclosure requirements.ObjectiveTo evaluate the perceived impact of a focused educational workshop on knowledge and attitudes toward AI in scientific publishing among participants in an abdominal wall surgery workshop.MethodsAn anonymous pre-post survey study was conducted during the JAWS Workshop 2026 on Artificial Intelligence in abdominal wall surgery. Participants voluntarily completed a 10-item baseline survey before two educational presentations and a 10-item post-workshop survey immediately afterwards. Responses were analysed descriptively. Because the questionnaires were not identical, formal paired analysis was restricted to the common ordinal knowledge item using anonymous participant codes.ResultsThirty-nine participants completed the baseline survey and 41 completed the post-workshop survey; 34 anonymous codes could be matched. Before the workshop, 48.7% reported basic knowledge, 35.9% intermediate knowledge, 5.1% advanced knowledge, and 10.3% no knowledge. AI tools were used occasionally, frequently, or systematically by 89.7% of respondents. The most frequent uses were language editing (74.4%), manuscript structuring (46.2%), literature summarization (46.2%), and data analysis or interpretation (41%). After the workshop, intermediate or advanced self-reported knowledge was observed in 68.3% of respondents. In matched analysis, self-reported knowledge scores improved in 18/34 participants (52.9%; Wilcoxon signed-rank, p = 0.0005). Post-workshop, 92.7% agreed or strongly agreed that they better understood AI limitations, 97.6% would almost always or always verify AI-generated references, 85.4% supported disclosure of AI use in manuscripts, and 87.8% considered society guidelines recommended or essential.ConclusionAI use for scientific activities was common among workshop participants, and a brief targeted educational intervention was associated with improved self-reported knowledge and support for responsible AI use. Scientific societies and journals may play an important role in promoting the responsible integration of AI into scientific publishing through focused educational initiatives.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17006</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17006</link>
        <title><![CDATA[Contemporary global practice in dissection and closure techniques for lower abdominal transverse incisions: a cross-sectional survey]]></title>
        <pubdate>2026-09-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Leo R. Brown</author><author>Hephzibah Adegoke</author><author>Ellen Gardner</author><author>Thomas M. Drake</author><author>James Lucocq</author><author>Artur Zanellato</author>
        <description><![CDATA[PurposeTo characterise international contemporary practice in dissection and closure of lower abdominal transverse incisions (LATI) across surgical specialties.MethodsAn open, cross-sectional survey of surgeons with experience of performing LATI independently was conducted using an anonymised online questionnaire disseminated via professional networks. Data were captured pertaining to respondent characteristics, operative techniques for dissection and closure of abdominal layers, and experience with incisional hernias related to these incisions.ResultsOverall, 231 respondents from 31 countries across 6 continents were included, following relevant exclusions. Respondents comprised general surgeons (68.4%), obstetricians and gynaecologists (O&G; 26.4%) and urologists (5.2%). O&G respondents performed a significantly higher annual LATI case volume, when compared to other specialists (>50 cases/year: 60.7% vs. 6.5%, p < 0.001). Peritoneal entry varied between O&G and other surgeons, with O&G more commonly using blunt peritoneal entry (62.3% vs. 7.6%, p < 0.001) and a transverse, rather than longitudinal, peritoneal opening (54.1% vs. 15.9%, p < 0.001). Rates of peritoneal non-closure were higher amongst O&G compared to other subspecialties (77.0% vs. 24.1%, p < 0.001). More frequent use of a ‘small bites’ fascial closure technique was noted among general surgeons and urologists (85.3%), when compared to O&G (42.6%, p < 0.001). Most respondents considered LATI hernias to be underreported (84.0%), however more general surgeons had encountered LATI hernias (general surgery: 85.4%, urology: 41.7% and O&G: 42.6%, p < 0.001).ConclusionThere is substantial inter-specialty variation in closure techniques for LATI. Differences in practice may influence incisional hernia development and reporting, highlighting a need for further outcome-focused research and standardisation.]]></description>
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        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16438</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16438</link>
        <title><![CDATA[Use of intraperitoneal fascial traction in robotic eTEP approach for complex ventral hernias: technique and outcomes]]></title>
        <pubdate>2026-08-26T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Vivek Bindal</author><author>Dhananjay Pandey</author><author>Deepak Kumar</author><author>Shahiq Ahmed</author><author>Aakash Patel</author>
        <description><![CDATA[BackgroundTension-reduced midline closure remains a key challenge in the minimally invasive repair of large and complex ventral and incisional hernias. Commonly employed adjuncts, such as botulinum toxin A (BTA), progressive pneumoperitoneum (PPP), and component separation (CS), increase treatment complexity and may be associated with additional morbidity. Intraoperative fascial traction (IFT) has been described in open surgery to facilitate fascial medialisation; however, data related to its application in minimally invasive and robotic approaches supplementing IFT are scarce.MethodsA retrospective analysis was conducted of six patients who underwent robotic-assisted enhanced-view totally extraperitoneal (eTEP) ventral hernia repair with adjunctive IFT between June 2024 and March 2025. A comprehensive preoperative workup was performed, which included clinical evaluation and computed tomography (CT) imaging. The width of the fascial defect was meticulously measured intraoperatively before and after traction. For patients with transverse defects exceeding 15 cm, preoperative BTA injections were administered.ResultsThe mean pre-traction defect width was 15.8 ± 5.4 cm and reduced to 8.9 ± 3.2 cm following traction, achieving a mean medialisation of 6.9 ± 1.8 cm. Tension-reduced midline closure was achieved in all patients, without the need for CS or conversion to open surgery. Postoperative recovery was uneventful, with low pain scores, early ambulation, and no surgical site complications or 30-day readmissions.ConclusionIFT is a feasible and effective adjunct in robotic eTEP repair of large ventral hernias. When combined with robotic precision, it facilitates closure without undue fascial tension while preserving abdominal wall integrity and avoiding CS. Larger-scale studies are warranted to validate these findings.]]></description>
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        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17443</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17443</link>
        <title><![CDATA[Negative and neutral results matter in abdominal wall surgery]]></title>
        <pubdate>2026-08-20T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>Manuel López-Cano</author><author>Josep M. Garcia-Alamino</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16806</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.16806</link>
        <title><![CDATA[Why LATI-H must enter the surgical lexicon]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Artur Zanellato</author><author>James Lucocq</author><author>Leo Brown</author><author>Thomas M. Drake</author><author>Frederik Berrevoet</author><author>Stephen J. Wigmore</author>
        <description><![CDATA[BackgroundMillions of people undergo surgery with utilises a lower abdominal transverse incision (LATI). These incisions offer straightforward surgical access to the abdomen and pelvis and are ubiquitously used worldwide including for caesarean section. The incidence of hernia following these incisions have not been comprehensively studied and there are marked differences in abdominal entry across different LATI types. To address these hernias with a pivotal role in recognition and awareness, we propose a new term for hernias arising from these incisions: Lower Abdominal Transverse Interparietal/Incisional Hernias (LATI-H).MethodsA narrative review based on relevant literature was conducted to explore how LATI-H is described and reported. We searched the literature using MEDLINE and PubMed from inception to March 2025 to identify relevant studies. We retrieved relevant articles and included articles which described lower abdominal transverse incision complications including their hernias, with no limit on indication. Non-English articles were translated by medical translator for accurate understanding of the technique and literal transcription.ResultsLower abdominal transverse incisional hernias are poorly described and defined in the literature. They are frequently incorporated to large series of incisional hernias, but they are usually a mix of a large posterior defect with small incisional defects and have different features from other types of incisional hernia. This makes lower abdominal transverse interparietal hernias (LATI-H) a concern for general surgeons due to difficult diagnosis. LATI-H can progress and risk serious complications such as bowel obstruction and bowel ischemia.ConclusionLower abdominal transverse interparietal hernias (LATI-H) are poorly defined and are often erroneously termed Pfannenstiel or C-section hernias. The authors suggest the use of LATI-H to provide clear definition and provide a framework for future research to identify how these arise and find strategies to prevent and repair these hernias effectively.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17039</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/jaws.2026.17039</link>
        <title><![CDATA[Impact of incisional hernia on quality of life after colorectal cancer surgery – results of the Rein4CeTo1 randomized clinical trial]]></title>
        <pubdate>2026-08-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Charlotta L. Wenzelberg</author><author>Carl-Fredrik Rönnow</author><author>Ulf Petersson</author><author>Peder Rogmark</author>
        <description><![CDATA[PurposeTo evaluate quality of life (QoL), abdominal wall pain and discomfort 1 and 3 years after colorectal cancer (CRC) surgery in patients with and without incisional hernia (IH) and perform a risk factor analysis for impaired QoL.MethodsLongitudinal observational study with patients included in the randomized controlled trial, Rein4CeTo1, carried out 2017–2021. Patients underwent CT-scans 12 ± 3 and 36 ± 3 months after surgery, scrutinized for diagnosis of IH. General health was evaluated using the EQ-5D-5L questionnaire. For QoL related to IH and overall abdominal wall symptoms a slightly modified version of the Ventral Hernia Pain Questionnaire (VHPQ) was used. Potential risk factors of impaired QoL were investigated with multivariable linear regression analysis.ResultsOf 160 randomized patients, 134 were eligible for 1-year follow-up and 119/134 (89%) answered the questionnaires. Corresponding numbers at 3 years was 81/101 (80%). The EQ-5D-5L results were similar at 1 and 3 years for patients with and without IH (p = 0.276 1 year, p = 0.404 3 years). The VHPQ concluded low frequency of pain, stiffness in the abdominal wall and other discomforting symptoms without differences between patients with and without IH. In multivariable linear regression stoma was an independent risk factor for impaired general QoL at 3 years, p < 0.005.ConclusionIn this study, comparing QoL 1 and 3 years after CRC surgery, we could not find a statistically significant difference in patients developing an IH compared to those who did not. The presence of a stoma was an independent risk factor for impaired general QoL after 3 years.]]></description>
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