Recent Abdominal Wall Hernia Surgical Treatment Trends

Abstract

This article describes incisional and primary abdominal wall hernias, including umbilical and epigastric hernias. Complementary to medical consultations and physical examinations, computed tomography is an important tool for diagnosis and treatment decision-making. While hernia surgeries can be performed using open or laparoscopic approaches, numbers of laparoscopic surgeries have been increasing. Mesh repair can effectively decrease the recurrence rate, and the retromuscular is the recommended location for mesh placement. New minimally invasive surgical techniques, including eTEP and MILOS, have recently been introduced and are expected to reduce pain and postoperative complications. As perioperative treatment strategies, including preventive measures, exert significant impacts on postoperative complications, the selection of an appropriate surgical approach and measures to address complications must be tailored to each case. In asymptomatic cases of umbilical and epigastric hernias, observation is recommended, whereas surgery must be considered for symptomatic hernias and those with a high risk of incarceration. For patients with diastasis recti abdominis, the new laparoscopic technique SCOLA may be an option. Selection of an appropriate surgical approach, surgical procedures, and perioperative management based on patient background and lesions is essential.