Abdominal Wall Hernia: new perspectives for clinical research

Abstract

Abdominal wall surgery is a broad term, covering different treatment strategies for all different types of abdominal wall hernias. For example, an inguinal hernia is a totally different entity than an incisional hernia and requires a different treatment strategy. Nevertheless, some issues and solutions are common and do apply for all types of abdominal wall hernia. Abdominal wall surgery has undergone great evolution and transformation in the last century. Several important milestones were reached in the past few decades. The incidence of hernia recurrence was up to 60% in the long term before routine use of mesh prostheses. The introduction of prostetic mesh for reinforcement of surgical repair proved one of the true milestones with regard to the reduction of recurrences. Meshes are not only suitable for hernia repair, but can also be used for hernia prevention in selected patient groups. However, disadvantages of prosthetic material, such as infection, adhesions, erosion, shrinkage or even meshoma also occupy surgeons’ minds. Although modern mesh prostheses have been modified to include anti-adhesive layers, and consist of materials that are less prone to infection, meshrelated problems have continued to complicate hernia surgery. Another milestone in the era of abdominal wall surgery was the concept of tension-free repair. The concept of tension free repair has been associated with less postoperative pain and faster recovery, especially after inguinal hernia surgery. Also, tension free repair has been associated with a reduction of recurrence rates.