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Hernia Surgery and Postoperative Management
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Hernia Surgery and Postoperative Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 11342

Special Issue Editor

Prof. Dr. Jacob Rosenberg

E-Mail Website
Guest Editor
Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, 2730 Herlev, Denmark
Interests: hernia; diverticulitis; gallstone disease; appendicitis; colorectal cancer

Special Issue Information

Dear Colleagues,

Journal of Clinical Medicine is hosting a Special Issue about hernia surgery and postoperative management. I would therefore encourage you to submit papers to this Special Issue. You can submit all types of papers, including original articles, reviews, etc. Please consult the instructions for authors for details.

With the increasing prevalence of hernias and the demand for minimally invasive techniques, it is crucial to stay up-to-date with the latest advancements and share knowledge among experts in the field. This Special Issue serves as a comprehensive compilation of cutting-edge clinical insights and advancements in hernia surgery including innovative surgical techniques, novel approaches for hernia repair, advances in mesh technologies, management of complex and recurrent hernias, and postoperative care.

For the special issue, we will consider papers concerning both preoperative, intraoperative, as well as postoperative management of the various surgical diseases in hernia surgery. Thus, we will consider, for example, papers concerning preoperative optimization, intraoperative management including surgical technical papers as well as papers concerning anesthesiological issues for the patient undergoing hernia surgery, and papers dealing with a variety of issues concerning management in the early and late postoperative period.

Prof. Dr. Jacob Rosenberg
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hernia surgery
  • hernia repair
  • abdominal hernia
  • preoperative
  • intraoperative
  • postoperative
  • management
  • complications

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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11 pages, 626 KB  
Article
Incidence and Risk Factors for Incisional Hernia Following Ileostomy Takedown: A Retrospective Cohort Study
by Tamás Talpai, Flaviu-Ionuţ Faur, Cătălin-Alexandru Pîrvu, Daniela Marinescu, Cristi Tarta, Dragos Nicolae Margaritescu, Stelian Pantea, Cristian Nica, Rãzvan-Sorin Albu, Tudor-Alexandru Popoiu, Razvan Lazea, Larisa Balanoiu and Valeriu Șurlin
J. Clin. Med. 2025, 14(10), 3597; https://doi.org/10.3390/jcm14103597 - 21 May 2025
Viewed by 5281
Abstract
Background: Incisional hernias are a frequent complication following ileostomy closure, with rates reaching 24%. Protective ileostomies are commonly performed in colorectal surgery, but their closure presents a significant risk for abdominal wall defects. Identifying risk factors for incisional hernias at the ileostomy [...] Read more.
Background: Incisional hernias are a frequent complication following ileostomy closure, with rates reaching 24%. Protective ileostomies are commonly performed in colorectal surgery, but their closure presents a significant risk for abdominal wall defects. Identifying risk factors for incisional hernias at the ileostomy site is crucial for improving patient outcomes. Methods: This retrospective study analyzed data from 95 patients who underwent loop ileostomy closure at two Romanian hospitals between 2018 and 2023. Patient demographics, surgical details, and follow-up data were reviewed. Incisional hernias were diagnosed through clinical examination or radiological imaging. Statistical analyses, including univariate and multivariate regression, were performed to identify independent risk factors. Results: The incidence of incisional hernias at the ileostomy site was 13.7% (13/95). Univariate analysis identified BMI (HR 30.08; p = 0.007), previous hernia (HR 7.99; p = 0.059), radiotherapy (HR 299.15; p = 0.029), and chemotherapy (HR 0.004; p = 0.026) as significant factors. Multivariate analysis confirmed BMI > 30 kg/m2 (HR 12.27; p = 0.002) and prior hernia (HR 8.14; p = 0.007) as independent risk factors. Conclusions: Obesity and previous hernias significantly increase the risk of incisional hernias following ileostomy closure. Radiological follow-up enhances early detection, and further studies should explore the benefits of prophylactic mesh reinforcement. Optimizing patient selection and surgical technique may reduce postoperative hernia rates, improving long-term outcomes. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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12 pages, 740 KB  
Article
Beyond Traditional Repair: Comparing eTEP and Open Sublay for Ventral Hernia Repair
by Phillip Looft, Fadl Alfarawan, Maximilian Bockhorn and Nader El-Sourani
J. Clin. Med. 2025, 14(8), 2586; https://doi.org/10.3390/jcm14082586 - 9 Apr 2025
Cited by 2 | Viewed by 1400
Abstract
Background: Ventral hernias are common abdominal wall defects requiring surgical repair to prevent complications. This study compared two techniques: minimally invasive enhanced-view totally extraperitoneal (eTEP) approach and the open sublay (OS) method, historically regarded as the gold standard. Methods: A retrospective single-center study [...] Read more.
Background: Ventral hernias are common abdominal wall defects requiring surgical repair to prevent complications. This study compared two techniques: minimally invasive enhanced-view totally extraperitoneal (eTEP) approach and the open sublay (OS) method, historically regarded as the gold standard. Methods: A retrospective single-center study was conducted between July 2019 and March 2023 at the Department for General and Visceral Surgery, Klinikum Oldenburg. All patients who underwent either eTEP or OS for ventral hernia repair were included. Patient demographics and perioperative data were collected and compared. Results: A total of 139 patients were analyzed, with 92 undergoing eTEP repair and 47 undergoing OS. Both groups were comparable in demographic and clinical characteristics. Significant differences were found in defect size (median 6 cm2 for eTEP vs. 16 cm2 for OS, p < 0.028) and mesh size (median 450 cm2 for eTEP vs. 150 cm2 for OS p < 0.001). Operative time (p = 0.119) and postoperative pain levels over 3 days showed no significant differences (VAS Day1 p = 0.884; VAS Day3 p = 0.636). Intraoperative complications were 2.17% for eTEP and 6.38% for OS (p = 0.207). Postoperative complications (6.52% vs. 21.28%, p = 0.009) and hospital stay (median 3 days vs. 5 days, p < 0.001) were significantly lower in the eTEP group. Conclusions: eTEP is a safe, effective procedure and appears to offer more advantages than OS for ventral hernia repair. It is associated with a significantly lower complication rate, as well as shorter hospital stay. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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14 pages, 1375 KB  
Article
Short- and Long-Term Outcomes After Emergency Groin Hernia Surgery: A Nationwide Population-Based Study from the Swedish Hernia Register
by Maria Melkemichel, Henrik Holmberg, Ursula Dahlstrand and Hanna de la Croix
J. Clin. Med. 2025, 14(7), 2397; https://doi.org/10.3390/jcm14072397 - 31 Mar 2025
Cited by 1 | Viewed by 1834
Abstract
Background/Objectives: Emergency groin hernia repairs have consistently presented a higher risk of mortality and morbidity. This study aimed to compare both short- and long-term outcomes associated with emergency groin hernia surgery. Methods: A nationwide, population-based cohort study was conducted using prospective [...] Read more.
Background/Objectives: Emergency groin hernia repairs have consistently presented a higher risk of mortality and morbidity. This study aimed to compare both short- and long-term outcomes associated with emergency groin hernia surgery. Methods: A nationwide, population-based cohort study was conducted using prospective collected data from the Swedish Hernia Register combined with a questionnaire assessing patient-reported chronic pain. All patients who underwent a groin hernia repair between 2012 and 2018 were eligible for inclusion. Primary outcomes included 30-day mortality, chronic pain 1-year post-surgery, 30-day postoperative complication, and bowel resection and reoperation for recurrence for emergency versus elective repairs. Risk factors for these outcomes in emergency repair were investigated. Results: A total of 94,349 repairs were analyzed, with 5401 (5%) emergency repairs. Emergency repairs involved older patients (median age 74 vs. 65), more women (25% vs. 9%), more ASA grade III (38% vs. 12%), more femoral hernias (19% vs. 3%) and smaller defects (24% vs. 17%) compared to elective repairs. Multivariable analysis revealed increased rates and significant risks for 30-day mortality (2.7%, OR 11.61), chronic pain (20.6%, OR 1.30), 30-day postoperative complications (21.9%, OR 2.12) and bowel resection (7.8%, OR 408) compared to elective repairs. No significant difference was observed for reoperation for recurrence. Key risk factors for the outcomes following emergency repairs were higher age, higher ASA grade and femoral hernias. Conclusions: Emergency hernia surgery continues to pose a high risk of mortality and morbidity. Elective repair should be considered in frail patients and those with potential femoral hernias. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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Review

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15 pages, 654 KB  
Review
Chronic Groin Pain After Hernia Surgery: What Are We Missing?
by Roberto Cirocchi, Paolo Bruzzone, Bruno Cirillo, Sara Lauricella, Gianluca Costa, Francesco Brucchi, Maria Chiara Ranucci, Massimo Lancia, Piergiorgio Fedeli and Luca Tomassini
J. Clin. Med. 2025, 14(17), 6136; https://doi.org/10.3390/jcm14176136 - 29 Aug 2025
Viewed by 1403
Abstract
Background: Chronic postoperative inguinal pain [CPIP] is a prevalent and often debilitating complication following inguinal hernia repair. With the widespread adoption of mesh-based techniques, recurrence rates have significantly declined, shifting clinical focus toward postoperative pain management. Methods: This narrative review synthesizes international literature [...] Read more.
Background: Chronic postoperative inguinal pain [CPIP] is a prevalent and often debilitating complication following inguinal hernia repair. With the widespread adoption of mesh-based techniques, recurrence rates have significantly declined, shifting clinical focus toward postoperative pain management. Methods: This narrative review synthesizes international literature on CPIP incidence, surgical technique, geographic variation, and the distinction between neuropathic and nociceptive pain. Studies were selected based on relevance, sample size, and inclusion of pain subclassification. Results: CPIP incidence varies markedly across studies (6–64.3%), influenced by follow-up duration, surgical approach, and regional healthcare practices. The risk of CPIP varies significantly, depending on the surgical technique employed, with open repairs generally associated with higher rates than laparoscopic approaches. Neuropathic pain predominates in specific cohorts, particularly following open repairs with limited nerve preservation. Few studies differentiate pain types, revealing a critical gap in diagnostic precision. Conclusions: CPIP is a multifactorial and under-recognized problem in clinical practice. The adoption of standardized diagnostic tools and long-term follow-up protocols is essential to improve pain classification and management. A structured diagnostic algorithm may assist clinicians in distinguishing pain types and tailoring treatment strategies to individual patient profiles. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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Other

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13 pages, 929 KB  
Perspective
Redefining Success in Hernia Surgery: The Case for Patient-Reported Outcomes
by Jacob Rosenberg, Anders Gram-Hanssen, Hugin Reistrup and Jason Joe Baker
J. Clin. Med. 2025, 14(17), 6131; https://doi.org/10.3390/jcm14176131 - 29 Aug 2025
Viewed by 650
Abstract
In elective hernia surgery, the primary aim is to improve quality of life, rather than to save life. Therefore, outcome measures should emphasize domains such as pain, function, and overall satisfaction. While some principles also apply to other benign procedures, this perspective article [...] Read more.
In elective hernia surgery, the primary aim is to improve quality of life, rather than to save life. Therefore, outcome measures should emphasize domains such as pain, function, and overall satisfaction. While some principles also apply to other benign procedures, this perspective article centers on hernia repair as a paradigm for redefining surgical success. We perform hernia surgeries primarily due to quality-of-life concerns, and, consequently, it makes sense that outcome measures should emphasize quality-of-life indicators such as pain, other complaints impacting daily life, and most importantly, overall patient satisfaction with the procedure. Nonetheless, many interventional studies related to hernia disease tend to focus on tangible surgical outcomes like recurrence, infections, hospital stays, and readmissions. Therefore, we advocate for a shift in the evaluation of surgeries to prioritize more relevant patient-reported outcomes when assessing the effects of surgical procedures for benign conditions. These considerations not only apply to hernia surgery but also to other surgical interventions where the indication for surgery is based on quality-of-life issues. We urge the systematic incorporation of patient-reported outcomes into surgical practices and outcomes research to promote a more patient-centered approach, aligning surgical success with the outcomes that matter most to patients. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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