Management Of Hernia Research Articles

Tacker Fixation versus Suturing of Mesh in Laparoscopic Inguinal Hernia Repair

Abstract Background Laparoscopic hernia repair is more difficult technically than open surgery and there is evidence of learning curve in its performance and many complications which reported from laparoscopic procedure is due to learning curve lead to operative complications. Objective To compare the outcome results of the fixation of mesh by intracorporeal sutures and by tackers in TAPP hernia repair. Patients and Methods In our study, 30 patients were included divided on two groups, 15 for each. Group A; fixation mesh with tackers, Group B; fixation mesh with intracorporeal sutures. Both groups were compared in terms of operative technique, operative time, mesh device fixation cost, intra & post operative complications, early post operative pain within two weeks and in first month, hospital stay, restriction of physical activity and incidence of recurrence and chronic pain. Results We found that using Intracorporeal sutures for fixation mesh is available, cheaper and more handle than using the Tackers which are expensive and less available so it makes a laparoscopic hernia more practical and decrease need for open surgery so we avoid the complication of open surgery. Both techniques are considered safe and effective with similar rates of recurrence and chronic pain although further wider scale studies are recommended. Conclusion TAPP hernia is considered safe as all perioperative complications are well tolerated by patients and mostly there was no need for a second operative intervention. Mesh fixation technique did not affect long-term persistent pain. A large number of patients reported persistent pain regardless of mesh fixation technique, which emphasizes the need for preoperative information. Preoperative pain was a risk factor for persistent pain. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilateral or bilateral, primary or recurrent status, strangulation and type of anesthesia, occupation, and leisure activities. Both techniques are effective in the management of inguinal hernia and were associated with same recurrence rate. However, due to small sample size and short follow up duration, longer- term studies are also recommended.

282 Emergency Laparoscopic Parastomal Hernia Repair Around Ileal Coduit in a Morbidly Obese Patient - a Surgical Challenge Managed Successfully

Abstract Aim Management of a strangulated parastomal hernia (PH) around the ileal conduit can be a surgical challenge. We demonstrate here a safe and effective laparoscopic repair of a strangulated PH in the emergency setting for a 53year-old morbidly obese woman (BMI: 40). Method Entry to abdominal-cavity was by Veress-needle technique. PH defect was identified – containing strangulated part of ascending-colon that reduced spontaneously during creation of pneumoperitoneum. Adhesiolysis around stomal defect up to lateral attachment of ileal conduit was completed. 3cm defect was opposed using transfascial nonabsorbable sutures. 15cm circular-composite-mesh was fashioned U-shaped and introduced in medial to lateral direction with the U lips overlapped and fixed snug laterally around the ideal conduit. Mesh was further fixed through double-crown fixation. Results Patient had an uneventful recovery and discharged on the second post-operative day. A 10-month CT as a part of bladder cancer follow up showed no PH recurrence. Conclusions This case shows that strangulated PH around an ileal conduit, an uncommon presentation, can be successfully managed laparoscopically even in the emergency setting especially for patients of high BMI with proper assessment and appropriate expertise. Successful management of this challenging presentation of strangulated PH around ileal conduit demonstrates the safe and effective use of laparoscopic surgery especially in the emergency setting for patients of high BMI.

820 “Antibiotics Because We’re Inserting a Mesh”: A Study to Evaluate Antibiotic Prophylaxis in Elective Hernia Repairs

Abstract Aim Inguinal hernias are one of the most common pathologies worldwide. Over 20 million inguinal hernia repairs are performed each year. The HerniaSurge Collaboration recently updated their international guidelines for groin hernia management. They concluded that antibiotic prophylaxis is not recommended in elective open inguinal mesh hernia repairs in average-risk patients in a low infection risk environment. In laparoscopic hernia repairs, antibiotics are never recommended. This study aimed to identify current practice for antibiotic prophylaxis use in elective inguinal hernia repairs within our district general hospital environment. Method A retrospective study was performed, evaluating all elective inguinal hernia repairs with mesh between 1st June 2022-31st December 2022. Both laparoscopic and open techniques were included in this study. Operative notes were reviewed to ascertain if patients had been given antibiotics intra-operatively. Results The study identified 84 patients who underwent an inguinal hernia repair with mesh across a 7 month- period. Of these, all were operated on in a low-risk environment. 94% (N=79) were given antibiotic prophylaxis intraoperatively. Conclusions Antibiotic prophylaxis is still being used for low-risk patients undergoing elective inguinal hernia surgery. This is not in keeping with current hernia guidelines which suggests that there is no significant benefit to antibiotic use. Excessive antibiotic use is associated with an increase in adverse events, an increased rate of antibiotic resistant organisms and increased healthcare costs.

Ostomy Care Nurses' Knowledge and Practice Related to Prevention and Management of Parastomal Hernias in Adults: A Nationwide Survey of UK Stoma Care Nurses.

The purpose of this study was to describe the knowledge and practices of ostomy care nurses related to the United Kingdom's Association of Stoma Care Nurses (ASCN) 2016 guidelines for prevention and management of parastomal hernia (PSH) in adults. Cross-sectional descriptive study. The target population was approximately 300 stoma care nurses; 120 useable responses to the survey were received, reflecting a response rate of approximately 40%. A 31-item questionnaire was developed for the purposes of this study, consisting of multiple choice and short answer questions grouped into 2 sections; demographics, and knowledge and practices. The questionnaire was distributed to members of the ASCN who work with adults via an online survey platform with the aim of reaching as many respondents as possible. The Chi-square test was used to determine relationships between the nominal demographic data and the nominal knowledge and practices data. Almost two-thirds of respondents (65%, n =78) rated their knowledge relating to prevention and management of PSH as good or excellent. Nevertheless, 79.8% (n=95) indicated they needed additional education to improve their knowledge and practice related to prevention of PSH. Those who rated their knowledge as excellent or good were significantly more likely to be aware of the guidelines compared to those who ranked their knowledge as average or poor. Study findings suggest variability in knowledge among UK stoma care nurses, along with a desire for additional education in this area of care.

Management of Pediatric Umbilical Hernia

Management of Pediatric Umbilical Hernia

Management of Strangulated Richter’s Hernia in a Resource-Limited Setting: Report of Two Cases and Literature Review

Richter’s hernia is a rare type of abdominal wall hernia characterized by high morbidity and mortality. It occurs when the anti-mesenteric border of the bowel is partially trapped in a tight hernial ring. The femoral ring is the most common site, with the ileum being the most frequently involved intestinal segment. However, the advent of laparoscopic surgery has introduced another potential site for Richter’s hernia formation. In our region, this pathological entity is exceptionally diagnosed due to limited access to abdominal imaging and delayed management. Additionally, the wide variety of clinical manifestations resulting from incomplete intestinal obstruction makes it particularly difficult to diagnose. Consequently, it is usually identified during surgery. We present here the case of two adult patients (a 33-yeairs-old woman and a 59-year-old man), the first with a history of surgical procedures and the second with a spontaneously reducible painless inguinal swelling. They were transferred to the surgical emergency department for an acute abdomen with abdominal distension and cessation of matter and gas. Clinical and paraclinical examinations (including hydroaeric level on abdominal X-ray) indicated mechanical intestinal obstruction. Emergency laparotomy, necessitated by the unavailability of abdominal computed tomography due to financial constraints, confirmed the diagnosis of Richter's hernia, with the first case located in the right inguinal region and the second in the linea alba. Surgical management involved reduction of the hernia contents and suture repair in both cases. Despite requiring bowel resection in the second patient, the postoperative course was straightforward. These two rare cases highlight that emergency exploratory laparotomy is the cornerstone of Richter hernia management in resource-limited conditions.

ROBOT-ASSISTED EXTRAPERITONEAL VENTRAL HERNIA REPAIR—EXPERIENCE FROM THE FIRST 160 CONSECUTIVE OPERATIONS WITH LATERAL eTEP AND eTAR TECHNIQUES

Abstract Background As in various other surgical domains, robotically assisted procedures have become integral in the management of ventral hernias in recent years. The employment of robotic technology enables the integration of minimally invasive techniques with retromuscular mesh placement. Beyond the conventional transabdominal approach, these surgical interventions can alternatively be executed in a total extraperitoneal fashion. The objective of this study is to demonstrate that robotic total extraperitoneal management of abdominal wall hernias is safe and efficient. Method A retrospective analysis encompassing all patients who underwent robotic surgery for ventral hernia repair utilizing the extraperitoneal eTEP technique with a lateral approach was conducted. The study period spanned from December 2019 to December 2023. Results Over the study period, a total of 160 patients underwent surgical intervention utilizing the lateral robotic eTEP technique. Among these cases, 43 patients required a lateral extension of retro-rectal dissection through extraperitoneal transversus abdominis release (eTAR) due to either the hernia size or lateral hernia localization. In every instance, an uncoated synthetic mesh was positioned in the retromuscular location, accompanied by complete fascial closure. The median hernia defect area was 25 cm² (2.25–375 cm²). The median mesh size was 540 cm² (225–1350 cm²). The median mesh defect ratio (MDR) was 21 (2.3–150). Two conversions (1.72%) were necessary. One intraoperative and seven postoperative complications were encountered (5%) out of which two required reoperations (1.72%). Conclusion The robotic extraperitoneal eTEP technique enables a retromuscular mesh placement in a minimally invasive approach. With the possibility of combination with a transversus abdominis release, even complex findings can be treated using this technique.

Traumatic Abdominal Wall Hernia: Management Using a Standardized Approach.

Traumatic abdominal wall hernias are a rare complication of high energy blunt trauma. There exist several studies evaluating and outlining potential management options but still no generalized consensus on management. This series was meant to evaluate the diagnosis and management of traumatic abdominal wall hernias. A prospectively maintained database was used to identify patients with TAWH from 2021 to 2022. The primary outcome was operative management. Secondary outcomes included: time to diagnosis and post-operative outcomes. Of the 19 patients in this case series, 100% (n = 19/19) were secondary to blunt trauma with a mean ISS of 21. Exploratory laparotomy was performed in 17 cases. 14 cases had concomitant traumatic injuries to visceral structures. Complications were found in nearly half of the patients with 3 experiencing wound dehiscence. Future studies should be aimed at standardizing management approach taking into account nature of the mechanism and concomitant injuries.

Innovative Approaches to Address the Technical Challenge of Hernial Sac Distension Due to Pneumoperitoneum in the Synchronous Management of Complex Hernias in Individuals With Morbid Obesity

Innovative Approaches to Address the Technical Challenge of Hernial Sac Distension Due to Pneumoperitoneum in the Synchronous Management of Complex Hernias in Individuals With Morbid Obesity

Emergency umbilical hernia management: scoping review.

Umbilical hernias, while frequently asymptomatic, may become acutely symptomatic, strangulated or obstructed, and require emergency treatment. Robust evidence is required for high-quality care in this field. This scoping review aims to elucidate evidence gaps regarding emergency care of umbilical hernias. EMBASE, MEDLINE and CENTRAL databases were searched using a predefined strategy until November 2023. Primary research studies reporting on any aspect of emergency umbilical hernia care and published in the English language were eligible for inclusion. Studies were excluded where emergency umbilical hernia care was not the primary focus and subsets of relevant data were unable to be extracted. Two independent reviewers screened abstracts and full texts, resolving disagreements by consensus or a third reviewer. Data were charted according to core concepts addressed by each study and a narrative synthesis was performed. Searches generated 534 abstracts, from which 32 full texts were assessed and 14 included in the final review. This encompassed 52 042 patients undergoing emergency umbilical hernia care. Most were retrospective cohort designs (11/14), split between single (6/14) and multicentre (8/14) with only one randomized trial. Most multicentre studies were from national databases (7/8). Themes arising included risk assessment (n = 4), timing of surgery (n = 4), investigations (n = 1), repair method (n = 8, four mesh versus suture; four laparoscopic versus open) and operative outcomes (n = 11). The most commonly reported outcomes were mortality (n = 9) and morbidity (n = 7) rates and length of hospital stay (n = 5). No studies included patient-reported outcomes specific to emergency umbilical hernia repair. This scoping review demonstrates the paucity of high-quality data for this condition. There is a need for randomized trials addressing all aspects of emergency umbilical hernia repair, with patient-reported outcomes.

Amyand's Hernia a form of Inguinal Hernia: A Case Report and Literature Review

Introduction: Amyand hernia (HA) is a form of inguinal hernia considered to be very rare, and this type of hernia has occurred up to 1% of all inguinal hernia cases. In this type of inguinal hernia, the contents of the hernia is the appendix. Most patients with HA often remain asymptomatic and diagnosed intraoperatively. The diagnosis is difficult, surgery is the pillar of management. We report a case of Amyand hernia that was operationally managed in our institution. Case Report: A 50-year-old patient with a normal body mass index (BMI) with a history of right-side reducible inguino-scrotal hernia that has evolved for 4 years, he was admitted for management of elective right inguinal hernia. Two weeks before admission, he noticed worsening pain. Normal abdominal ultrasound. There was no history of abdominal pain and vomiting. The biological assessment was normal. So, with a diagnosis of partially reducible right inguinal hernia, incomplete and indirect, the patient was operated on surgical exploration, we found dense adhesions in the sac, and adhesiolysis was released which revealed a hernia of the appendix in the inguinal canal. The appendix was slightly congested with no signs of inflammation. Therefore, given the uninflated appendix, a hernia cure according to Lichtenstein with an appendectomy was performed. Simple post-operative follow-up. Clinical Conclusion: Amyand’s hernia, is a condition where the appendix is found in the hernia sac, is quite rare, accounting for only 0.4–1% of all instances of inguinal hernia. A review of the literature further emphasizes the rarity of Amyand’s hernia. Moreover, a mere 0.1% of these cases progress to acute appendicitis, often as a result of delayed presentation and overlooked diagnosis. Conclusion: Amyand’s hernia (AH) constitutes a minor percentage of all inguinal hernia cases, and its identification often occurs unexpectedly during surgery. This condition can stay symptom-free and mimic a typical inguinal hernia. .......

A new groin hernia classification with clinical relevance.

Groin hernia is one of the most commonly managed surgical diseases around the world. The typical question asked by patients is "Does my hernia require urgent surgery?". The currently available classifications are insufficient to stratify patients into different groups. We propose a new classification that incorporates diverse clinical elements together with anatomical and other vital information, which allows us to stratify patients into different groups. A task force was formed by the Hong Kong Hernia Society, working with international expert hernia surgeons. The framework of the classification system was formulated. Clinical elements that are important in groin disease stratification were identified. A comprehensive literature review was conducted using PubMed. Those which dictate the severity of the disease were selected and compiled to form the new proposed classification. Application of this classification model to a single hernia surgeon's registry in The Hong Kong Adventist Hospital Hernia Centre was done for initial evaluation. This new classification incorporates important clinical characteristics forming a total of nine grades of differentiation, together with the anatomical details and special information. This comprehensive system allows the stratification of patients into different groups based on disease severity. It also enables more accurate data collection for future audits, comparisons of disease progression over time, and the effect of different management strategies for different-stage patients. This is the first classification system which incorporates essential clinical parameters, which allows the stratification of groin hernia into different stages. Further studies and validation should be performed to evaluate the usefulness and value of this classification in groin hernia management.

Open intraperitoneal onlay mesh repair with anterior component separation as a bail-out procedure in the management of complex hernias.

Surgical repair of complex abdominal wall hernias remains technically demanding and is widely recognized as a risk factor for unfavorable outcomes with high recurrence and morbidity rates. The objective is to assess short- and long-term complications after open intraperitoneal onlay mesh (IPOM) repair combined with bilateral anterior component separation (ACS) for large and difficult incisional hernias, alongside evaluating hernia recurrence rates. This retrospective analysis utilized data sourced from Hospital electronic health records and a prospective database at an academic tertiary referral center. Data collection was carried out from patients operated between January 2006 and December 2017. Eligible patients had complex incisional hernias measuring at least 10cm in their transverse diameter and had an open IPOM repair with bilateral ACS. In our study group of 45 patients, the 30-day surgical site occurrence (SSO) rate was high (37.8%), primarily consisting of superficial postoperative complications as seroma (17.8%) and wound dehiscence (6.7%). Among six patients (13.3%), wound complications escalated to chronic infected mesh-related problems, leading to complete mesh removal in four cases (8.9%) and partial mesh removal in two cases (4.4%). Regarding long-term complications, five patients (11.1%) developed enterocutaneous fistula. The recurrence rate was modest [5 out of 41 (12.2%)] over a median follow-up period of 99 months. Despite a high SSO rate, application of the open IPOM technique with ACS could serve as a valuable rescue option for managing large and complex hernias, with acceptable hernia recurrence rates at long-term follow-up.

Prosthetic Management of Inguinal Hernias Using the Lichtenstein Technique in 100 Cases

Introduction: There has always been a plethora of hernia repairs in the absence of consensus. Techniques described as ancient, such as the Bassini, Mac Vay or Shouldice procedures, are still widely practised. Aponeurotic plasty has proved its worth in our practice. Prosthetic plasty, which has reduced recurrence by half, has become the gold standard. The aim of this study was to report on the feasibility of prosthetic management of inguinal hernias using the Lichtenstein technique. Material and method: This was a prospective fifteen (15)-month study: from July 1, 2022 to September 30, 2023. Study variables were sociodemographic, clinical and therapeutic. Results: During the study period, 173 patients underwent surgery for inguinal hernia. We noted one hundred (100) patients operated on according to the Lichtenstein procedure, i.e. 58% of all patients operated on for inguinal hernias in the department. We noted 98 men and 02 women. The mean age was 48.8 years (extremes: 20-91). The category of heavy laborer (laborer, farmer, etc....) accounted for % of cases. The hernia was exclusively right in 9 cases, left in 21 and bilateral in 10. A strangulated hernia was present in 9 patients. NYHUS classification was dominated by type IIIA (38.9%). Therapeutically, spinal anesthesia was the most common treatment: 8 cases. 40% of patients were pain-free in the immediate post-operative period, according to the analogue pain scale. The main complications were chronic pain in 10 patients and seroma in 02. After a minimum follow-up of three months for each patient, we noted no recurrence. Conclusion. The Lichtenstein technique is a relatively new procedure in our practice. Today, it is the technique of choice, with little postoperative morbidity.

A Ventral Hernia Management Pathway; A "Getting It Right First Time" approach to Complex Abdominal Wall Reconstruction.

Abdominal wall reconstruction (AWR) is an emerging specialty, involving complex multi-stage operations in patients with high medical and surgical risk. At our hospital, we have developed a growing interest in AWR, with a commitment to improving outcomes through a regular complex hernia MDT. An MDT approach to these patients is increasingly recognized as the path forward in management to optimize patients and improve outcomes. We conducted a literature review and combined this with our experiential knowledge of managing these cases to create a pathway for the management of our abdominal wall patients. This was done under the auspices of GIRFT (Getting It Right First Time) as a quality improvement project at our hospital. We describe, in detail, our current AWR pathway, including the checklists and information documents we use with a stepwise evidence and experience-based approach to identifying the multiple factors associated with good outcomes. We explore the current literature and discuss our best practice pathway. In this emerging specialty, there is limited guidance on the management of these patients. Our pathway, the "Complex Hernia Bundle," currently provides guidance for our abdominal wall team and may well be one that could be adopted/adapted by other centers where challenging hernia cases are undertaken.

Intraperitoneal Onlay Mesh (IPOM Plus) Repair Versus Extended-View Totally Extraperitoneal Rives-Stoppa (eTEP-RS) Repair in Primary Ventral Hernias: Experience With 50 Cases in a Tertiary Care Hospital.

Background Primary ventral hernias are abnormal protrusions of abdominal viscera through the areas of weakness in the fascia of the abdominal wall. The aim of this study was to compare the benefits and complications, and the overall outcome in the Extended-View Totally Extraperitoneal Rives-Stoppa (eTEP-RS) repair versus Intraperitoneal Onlay Mesh (IPOM Plus) repair in the management of primaryventral hernias. Methods After obtaining institutional ethical committee clearance, this prospective comparative study between IPOM Plus and eTEP-RS was conducted in a tertiary care hospital from December 2020 to January 2022. A total of 50 patients presenting with primary ventral hernias were included in the study, of whom 25 underwent IPOM Plusand 25 underwent eTEP-RS repairs. Group selection was doneby simple randomization using the lottery method. Patients more than 18 years of age with primary ventral hernias presenting with a hernial defect width less than 6 cm, consenting to the study, were included in the study. Patients who did not fulfill the inclusion criteria, strangulated/obstructed hernias, recurrent/incisional hernias, connective tissue disorders, skin infections, enterocutaneous fistulas, pregnancy, morbid obesity, and parastomal hernias were exclusion factors. Results The mean intraoperative duration in the eTEP-RS group (192.3 ± 16.20 min) was significantly higher than in theIPOM Plus group (102.6 ± 16.78min, p=0.001). The mean duration of hospital stay in the IPOM Plus group (5.9 ± 2.19 days) was longer than in the eTEP-RS group (4.6 ± 3.17 days, p=0.02). The mean postoperative pain scores, from the Visual Analogue Scale(VAS), on days 1, 7, and 90 were 3.2 ± 1.11, 2.64 ± 1.11, and 1.68 ± 1.46in the IPOM Plus group and 1.84 ± 0.688, 0.76 ± 0.66 and 0.08 ± 0.40 in the eTEP-RS group, respectively(p=0.001). Conclusion Despite being a technically easy procedure requiring less intraoperative time, IPOM Plus had several disadvantages, such as increased postoperative pain, longer duration of hospital stays, higher chances of wound site seromas, and higher rates of postoperative paralytic ileus.On the other hand, eTEP-RS was a more challenging procedure requiring more intraoperative time; however, it had several advantages: less postoperative pain, less duration of hospital stay, early recovery, and fewer chances of seromasand paralytic ileus.However, more robust data is required to compare and validate the differences between both procedures' short- and long-term outcomes.

Two-meshes approach in posterior component separation with transversus abdominis release: the IMPACT study (Italian Multicentric Posterior-separation Abdominal Complex hernia Transversus-release).

Surgical management of large ventral hernias (VH) has remained a challenge. Various techniques like anterior component separation and posterior component separation (PCS) with transversus abdominis release (TAR) have been employed. Despite the initial success, the long-term efficacy of TAR is not yet comprehensively studied. Authors aimed to investigate the early-, medium-, and long-term outcomes and health-related quality of life (QoL) in patients treated with PCS and TAR. This multicenter retrospective study analyzed data of 308 patients who underwent open PCS with TAR for primary or recurrent complex abdominal hernias between 2015 and 2020. The primary endpoint was the rate of hernia recurrence (HR) and mesh bulging (MB) at 3, 6, 12, 24, and 36months. Secondary outcomes included surgical site events and QoL, assessed using EuraHS-QoL score. The average follow-up was 38.3 ± 12.7months. The overall HR rate was 3.5% and the MB rate was 4.7%. Most of the recurrences were detected by clinical and ultrasound examination. QoL metrics showed improvement post-surgery. This study supports the long-term efficacy of PCS with TAR in the treatment of large and complex VH, with a low recurrence rate and an improvement in QoL. Further research is needed for a more in-depth understanding of these outcomes and the factors affecting them.

Evaluation of the Role of Eosaphageal Manometry in Tailoring of Fundoplication Type in the Management of Hiatal Hernia

Evaluation of the Role of Eosaphageal Manometry in Tailoring of Fundoplication Type in the Management of Hiatal Hernia

Impact Of Comorbidities On Outcomes And Healthcare Costs Of Open Inguinal Hernia Repair In Patients With Diabetes Mellitus.

Inguinal hernia management in patients with diabetes mellitus (DM) and comorbidities presents challenges due to potential impacts on wound healing and infection risk. This study evaluates the influence of additional comorbidities on outcomes following open inguinal hernia repair in DM patients. A retrospective cohort study was conducted at Craiova Emergency Clinical County Hospital from 2015 to 2020. Patients with documented DM undergoing hernia repair were categorized into two groups based on comorbidity status. Data on presentation mode, hernia type, comorbidities, hospitalization, operative details, postoperative outcomes, and costs were collected and analyzed statistically. Among 38 DM patients undergoing hernia repair, 16 were in Group A (DM alone) and 22 in Group B (DM with comorbidities). Group B patients were older (p = 0.0002) and more likely to present emergently (OR: 13.81, p=0.0148) with incarcerated (OR: 22.733, p=0.0339) or strangulated hernias (OR: 9.4545, p=0.0390). Group B had longer hospitalizations (p=0.00132) and higher hospitalization costs (p = 0.00262). DM patients with comorbidities are at higher risk for complex hernias and prolonged hospitalizations. Pulmonary fibrosis emerges as a significant comorbidity requiring specific perioperative strategies. Tailored preoperative assessments and care plans can optimize outcomes.

Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030.

Hernias, particularly inguinal, femoral, and abdominal, present a global health challenge. While the Global Burden of Disease (GBD) study offers insights, systematic analyses of hernias remain limited. This research utilizes the GBD dataset to explore hernia implications, combining current statistics with 2030 projections and frontier analysis. We analyzed data from the 2019 GBD Study, focusing on hernia-related metrics: prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries, grouped into 21 GBD regions by the SDI (SDI). Data analysis incorporated relative change calculations, Annual Percentage Change (APC), Average Annual Percentage Change (AAPC), and Joinpoint Regression Analysis. The study also employed frontier analysis and the Bayesian Age-Period-Cohort model for trend prediction up to 2030. Analyses utilized R version 4.2.3. From 1990 to 2019, global hernia cases surged by 36%, reaching over 32.5 million, even as age-standardized rates declined. A similar pattern was seen in mortality and DALYs, with absolute figures rising but age-standardized rates decreasing. Gender data between 1990 and 2020 showed consistent male dominance in hernia prevalence, even as rates for both genders fell. Regionally, Andean Latin America had the highest prevalence, with Qatar and Bulgaria noting significant increases and decreases, respectively. Frontier analyses across 204 countries linked higher SDIs with reduced hernia prevalence. Yet, some high SDI countries, like Qatar and the UK, deviated unexpectedly. Predictions up to 2030 anticipate increasing hernia prevalence, predominantly in males, while death rates are expected to decline. DALYs, after declining, are stabilizing. Our analysis reveals a complex interplay between socio-demographic factors and hernia trends, emphasizing the need for targeted healthcare interventions. Despite advancements, vigilance and continuous research are essential for optimal hernia management globally.