AIM: The incidence of parastomal hernia (PH) following the transperitoneal end sigmoid colostomy (TP) with prophylactic mesh placement has been reported unexpectedly high. We reviewed the incidence of PH after laparoscopic abdominoperineal excision (lap APE) using extraperitoneal end sigmoid colostomy (EP) in principle since 2013 to examine the appropriateness of prophylactic mesh placement for PH prevention in the laparoscopic setting.

MATERIALS AND METHODS: From September 2013 to August 2021, 28 consecutive patients underwent lap APE for local curative resection of rectal adenocarcinoma with a postoperative follow-up period of at least 20 months at the Department of Gastrointestinal Surgery, Kansai Medical University Hospital. We diagnosed a PH (+) based on either the findings of a follow-up CT examination or those of a certified wound, ostomy, and continence nurse. We examined the causes of PH based on the clinical and surgical findings.

RESULTS: We have experienced PH in 6 out of 28 patients (PH (+)). Of these, 5 were cases where EP was technically abandoned in favor of TP. The Cox proportional hazard model revealed that the risk factors of the PH were significant in the TP (relative risk = 46.8; 95% confidence interval = 2.3-940.4). The Kaplan-Meier curve showed that the 3-year PH occurrence rate was significantly lower in EP (5.1%) than in TP (71.4%; P < 0.001).

CONCLUSION: The EP is a highly effective method for preventing PH, and the intraperitoneal onlay mesh methods, in which TP is used as a pseudo-EP in cases where TP is necessary, warrants further investigation.

BACKGROUND: Chronic pain following inguinal hernia repair is a non-negligible issue, yet accurately assessing patients' postoperative quality of life remains challenging. This study aims to evaluate the reliability, validity, and acceptability of the EuraHS-QoL scale within the Chinese patient population.

MATERIALS AND METHODS: Using the Chinese version of the EuraHS-QoL as a questionnaire, 80 patients with abdominal wall hernias (enrolled between September and November 2024) were tested preoperatively, on postoperative day 1, and at 3 months postoperatively. Additionally, the Visual Analog Scale and SF-36 Health Survey were completed on the first day after surgery. Through data analysis, the scale's reliability, validity, and acceptability were confirmed.

RESULTS: The internal consistency of the three dimensions of the Chinese version of the EuraHS-QoL scale was confirmed, with high correlations among similar dimensions of the three scales. Meanwhile, the EuraHS-QoL scale demonstrated advantages in hernia-specific areas and exhibited higher patient compliance. Notably, EuraHS-QoL scores across all three modules were significantly lower at 3 months postsurgery than at the preoperative and 1 day postoperative assessments (p < 0.05), suggesting that hernia repair surgery enhances patients' physical and psychological well-being and overall quality of life.

CONCLUSION: The Chinese version of the EuraHS-QoL scale has good reliability, validity, and acceptability, and it can serve as a reference tool for assessing quality of life in studies of abdominal wall hernia patients in China.

BACKGROUND: Concurrent prosthetic mesh abdominal wall reconstruction during bowel resection remains controversial due to concerns over contamination risks. This study evaluates the safety and efficacy of single-stage mesh repair in bowel resection and compares outcomes between resection and non-resection cohorts. This study evaluates the safety and efficacy of single-stage mesh repair in bowel resection and compares outcomes between resection and non-resection cohorts.

MATERIALS AND METHODS: A retrospective analysis included 79 patients undergoing abdominal wall reconstruction (2018-2023), stratified into bowel resection (n = 22) and non-resection (n = 57) groups. Surgical techniques included open sublay and laparoscopic laparoscopic intraperitoneal onlay mesh plus mesh implantation. Outcomes assessed complication rates, recurrence, and quality of life through Carolinas comfort scale (CCS). Statistical analysis utilized Statistical Package for the Social Sciences 26.0 with P < 0.05 as significance threshold.

RESULTS: Operative time and hospitalization were longer in the bowel resection group (P < 0.05). No significant differences were observed in overall complication rates (36.36% vs. 36.84%, P > 0.05), including mesh infection (4.55% vs. 7.02%), and recurrence (9.09% vs. 8.77%). CCS scores indicated comparable quality of life, with 77.27% of resection and 71.93% of non-resection patients reporting minimal discomfort (scores ≤10).

CONCLUSIONS: Single-stage mesh repair with bowel resection demonstrates safety and efficacy equivalent to non-resection procedures under rigorous infection control. The findings challenge traditional multi-stage approaches, supporting individualized decisions based on contamination severity and patient factors.

INTRODUCTION: Laparoscopic repairs for pediatric inguinal hernia have gained gradual acceptance in the past. The objective of this study was to evaluate the clinical efficacy and significance of singlesite laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural needle for children with inguinal hernia.

MATERIALS AND METHODS: We retrospectively analyzed clinical data of 529 children with inguinal hernia who underwent single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural needle at our hospital from January 2019 to August 2024.

RESULTS: All micro-laparoscopic surgeries were successfully performed in the 529 patients, among them, a contralateral patent processus vaginalis was present in 208 patients with unilateral pathology and thus simultaneously repaired; a total of 737 cases of inguinal hernia were repaired. The average operating time was 13.42 ± 4.42min for unilateral hernioplasty and 19.20 ± 2.49min for bilateral hernioplasty. Only one male patient experienced a recurrence that required reoperation. In terms of postoperative complications, there were no surgical site infections, testicular atrophy, or abdominal adhesions. The mean follow-up time was 14.12 ± 3.45 months. All the patients had a small operative scar, which was minimally visible.

CONCLUSION: Single-port laparoscopic surgery using an epidural needle for children is a technically straightforward and reliable approach for treating pediatric inguinal hernias, characterized by high applicability, minimal postoperative complications, reduced recurrence risk, rapid convalescence, and superior aesthetic outcomes.

We present the case of an ectopic kidney located in the scrotum, discussing decision-making, surgical management, and outcomes. Although this is a rare pathology, we aimed to correlate this case with other reports of inguinal hernias and provide a literature review focusing on surgical and urological findings and management in similar patients. The patient is a 73-year-old man who presented with a progressive enlargement of his right inguinal area over the past 4 years. A routine computed tomography scan revealed an ectopic kidney in the scrotum, extending into a ~10 cm inguinal hernia, with severe hydronephrosis and a dilated ureter. Management options included nephropexy versus nephrectomy. A multidisciplinary approach involving general surgery and urology was employed, and the patient underwent a robot-assisted laparoscopic right inguinal hernia repair and kidney relocation. Postoperatively, renal function showed slight improvement, and no hernia recurrence was reported at the 6-month follow-up. This case highlights the importance of a multidisciplinary approach in the management of ectopic kidneys associated with inguinal hernias and contributes to the limited literature on this rare condition.

Amyand's hernia, characterized by the presence of an appendix within an inguinal hernia sac, is a rare clinical entity. When complicated by acute appendicitis, it presents both diagnostic and therapeutic challenges, particularly in recurrent hernias where scar tissue and altered anatomy complicate surgical management. An 85-year-old male presented with recurrent right inguinal hernia, localized pain, nausea, and leukocytosis. Imaging revealed an inflamed appendix within the hernia sac. Laparoscopic exploration confirmed Amyand's appendicitis, and concurrent transabdominal preperitoneal hernia repair with appendectomy was performed. The minimally invasive approach allowed for definitive management of both pathologies without conversion to open surgery. This case highlights the feasibility and utility of laparoscopy in managing Amyand's appendicitis in recurrent hernias. It underscores the importance of considering dual pathology in patients with atypical presentations of inguinal hernia.

BACKGROUND: Isolated traumatic appendicular perforation is an extremely rare complication of blunt abdominal trauma. The concurrent occurrence with blunt traumatic abdominal hernia represents an exceptionally rare combination, with fewer than 10 cases documented in the literature worldwide.

CASE PRESENTATION: We present a case of an 18-year-old male who sustained isolated traumatic appendicular perforation with concurrent blunt traumatic abdominal wall hernia following a high-speed motor vehicle accident. The patient presented with right lumbar swelling and underwent emergency exploratory laparotomy, which revealed perforation at the base of the appendix with complete disruption of the mesoappendix and active bleeding from the appendicular artery, herniated through a traumatic abdominal wall defect.

CONCLUSION: This case emphasizes the importance of maintaining high clinical suspicion for complex intra-abdominal injuries in blunt trauma patients. Early recognition and surgical intervention are crucial for optimal outcomes in these rare combined injuries.

BACKGROUND: Inguinal hernia is a common surgical condition; however, rare entities such as transverse testicular ectopia (TTE) can present with similar symptoms, often resulting in misdiagnosis and inappropriate initial management. This report underscores the diagnostic value of laparoscopy in such challenging cases.

CASE PRESENTATION: We present two adult male patients who were initially diagnosed with inguinal hernia based on the clinical evaluation and imaging. Both had a history of urogenital anomalies, including cryptorchidism or prior inguinal surgery. Due to persistent symptoms or atypical findings, both underwent laparoscopic exploration, during which TTE was identified: both testes were located on the same side with no evidence of hernia.

CONCLUSION: These cases highlight the importance of considering TTE in the differential diagnosis of atypical inguinal hernia, particularly in adults with relevant surgical or urogenital history. Laparoscopic exploration is a valuable tool for both diagnosis and definitive surgical management. Early recognition of this rare entity is essential to prevent misdiagnosis and optimize clinical outcomes.