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25 February 2026, Volume 31 Issue 01 Previous Issue   

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Editorial

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Development of hernia and abdominal wall surgery in China over the past decade TANG Jianxiong, LI Shaojie, LI Shaochun 2026, 31 (01):  1-5.  DOI: 10.16139/j.1007-9610.2026.01.01 Abstract ( 0 )   HTML ( 7 )   PDF (870KB) ( 26 )   The past decade has been a "golden decade" of leapfrog development for hernia and abdominal wall surgery in China. Driven by minimally invasive surgery, the concept of enhanced recovery, and artificial intelligence technology, this field has undergone tremendous progress, evolving from mere technical modifications to conceptual innovation. Firstly, the concept of minimally invasive surgery has transitioned from a focus on procedural selection to a paradigm shift in philosophy. Laparoscopic techniques have been widely adopted and refined towards mastery, while open surgery has also achieved "minimally invasive" outcomes through component separation techniques. Emerging robotic surgery represents the cutting edge of technological innovation. Secondly, in response to the increasing number of very elderly and high-risk patients, an individualized comprehensive perioperative management system based on multidisciplinary collaboration has been established. This system deeply integrates prehabilitation, precise anesthesia, and the principles of enhanced recovery after surgery（ERAS）, significantly improving surgical safety and patient outcomes. Among these, precise anesthesia strategies have become a key factor in facilitating enhanced recovery. Simultaneously, artificial intelligence and big data technologies have begun to empower clinical practice, demonstrating great potential in assisting diagnosis, preoperative planning, and risk prediction, thereby guiding the discipline into a new digital and intelligent phase. Overall, Chinese hernia and abdominal wall surgery has progressively transformed from a follower into an innovative force achieving parallel and even leading positions in certain fields internationally. References | Related Articles | Metrics

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Tracing the origin, debates, and option of minimally invasive surgical techniques for parastomal hernia BATUER Aikemu, LI Jianwen, YUE Fei 2026, 31 (01):  6-11.  DOI: 10.16139/j.1007-9610.2026.01.02 Abstract ( 0 )   HTML ( 6 )   PDF (988KB) ( 24 )   Laparoscopic repair of parastomal hernia was initially performed with the Sugarbaker technique. Owing to potential complications such as bowel incarceration, the Keyhole technique was subsequently developed, followed by reports of the Sandwich technique and various hybrid approaches. In the early stage, the totally laparoscopic Keyhole technique was most widely applied; however, its limitations, particularly the high recurrence rate, became increasingly evident. Although the Sandwich technique demonstrated favorable efficacy, its application remained limited because of excessive prosthetic material. The laparoscopic redo of the stoma at the original site (Lap-re-Do), derived from hybrid technique and combined with the Keyhole technique, offered procedural optimization. During the intermediate stage, its technical workflow was progressively refined and widely adopted in clinical practice. Nevertheless, the inherent defect of the Keyhole technique, namely the mesh aperture, constrained further improvement in overall outcomes. In the mid-to-late stage, following “weak” recommendations in clinical guidelines, the Sugarbaker technique regained prominence, accompanied by the emergence of novel approaches such as minimally invasive extraperitoneal Sugarbaker repair. However, the fundamental concerns that initially limited the Sugarbaker technique persist. The application of Lap-re-Do declined due to the lack of synergistic optimization with the Sugarbaker technique and the potential risks of infection and stoma-related complications. Parastomal hernia repair is essentially a quality-of-life-oriented intervention. When overall efficacy is comparable, the simplest surgical approach should be preferred. At present, no gold-standard technique exists for parastomal hernia repair, and each minimally invasive method has distinct advantages and inherent limitations. Under routine circumstances, a totally laparoscopic Sugarbaker technique is recommended as the preferred option. For complex hernias with indications for stoma reconstruction, Lap-re-Do combined with either the Keyhole or Sugarbaker technique may be considered. References | Related Articles | Metrics

Experts forum

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Progress in application of robotics and artificial intelligence in field of hernia surgery TIAN Wen, YANG Xiaodong 2026, 31 (01):  12-16.  DOI: 10.16139/j.1007-9610.2026.01.03 Abstract ( 0 )   HTML ( 3 )   PDF (917KB) ( 18 )   In recent years, the rapid development of robotics and artificial intelligence(AI) has gradually extended to all surgical fields. After experiencing the first major revolution brought by laparoscopic surgery, hernia surgery has also entered the era of robotics and AI. This article reviewed the milestone events of robotic surgery application in hernia surgery and the rapid development of domestic robots. AI mainly includes four fields: machine learning, natural language processing, artificial neural networks, and computer vision. This article introduced the current applications of AI in actual cases, including preoperative risk factor analysis, intraoperative navigation, and postoperative complication prediction models, both domestically and internationally. It also explained the limitations and ethical issues of current technology, and looked forward to future development directions. Surgeons should pay attention to and follow the latest development of robotics and AI, and apply them to clinical practice, thereby benefiting patients. References | Related Articles | Metrics

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Contemporary perspectives on intraperitoneal Onlay mesh versus extraperitoneal repair in ventral hernia repair HUANG Bohan, CAO Zhen, LIU Ziwen 2026, 31 (01):  17-22.  DOI: 10.16139/j.1007-9610.2026.01.04 Abstract ( 0 )   HTML ( 2 )   PDF (940KB) ( 19 )   Ventral hernias are most commonly of primary ventral hernia and incisional hernia. Over the past two decades, significant advancements have been made in their surgical management. With the development of minimally invasive techniques and mesh materials, intraperitoneal Onlay mesh(IPOM) repair has emerged and been widely adopted. However, due to the continuous emergence of its specific complications, academic skepticism regarding this approach has arisen. Consequently, open Sublay repair and laparoscopic extraperitoneal repair have regained attention. This article systematically compared these techniques in terms of technical evolution, clinical efficacy, and complication profiles, objectively analyzing their respective advantages and limitations. It provided theoretical foundations and practical guidance for surgeons in selecting repair strategies, and promoted the standardization and individualized treatment concepts in clinical practice. References | Related Articles | Metrics

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Endoscopic totally visceral sac separation for ventral hernias repair: a novel concept and its technical considera-tions LI Binggen 2026, 31 (01):  23-31.  DOI: 10.16139/j.1007-9610.2026.01.05 Abstract ( 0 )   HTML ( 5 )   PDF (15439KB) ( 20 )   The abdominal wall can be treated as a whole physiological and functional entity which is composed of multiple anatomical structures and planes. Surgical approaches and technical details that required for hernic repair are diverse in different area. Indeed, the abdominal wall is confined by several anatomical boundaries which make these surgical planes separated. If one could dissect these boundaries, then separated spaces could be connected, establishing an ample retromuscular/preperitoneal space to accommodate the mesh of ventral hernia repair. The concept of totally visceral sac separation (TVS) is achieved. The TVS concept is not just an isolated technique, but the summary of diverse ventral hernia repair techniques. The article reviewed the relevant anatomy as well as surgical details used in different types of ventral hernia. Meanwhile, the article highlighted the core essence of the TVS concept, in order to facilitate better implementation of TVS techniques by hernia colleagues. Figures and Tables | References | Related Articles | Metrics

Consensus and guideline

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Interpretation of guideline for the diagnosis and treatment of abdominal wall incisional hernia (2024 edition) CHEN Shuang, ZHOU Taicheng 2026, 31 (01):  32-35.  DOI: 10.16139/j.1007-9610.2026.01.06 Abstract ( 0 )   HTML ( 4 )   PDF (969KB) ( 20 )   Published in early 2025, the guidelines for the diagnosis and treatment of abdominal wall incisional hernia (2024 edition) has systematically introduced key concepts and technologies, including "conversion therapy" "three-dimensional suture" technique, and "complex abdominal wall status", for the first time. In terms of preoperative preparation, the 2024 edition innovatively proposed a conversion therapy strategy centered on botulinum toxin injection combined with progressive pneumoperitoneum. By increasing abdominal cavity volume and abdominal wall compliance preoperatively, this strategy converts patients with large incisional hernias who were originally high-risk or even contraindicated into operable candidates, significantly reducing the risks of abdominal compartment syndrome and postoperative complications. At the surgical technical level, laparoscopic "three-dimensional suture" has been incorporated into standardized procedures for the first time. The guideline emphasized defect closure and reconstruction of abdominal wall anatomical continuity, promoting a shift from traditional bridging repair to functional reconstruction in incisional hernia repair. Additionally, the guideline systematically defined the multidimensional risk factors of "complex abdominal wall status", highlighting the importance of multidisciplinary team and individualized surgical approach selection. It also proposed a threshold-based comprehensive assessment model for LOD (loss of domain), integrating abdominal wall compliance and dynamic imaging. Overall, with abdominal wall functional reconstruction as the core, the new edition established a more refined, safer, and biomechanically sound diagnostic and therapeutic system for incisional hernia. It provided important guidance for the standardized treatment of complex and large incisional hernias, and pointed out directions for future evidence-based research and technological innovation. References | Related Articles | Metrics

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Interpretation of Chinese expert consensus on laparoscopic diagnosis and treatment algorithm for incarcerated inguinal hernia (2024 edition) DONG Ruizhao, ZHUANG Qiulin, DING Zuoyou, XU Jing, YANG Ziang 2026, 31 (01):  36-44.  DOI: 10.16139/j.1007-9610.2026.01.07 Abstract ( 0 )   HTML ( 4 )   PDF (1162KB) ( 29 )   Incarcerated inguinal hernia is a common surgical emergency, traditionally treated primarily with open surgery. In recent years, laparoscopic techniques have gradually gained attention, but there is a lack of relevant consensus in China. This article was based on the pioneering Chinese expert consensus on laparoscopic diagnosis and treatment algorithm for incarcerated hernia (2024 edition), jointly formulated by the Hernia and Abdominal Wall Surgery Group and the Laparoscopic and Endoscopic Surgery Group of the Surgery Branch of the Chinese Medical Association. Combining evidence-based evidence and clinical practice, it further interpreted the scientificity of its methods, organized core opinions, and described the clinical implementation process oriented toward clinical scenarios. The aim was to provide practical solutions for clinical doctors, especially grassroots physicians, offering the most direct scheme support, to enhance the therapeutic outcomes for patients with incarcerated hernia and reduce complications and mortality rates. Figures and Tables | References | Related Articles | Metrics

Original article

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Clinical efficacy analysis of laparoscopic hernia repair in treating hiatal hernia with iron-deficiency anemia MAIMAITIAILI Maimaitiming, DUOLIKUN Yasheng, HUANG Zhuo, HUANG Xudong, AIKEBAIER Aili, KELIMU Abudureyimu 2026, 31 (01):  45-49.  DOI: 10.16139/j.1007-9610.2026.01.08 Abstract ( 0 )   HTML ( 4 )   PDF (6964KB) ( 20 )   Objective To investigate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) in patients with hiatal hernia (HH) complicated by iron-deficiency anemia (IDA). Methods A retrospective analysis was conducted on 195 HH patients with IDA who underwent LHHR at our hospital from January 2012 to December 2024. Preoperative and 12 months postoperative hemoglobin (Hb) levels, anemia-related symptoms, and Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scores were compared. Results Among the 195 patients, 129 (66.2%) were female, and 80 (41.0%) had massive HH. There were 13 patients (6.7%) aged 18-40 years, 78 (40.0%) aged 41-60 years, and 104 (53.3%) over 60 years. At 12 months follow-up, Hb levels significantly increased from (108.4±12.6) g/L to (128.7±11.3) g/L (P<0.001), with resolution of anemia symptoms in all patients. GERD-Q scores decreased from (11.2±2.1) to (7.0±1.5) (P<0.001). No recurrence of HH was observed on imaging. Conclusions LHHR is effective in correcting IDA and alleviating reflux symptoms, demonstrating favorable short-term outcomes and safety. Long-term efficacy warrants further follow-up evaluation. Figures and Tables | References | Related Articles | Metrics

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Application of single balloon enteroscopy-assisted endoscopic retrograde pancreatography in patients with pancreaticojejunal anastomotic stenosis ZHOU Xueping, WENG Hao, WENG Mingzhe, SHU Yijun, ZHAO Mingning, GU Jun, WANG Xuefeng 2026, 31 (01):  50-57.  DOI: 10.16139/j.1007-9610.2026.01.09 Abstract ( 0 )   HTML ( 5 )   PDF (950KB) ( 23 )   Objective To evaluate the feasibility, effectiveness, and long-term outcome of single balloon enteroscopy(SBE)-assisted endoscopic retrograde pancreatography(ERP) in patients with pancreaticojejunal anastomotic stenosis (PJS). Methods The clinical data of 16 PJS cases undergoing SBE-assisted ERP from March 2016 to March 2021 were retrospectively reviewed. Technical and clinical success, adverse events, risk factors for failure and long-term outcomes were assessed. Results Eight of 16 patients were successfully treated, the success rate was 50%. No serious complications after ERP occurred. Risk factors for failure of pancreaticojejunostomy site identification included digestive tract Child reconstruction sequence (P=0.001), pancreaticojejunostomy method (P=0.001), without pancreatic duct support tube placement (P=0.037), undilated preoperative pancreatic duct (P=0.037) and postoperative pancreatic fistula (P=0.001). The interval between the first occurrence of abdominal pain after pancreaticoduodenectomy (PD) operation in the successful anastomotic site identification group was significantly longer than that in the failed group（44.7 months vs. 19.9 months, P=0.044）, while the time from symptom onset to the first ERP intervention was shorter than that in the anastomotic site identification failed group （8.4 months vs. 22.4 months, P=0.021）. During the follow-up periods [77.2(6.8, 187.7)months], recurrence rates were 25%. The total duration of stent placement in 7 patients with endoscopic pancreatic drainage treatment was 62.3 (6.8, 153.7). Body mass index (BMI) variation is +2.46 kg/m2 in non-recurrence group compare to -1.09 kg/m2 in recurrence group and -2.12 kg/m2 in ERP treatment failure group. Conclusions SBE-assisted ERP treatment for PJS after PD showed favorable safety, effectiveness and durable long-term outcomes. ERP intervention should be carried out early once PJS occurs. BMI is an important index to be monitored during the follow-up of PJS patients. Figures and Tables | References | Related Articles | Metrics

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Impact of laparoscopic sleeve gastrectomy on gastroesophageal reflux disease in patients with obesity and type Ⅰ hiatal hernia SUN Wuqing, GUO Zhen, JI Lang, HAO Shaolong, SUN Haitao, BAI Rixing, HAN Wei 2026, 31 (01):  58-63.  DOI: 10.16139/j.1007-9610.2026.01.10 Abstract ( 0 )   HTML ( 2 )   PDF (3469KB) ( 16 )   Objective To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) after surgery in obese patients with type Ⅰ hiatal hernia (HH). Methods A retrospective analysis was conducted on 63 obese patients admitted between March 2023 and December 2024. The patients were divided into two groups: group A, simple obesity (n=50), and group B, obesity with type ⅠHH (n=13). Both groups underwent SG, and no concurrent HH repair was performed in Group B. Gerd-Q scores were used to evaluate reflux symptoms preoperatively and at 3 and 6 months postoperatively, and the differences between the groups were compared. Results There was no significant difference in the Gerd-Q scores between the two groups before surgery and 3, 6 months after surgery (all P>0.05). When comparing the Gerd-Q scores of the two groups of patients at 3, 6 months after surgery with those before surgery, there were no significant differences (P>0.05). There was no significant difference in the prevalence of GERD between the two groups before surgery and 3, 6 months after surgery (all P>0.05). Conclusions For obese patients with type ⅠHH, undergoing LSG did not increase the incidence of postoperative GERD. Figures and Tables | References | Related Articles | Metrics

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Clinical diagnostic value of fasting end-expiratory H2S, NO, H2 and CH4 for colorectal polyps LIU Ningwei, LAI Shuang, GUAN Lin, YANG Meiqi, LI Yiling 2026, 31 (01):  64-69.  DOI: 10.16139/j.1007-9610.2026.01.11 Abstract ( 0 )   HTML ( 2 )   PDF (1564KB) ( 22 )   Objective To evaluate the diagnostic value of fasting end-expiratory H2S, NO, H2, and CH4 for colorectal polyps, and to explore the impact of factors such as gender and age on these markers. Methods A total of 245 colonoscopy subjects from the First Affiliated Hospital of China Medical University from January 2024 to December 2024 were included, divided into colorectal polyp group (CP, n=117) and normal control group (NC, n=128). The subject underwent breath test, which used a breath analyzer in a fasting state to test the concentrations of H2S, NO, H2, and CH4.The differences between groups, as well as the results of subgroup analysis of influencing factors, were analyzed to evaluate the diagnostic efficacy of the four gases for colorectal polyps. Results Analyzing the concentrations of H2S, NO, H2, and CH4 gases at fasting end-expiratory of the subjects, it was found that the H2S level in the CP group was significantly higher than that in the NC group (107.50 ppb vs. 9.00 ppb) (P<0.000 1), while there were no differences of other gases (NO, H2, CH4) between the two groups (P>0.05); using colonoscopy and pathological examination as the standard, the AUC for diagnosing colorectal polyps with H2S concentration was 0.966; males and smokers had higher H2S concentration (P<0.01). End-expiratory H2S has high diagnostic efficacy as a novel non-invasive diagnostic marker for colorectal polyps, providing a new strategy for non-invasive screening of colorectal polyps. Conclusions Fasting end-expiratory H2S concentration is a novel non-invasive diagnostic marker for colorectal polyps, with high diagnostic efficacy, providing a new strategy for the non-invasive screening of colorectal polyps. Figures and Tables | References | Related Articles | Metrics

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Ginsenoside RG3 inhibits epithelial-mesenchymal transition of gallbladder cancer cells through PI3K/AKT/mTOR signaling pathway ZHOU Xin, WANG Lubing, ZHANG Bo 2026, 31 (01):  70-76.  DOI: 10.16139/j.1007-9610.2026.01.12 Abstract ( 0 )   HTML ( 2 )   PDF (3848KB) ( 23 )   Objective To explore the specific mechanism of Ginsenoside Rg3 inhibiting gallbladder cancer (GBC)cells. Methods Cell counting kit-8(CCK-8) assay was used to examine the effect of Ginsenoside Rg3 on the viability of GBC cells. The effect of Ginsenoside Rg3 on the migration and invasion of gallbladder cancer cells was verified by cell scratch assay and Transwell assay. Western blot was used to verify the effect of Ginsenoside Rg3 on epithelial-mesenchymal transition (EMT)-related proteins and phosphatidylinositol 3-kinase / protein kinase B (AKT) / mammalian target of rapamycin [PI3K/PKB(AKT)/mTOR] signaling pathway-related proteins. Results Ginsenoside Rg3 significantly inhibited the viability of GBC cells. Ginsenoside Rg3 significantly inhibited the rate of cell migration and the number of cells passing through the Transwell assay. Western blot showed that Ginsenoside Rg3 could significantly reduce the level of phosphorylated PI3K/AKT/mTOR protein, increase the expression level of E-cadherin, and inhibit the expression levels of N-cadherin and vimentin in gallbladder cancer cells, and finally inhibit the EMT process. Conclusions Ginsenoside RG3 inhibits the activity of gallbladder cancer cells, also suppresses the EMT process by regulating the PI3K/AKT/mTOR signaling pathway and inhibits the migration and invasion of gallbladder cancer cells. Figures and Tables | References | Related Articles | Metrics

Domestic and international academic progresses

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Convergence and co-advancement of clinical and basic research: summary of the 2025 15th Peritoneal Surface Oncology Group International Congress LUO Rui, QIN Xiusen, WANG Hui 2026, 31 (01):  77-79.  DOI: 10.16139/j.1007-9610.2026.01.13 Abstract ( 0 )   HTML ( 3 )   PDF (856KB) ( 20 )   The 2025 15th Peritoneal Surface Oncology Group International Congress was held in Barcelona, Spain, with a focus on the theme "convergence and co-advancement of clinical and basic research", comprehensively showcasing the latest advancements in the diagnosis and treatment of peritoneal surface tumors. This article summarized the clinical progress and basic-translational research presented at the congress, aiming to provide insights into international frontiers and promote standardized and personalized treatment of peritoneal surface tumors. References | Related Articles | Metrics

Review

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Advances of therapy targeting epigenetic regulation for cancer WEI Lan, SANG Qingqing, LIU Bingya 2026, 31 (01):  80-87.  DOI: 10.16139/j.1007-9610.2026.01.14 Abstract ( 0 )   HTML ( 6 )   PDF (1626KB) ( 21 )   The article reviewed the progress in cancer therapy targeting epigenetic regulation, introduced the basic concepts of epigenetics and its role in tumorigenesis and development. Epigenetics refers to heritable changes in gene expression that occur without alterations in the DNA sequence. It precisely controls the temporal-spatial-specific expression of genes through dynamic and reversible DNA and histone modification, and non-coding RNA-mediated regulatory networks. The article discussed the mechanisms of epigenetic regulatory and chromatin remodeling, and described the abnormal manifestations of these mechanisms in tumors. Furthermore, the article reviewed the progress in drug development targeting epigenetic regulation. Finally, the article discussed the combined application of targeted epigenetic therapy with other conventional treatment modalities, and proposed future research directions and challenges. Figures and Tables | References | Related Articles | Metrics

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Controversy and collaboration of multi-disciplinary team in surgical treatment of secondary hyperparathyroidism PAN Jiahao, LIN Sen, YANG Peng, WANG Qiang, CUI Xinhua, ZHANG Wei 2026, 31 (01):  88-94.  DOI: 10.16139/j.1007-9610.2026.01.15 Abstract ( 0 )   HTML ( 2 )   PDF (1213KB) ( 20 )   The multi‑disciplinary team (MDT) care centered on parathyroidectomy (PTX) has gradually become the main treatment model for secondary hyperparathyroidism (SHPT). However, different departments such as surgery, nephrology, laboratory medicine, radiology, and endocrinology have varying understandings and treatment strategies for SHPT. This article, from a surgical perspective, reviewed the controversies and collaborations in MDT during the diagnosis and treatment of SHPT, including disputes with nephrology over the timing of surgery and treatment goals, collaboration with radiology for preoperative localization, collaboration with laboratory medicine for intraoperative monitoring of parathyroid hormone, collaboration with intensive care units, endocrinology, and cardiology in the management of complications such as electrolyte disorders, bone hunger syndrome, and cardiovascular events during the perioperative period, as well as disputes with the metabolic department regarding the evaluation of postoperative bone metabolism changes. This provided a reference for the clinical promotion of MDT diagnosis and treatment of SHPT. Figures and Tables | References | Related Articles | Metrics