In 2012, the process of developing an international guideline for laparoscopic treatment of ventral and incisional abdominal wall hernias was started. The aim of the project was to provide guidelines for the selection of optimal diagnostic and therapeutic concepts in order to improve the quality of treatment of incisional hernias. Thus, in 2014, the Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias were published in the Journal of Surgical Endoscopy by experienced hernia surgeons from all over the world[1-3]. That project was updated in 2019[4,5].
In December 2024, a first meeting of the International Endohernia Society was held in Hainan, China. The aim was to coordinate a second update to take into account new findings on robot-assisted surgery (Fig. 1).
Figure 1.
IEHS Update Guidelines Meeting in Hainan, China. December 2024.
When assembling experts to work on a 2nd update of these guidelines, the Steering Committee was in some cases confronted by hernia surgery experts with the argument that not enough new evidence had been published since 2019. It was recommended that no Update should take place at this point. This letter to the editor was written to address this concern.
We carried out a current pubmed search in December 2024. The following search terms were used: “Incisional” [title/abstract] AND “hernia” [title/abstract]. The selected time period was 2019 to 2024 and the search yielded 1705 results. A total of 91 meta-analyses on incisional hernias were published, 78 publications were clinical studies, of which at least 5 clinical studies focussed on robotic surgery. There is also a clear trend towards an increase in publications on robotics (Fig. 2). Hence, the scientific findings on robot-assisted incisional hernia surgery will be extensively updated in the upcoming guideline.
Figure 2.
A total of 191 publications with following search terms were yielded on pubmed: robotic [title/abstract] AND hernia [title/abstract] AND incisional [title/abstract]. There is also a clear trend towards an increase in publications on robotics.
Against that background, the Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias should be updated again.
Footnotes
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
Published online 16 July 2025
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Not applicable.
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Sources of funding
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Author contributions
C.P. wrote the article; R.B. and R.F. were supervising the writing process.
Conflicts of interest disclosure
None declared.
Guarantor
Christoph Paasch.
Research registration unique identifying number (UIN)
Not applicable.
Provenance and peer review
No.
Data availability statement
Not applicable.
References
- [1].Bittner R, Bingener-Casey J, Dietz U, et al. International Endohernia Society (IEHS). Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)-part 1. Surg Endosc 2014;28:2–29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [2].Bittner R, Bingener-Casey J, Dietz U, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])—Part 2. Surg Endosc 2014;28:353–79. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [3].Bittner R, Bingener-Casey J, Dietz U, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])-Part III. Surg Endosc 2014;28:380–404. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [4].Bittner R, Bain K, Bansal VK, et al. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))-Part A. Surg Endosc 2019;33:3069–139. Epub 2019 Jun 27. Erratum in: Surg Endosc. 2019 Oct;33(10):3140-3142. doi: 10.1007/s00464-019-06907-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [5].Bittner R, Bain K, Bansal VK, et al. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)): Part B. Surg Endosc 2019;33:3511–49. [DOI] [PMC free article] [PubMed] [Google Scholar]
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Data Availability Statement
Not applicable.