SynthesisBJS open2020
EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances.
Synthesis in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 5 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Subcutaneous versus retromuscular approach for the minimally invasive surgical treatment of rectus diastasis with concomitant ventral hernia: systematic review and meta-analysis of current techniques.Hernia : the journal of hernias and abdominal wall surgery · 2025Pooled it
- "Comparative safety and efficacy of robotic TAPP and IPOM techniques in ventral hernia repair: a systematic review and meta-analysis of Short-term Outcomes".Hernia : the journal of hernias and abdominal wall surgery · 2025Pooled it
- Spigelian hernias in the adult population: a systematic review of the literature.Langenbeck's archives of surgery · 2024Pooled it
- Umbilical hernia repair in patients with cirrhosis: systematic review of mortality and complications.Hernia : the journal of hernias and abdominal wall surgery · 2022Pooled it
- Endoscopic onlay repair for ventral hernia and rectus abdominis diastasis repair: Why so many different names for the same procedure? A qualitative systematic review.Surgical endoscopy · 2021Pooled it
- Subcutaneous onlay laparoscopic approach (SCOLA) for ventral hernia with concomitant diastasis recti: a single-center experience.Updates in surgery · 2026Article
- Robotic single-port totally extraperitoneal repair and plication for ventral hernia with concomitant rectus diastasis: a case report.International journal of surgery case reports · 2026Article
- The Posterior Rectus Sheath Incision (PRSI) to allow the repair of Spigelian Hernias by TEP.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Incarcerated Spigelian Hernia: A Case Report.Cureus · 2026Article
- Lateral single-port laparoscopic repair of primary ventral hernias via the plane posterior to the posterior rectus sheath : The world journal of hernia and abdominal wall surgery.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Open preperitoneal repair versus laparoscopic totally extraperitoneal repair for primary lumbar hernia: a retrospective cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Sacless Spigelian hernia: a rare diagnostic and operative challenge-a case report.Journal of surgical case reports · 2026Article
- Distinguishing abdominal wall denervation injury from normal anatomy via cross section imaging.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Do patient-reported outcomes reliably screen for radiographic hernia recurrence? External validation of the ventral hernia recurrence inventory.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Hybrid approach for ventral hernia associated with rectus diastasis: endoscopic single-port diastasis plication with open preperitoneal hernia repair. ENDOP technique in 10 steps.Surgical endoscopy · 2026Article
- Open elective prosthetic repair of Spigelian hernias: long-term outcomes from a single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Diastasis recti in male patients: a literature review and proposed management.Hernia : the journal of hernias and abdominal wall surgery · 2026Review
- Totally Extraperitoneal Approach with Preperitoneal Repair (PeTEP) for the Treatment of the Abdominal Wall Defects in Patients with Severe Obesity: A New Technique for a Long Standing Problem.Obesity surgery · 2026Article
- A scoping review of outcome reporting in randomized controlled trials of incisional and non-incisional ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Spiegel hernia in elective repair: a single-center experience with 47 cases, comparison of laparoscopic and open repair outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 11 institutions in 9 countries.
Funding
Abstract
backgroundRare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management.
methodsThe guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full-text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed.
resultsLiterature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence.
conclusionThis is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.