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Hernia is a term used to describe the protrusion of an internal organ or tissue through a weak portion of a muscle or connective tissue. The majority of hernias occur in the abdomen, where they are caused by a combination of increased abdominal pressure and a weakness in a particular portion of the abdomen (which is often present at birth). Certain conditions such as obesity and persistent coughing can cause an increase in intra-abdominal pressure and contribute to hernia development.
The advancement of hernia repair has been hallmarked by three significant shifts in surgical treatment. The first was the transition from the “tension” techniques, which involved the use of sutures to tie adjacent tissue layers together, to a “tension-free” technique that incorporated flat sheets of mesh to bridge the defect. The second transition was the overwhelming adoption of large pore meshes in replacement of small pore meshes. Both shifts were prompted by improvements in patient outcomes. The third transition is currently underway as surgeons adopt the laparoscopic technique over the standard open technique.
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