Vedra Augenstein (VA) | I think it’s important for anybody who is operating on patients to know how to perform operations in the MIS and open fashion. It’s part of the “tool belt” and decisions regarding methods are multifactorial.   Personally, patients who have a large amount of redundant skin benefit from a combination of panniculectomy and an open repair.

NF | As we’ve discussed throughout this congress, the success of abdominal wall reconstruction relies heavily on precise anatomy and technical nuances. What are the most critical technical pitfalls surgeons encounter when transitioning to or performing the open preperitoneal plane, and how can the EHS help standardize this training globally?

VA | Mastery of the preperitoneal plane dissection and reconstruction, as with many other surgical skills comes from practice. Decision making regarding where to begin the flap creation, how to avoid making holes and how to reconstruct the peritoneal flap comes from repetition, knowledge of the normal anatomy and understanding the different ways of getting into the correct planes when the anatomy is abnormal.

NF | Looking at the future of the specialty, how do you see the open preperitoneal approach evolving alongside emerging technologies like regenerative medicine, advanced biomaterials, or even pre-operative artificial intelligence planning?

VA | I think more surgeons will be choosing to use the peritoneum only to separate the mesh from viscera and avoid disruption of fascial and muscle planes. The method has been around for a very long time so I’m not sure how AI or regenerative medicine will change it. Certainly, avoiding intraperitoneal mesh will allow for us to use less coated products in abdominal wall reconstruction.

NF | What is your evaluation of your participation in the EHS 2026?

VA | I’m very grateful to have been invited in this fantastic congress. Such a pleasure to see that our specialty is drawing so much interest.

O conteúdo Mastering the preperitoneal plane: surgical tools, technical Nuances, and the future of abdominal reconstruction aparece primeiro em Médico News.

According to René Fortelny, the biggest obstacle in modern surgery is not introducing new data, but implementing it across all levels of hospital staff. While convincing young fellows to adopt the right closure technique is relatively easy, the real challenge lies with senior consultants and department leadership who are deeply set in old habits. He concluded that improving overall patient outcomes requires strong departmental leadership capable of enforcing strict structural rules and standardized preventative training within their teams.

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Expressing her deep satisfaction with the event, Joana Correia praised the extensive array of pre-congress courses that provided young surgeons and students a unique opportunity to interact directly with established masters of the craft. She noted that the gathering successfully brought together an exceptionally diverse group of over 2,000 participants from across the globe to exchange practical clinical tips and tricks. Ultimately, Correia concluded that the impeccably organized congress has significantly elevated the international prestige of hernia surgery in Portugal and left a brilliant image of the country’s medical community.

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Discussing the primary challenges within the field, Anabela Garcia identified the logistical demands of team synchronization and pre-empting supply chain deficits, noting that nurses must frequently identify and acquire specialized hospital equipment well in advance of complex cases. She praised the EHS platform as an invaluable asset for global nursing, stating that the sharing of knowledge between professionals from different countries allows teams to learn new techniques and improve overall institutional care.

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Looking toward the future of abdominal wall surgery, Carlos Magalhães identified two core pillars of development: individualized treatment plans and rapid technological integration. He emphasized that modern hernia care must reject one-size-fits-all strategies in favor of a strictly tailored approach for every patient. Furthermore, he noted that the future of the specialty will be defined by the inclusion of advanced tools, specifically citing the expanding roles of robotic systems, minimally invasive procedures, and artificial intelligence in surgical planning.

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To ensure optimal patient outcomes, Andrew de Beaux proposed that these highly complex and recurrent hernia cases should be directed away from general practices and instead managed by a select group of specialized surgeons with a dedicated interest in complex abdominal wall repairs. He acknowledged that while managing conflicting surgical egos can sometimes prove difficult, the ultimate benchmark of success remains clear and focused. According to the society president, the golden standard for the field must always revolve around getting the right patient to the right surgeon, performing the procedure at the ideal time, and executing it flawlessly.

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David Chen underscored that prevention remains the ultimate key to patient success, noting that the primary goal should always be to teach young surgeons how to perform operations correctly from the start. He lauded the inclusive nature of the meeting, which brought together medical professionals from every corner of the European Union and the world, regardless of their local hospital resources. For cases where complications do arise, Chen reminded the audience that the EHS functions as a highly supportive, collaborative community where surgeons can rely on each other to tackle even the most complex patient scenarios.

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Looking ahead, Cesare Stabilini shared his bright vision for the future of hernia surgery, which will heavily feature the incorporation of artificial intelligence (AI), enhanced surgical education through AI, and a continued rise in robotic procedures. However, he playfully advised surgeons to “keep the knife in their pocket,” as traditional open surgery remains a vital tool for certain procedures. He also predicted that long-term advancements, such as regenerative medicine, might eventually reduce the overall global need for hernia operations, much like recent breakthroughs have changed the landscape of cancer surgeries.

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