Why LATI-H must enter the surgical lexicon

Millions of people undergo surgery with utilises a lower abdominal transverse incision (LATI). These incisions offer straightforward surgical access to the abdomen and pelvis and are ubiquitously used worldwide including for caesarean section. The incidence of hernia following these incisions have not been comprehensively studied and there are marked differences in abdominal entry across different LATI types. To address these hernias with a pivotal role in recognition and awareness, we propose a new term for hernias arising from these incisions: Lower Abdominal Transverse Interparietal/Incisional Hernias (LATI-H).

A narrative review based on relevant literature was conducted to explore how LATI-H is described and reported. We searched the literature using MEDLINE and PubMed from inception to March 2025 to identify relevant studies. We retrieved relevant articles and included articles which described lower abdominal transverse incision complications including their hernias, with no limit on indication. Non-English articles were translated by medical translator for accurate understanding of the technique and literal transcription.

Lower abdominal transverse incisional hernias are poorly described and defined in the literature. They are frequently incorporated to large series of incisional hernias, but they are usually a mix of a large posterior defect with small incisional defects and have different features from other types of incisional hernia. This makes lower abdominal transverse interparietal hernias (LATI-H) a concern for general surgeons due to difficult diagnosis. LATI-H can progress and risk serious complications such as bowel obstruction and bowel ischemia.

Lower abdominal transverse interparietal hernias (LATI-H) are poorly defined and are often erroneously termed Pfannenstiel or C-section hernias. The authors suggest the use of LATI-H to provide clear definition and provide a framework for future research to identify how these arise and find strategies to prevent and repair these hernias effectively.