Development trends and material advances in abdominal wall surgery

The technological development of abdominal wall surgery represents an evolu-tionary history from traditional tissue suture to mesh‑reinforced repair. Examining its trajectory⁃from tension‑free repair in open surgery to the introduction of laparoscopic techniques, and further to the novel concept of retromuscular repair exemplified by enhanced‑view totally extraperitoneal repair-clearly demonstrates the deepening understanding of abdominal wall anatomy and biomech-anics among surgeons. The underlying logic of this technological evolution has shifted from mere "anatomical repair" towards "functional reconstruction" and "restoration of anatomical planes". Concurrently, breakthroughs in materials science have provided critical support for this progression: from the early concept of "inert scaffold" repair with non‑absorbable synthetic meshes, to the "regenerative repair" design of absorbable materials, and further to the current development of functional materials represented by biomimetic modification, immunomodulation, and three-dimen-sional-printed intelligent scaffolds. Future repair materials will continue to evolve along the trajectory of precise adaptation, dynamic responsiveness, functional integration, and individualized customization, ultimately achieving a fundamental leap from replacement repair to regenerative reconstruction. Based on clinical experience and a review of the literature, the authors summarize the evolution of surgical procedures and repair materials in the field of abdominal wall surgery, with a focus on evolving repair concepts and emerging trends in future material development, in the hope of provi-ding a useful reference for colleagues.