Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus

IntroductionBoth open and laparoendoscopic preperitoneal mesh techniques are good options for the treatment of inguinal hernias. The 2023 updated HerniaSurge Guidelines recommend open preperitoneal mesh techniques as an acceptable alternative to Lichtenstein repair if a competent and experienced sur...

Full description

Saved in:
Bibliographic Details
Main Authors: Ralph Lorenz, Willem Akkersdijk, Gabriel Paiva De Oliveira, Marc Soler, Jean-Francois Gillion, Augusto Lourenço, Rui Soares Da Costa, Edouard Pelissier, Franz Ugahary, Frederik Berrevoet
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Journal of Abdominal Wall Surgery
Subjects:
Online Access:https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13990/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849394203088388096
author Ralph Lorenz
Ralph Lorenz
Willem Akkersdijk
Gabriel Paiva De Oliveira
Marc Soler
Jean-Francois Gillion
Augusto Lourenço
Rui Soares Da Costa
Edouard Pelissier
Franz Ugahary
Frederik Berrevoet
author_facet Ralph Lorenz
Ralph Lorenz
Willem Akkersdijk
Gabriel Paiva De Oliveira
Marc Soler
Jean-Francois Gillion
Augusto Lourenço
Rui Soares Da Costa
Edouard Pelissier
Franz Ugahary
Frederik Berrevoet
author_sort Ralph Lorenz
collection DOAJ
description IntroductionBoth open and laparoendoscopic preperitoneal mesh techniques are good options for the treatment of inguinal hernias. The 2023 updated HerniaSurge Guidelines recommend open preperitoneal mesh techniques as an acceptable alternative to Lichtenstein repair if a competent and experienced surgeon is available. However, although numerous open preperitoneal surgical techniques have been developed, only a few comparative studies comparing them are available. Because of the lack of scientific evidence and standardisation, the aim of this article is to define comparable standards and compare four frequently used open preperitoneal techniques.MethodUsing a Delphi-consensus process among both the authors and experts in the field, various key steps for each procedure, indications, and outcome parameters were set to allow adequate comparison of different open preperitoneal techniques.ResultsWe present four different and frequently used open preperitoneal techniques: Minimal Open PrePeritoneal repair (MOPP), TransInguinal PrePeritoneal repair (TIPP), TransREctus sheat PrePeritoneal repair (TREPP), and Open New Simplifyed Total Extraperitoneal repair (ONSTEP). We provide a clear and comparable standard regarding the best indication, different procedural steps, the use of meshes and fixation, the learning curve involved, and possible complications and limitations. We also identify some similarities for the techniques but also specific differences on different topics.ConclusionDevelopment, validation, and implementation of these standards for the various open preperitoneal techniques are necessary both for education and training as well as for future comparative studies.
format Article
id doaj-art-c948239898d642d498cdeb95e90353b0
institution Kabale University
issn 2813-2092
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Journal of Abdominal Wall Surgery
spelling doaj-art-c948239898d642d498cdeb95e90353b02025-08-20T03:40:06ZengFrontiers Media S.A.Journal of Abdominal Wall Surgery2813-20922025-03-01410.3389/jaws.2025.1399013990Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and ConsensusRalph Lorenz0Ralph Lorenz1Willem Akkersdijk2Gabriel Paiva De Oliveira3Marc Soler4Jean-Francois Gillion5Augusto Lourenço6Rui Soares Da Costa7Edouard Pelissier8Franz Ugahary9Frederik Berrevoet10Hernia Center 3+CHIRURGEN, Berlin, GermanyDepartment of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, Medical University Brandenburg an der Havel, Neuruppin, GermanySurgical Department, St Jansdal Hospital, Harderwijk, NetherlandsDepartment for General Surgery, Hospital Garcia de Orta, Almada, PortugalService de Chirurgie Viscérale et Digestive, Clinique Saint-Jean, Cagnes-sur-Mer, FranceSurgical Department, Ramsay Sante Hôpital Privé d’Antony, Antony, FranceFaculty of Healthcare Sciences, Beira Interior University, Covilhã, PortugalDepartment for General Surgery, Hospital Lusíadas Porto, Porto, PortugalInstitut de la Hernie Paris, Paris, France0Former General and Vascular Surgeon (NP), Ziekenhuis Rivierenland Tiel, Tiel, Netherlands1Department of General and HPB Surgery and Liver Transplantation, Ghent University Hospital, Ghent, BelgiumIntroductionBoth open and laparoendoscopic preperitoneal mesh techniques are good options for the treatment of inguinal hernias. The 2023 updated HerniaSurge Guidelines recommend open preperitoneal mesh techniques as an acceptable alternative to Lichtenstein repair if a competent and experienced surgeon is available. However, although numerous open preperitoneal surgical techniques have been developed, only a few comparative studies comparing them are available. Because of the lack of scientific evidence and standardisation, the aim of this article is to define comparable standards and compare four frequently used open preperitoneal techniques.MethodUsing a Delphi-consensus process among both the authors and experts in the field, various key steps for each procedure, indications, and outcome parameters were set to allow adequate comparison of different open preperitoneal techniques.ResultsWe present four different and frequently used open preperitoneal techniques: Minimal Open PrePeritoneal repair (MOPP), TransInguinal PrePeritoneal repair (TIPP), TransREctus sheat PrePeritoneal repair (TREPP), and Open New Simplifyed Total Extraperitoneal repair (ONSTEP). We provide a clear and comparable standard regarding the best indication, different procedural steps, the use of meshes and fixation, the learning curve involved, and possible complications and limitations. We also identify some similarities for the techniques but also specific differences on different topics.ConclusionDevelopment, validation, and implementation of these standards for the various open preperitoneal techniques are necessary both for education and training as well as for future comparative studies.https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13990/fullgroin herniasopen preperitoneal techniquesMOPPONSTEPTIPP, TREPP
spellingShingle Ralph Lorenz
Ralph Lorenz
Willem Akkersdijk
Gabriel Paiva De Oliveira
Marc Soler
Jean-Francois Gillion
Augusto Lourenço
Rui Soares Da Costa
Edouard Pelissier
Franz Ugahary
Frederik Berrevoet
Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
Journal of Abdominal Wall Surgery
groin hernias
open preperitoneal techniques
MOPP
ONSTEP
TIPP, TREPP
title Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
title_full Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
title_fullStr Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
title_full_unstemmed Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
title_short Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery–Results of a Review and Consensus
title_sort comparison and standardisation of various open preperitoneal techniques in inguinal hernia surgery results of a review and consensus
topic groin hernias
open preperitoneal techniques
MOPP
ONSTEP
TIPP, TREPP
url https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13990/full
work_keys_str_mv AT ralphlorenz comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT ralphlorenz comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT willemakkersdijk comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT gabrielpaivadeoliveira comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT marcsoler comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT jeanfrancoisgillion comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT augustolourenco comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT ruisoaresdacosta comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT edouardpelissier comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT franzugahary comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus
AT frederikberrevoet comparisonandstandardisationofvariousopenpreperitonealtechniquesininguinalherniasurgeryresultsofareviewandconsensus