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...
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Frontiers Media S.A.
2025-03-01
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| Series: | Journal of Abdominal Wall Surgery |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13990/full |
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| 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 |
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