pp 1–4 | Cite as

Why I prefer TAPP repair for uncomplicated unilateral groin hernia in adults

  • J. F. KukletaEmail author
Letter to the Editor
Part of the following topical collections:
  1. Forum on primary monolateral uncomplicated inguinal hernia

My first choice of repair of an uncomplicated unilateral groin hernia of an adult person is the transabdominal preperitoneal patch technique—TAPP. Over the past 27 years, since I have started this minimal invasive repair, my conviction in making this choice became stronger and stronger, being nourished by the very good clinical outcomes and high patient’s satisfaction. Based on my personal experience TAPP is the logic of groin hernia repair [1].

To understand the arguments and reasons for this evolutional process we have to flashback about three decades. Gold standard was then the pure tissue repair, at its best the Shouldice repair. Wound healing complications belonged to surgery, acute postoperative pain too and chronic pain was not “discovered” yet. Recurrence rates from 16 to 20% were normal, 6 weeks lifting restriction to 5 kg led to incapacity for work of 6–8 weeks. Prosthetic materials were introduced to reinforce the repair (e.g. Acquaviva, Usher, Stoppa, Lichtenstein) and to...


Compliance with ethical standards

Conflict of interest

The author declares no conflict of interest.

Ethical approval

Approval from institutional board was not required for this communication.

Human and animal rights

This article does not contain any studies with human participants or animals.

Informed consent

For this retrospective review formal consent is not required.


  1. 1.
    Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492CrossRefGoogle Scholar
  2. 2.
    McCormack K, Wake BL, Fraser C, Vale L, Perez J, Grant A (2005) Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia 9(2):109–114CrossRefGoogle Scholar
  3. 3.
    McCormack K, Wake B, Perez J et al (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9(14):1–203CrossRefGoogle Scholar
  4. 4.
    Kukleta JF (2010) TAPP—the logic of hernia repair. Le Journal de Coelio-chirugie 76:14–20Google Scholar
  5. 5.
    Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403CrossRefGoogle Scholar
  6. 6.
    Bittner R, Arregui ME, Bisgaard T et al (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia (International Endohernia Society (IEHS)). Surg Endosc 25:2773–2843CrossRefGoogle Scholar
  7. 7.
    Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP (2014) Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 18:151–163CrossRefGoogle Scholar
  8. 8.
    Bittner R, Montgomery MA, Arregui E et al (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321CrossRefGoogle Scholar
  9. 9.
    Kukleta JF, Köckerling F, Ferzli G. (2018) Indication for surgical repair of groin hernia. In: Bittner R (eds) Chapter in Laparo-endoscopic Hernia Surgery, pp 37–41. (ISBN 978-3-662-55491-3)
  10. 10.
    Kukleta JF (2017) Transabdominal Preperitoneal Patch (TAPP). In: Campanelli G Inguinal Hernia Surgery Chapter 11, pp 101–113. (ISBN 978-88-470-3946-9)
  11. 11.
    De Beaux AC, Schouten N, Kukleta JF (2018) Occult hernias The HerniaSurge Group. International guidelines for groin hernia management. Chapter 8. Hernia 22:1–165Google Scholar
  12. 12.
    Griffin KJ, Harris S, Tang TY, Skelton N, Reed JB, Harris AM (2010) Incidence of contralateral occult inguinal hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair. Hernia 14(4):345–349 (Epub 2010 Apr 1) CrossRefGoogle Scholar
  13. 13.
    Schouten N, Eker H, Bury K, Muysoms F (2018) Groin hernias in women The HerniaSurge Group. International guidelines for groin hernia management, Chapter 16. Hernia 22:1–165Google Scholar
  14. 14.
    Poelman MM, van den Heuvel B, Deelder JD et al (2013) EAES Consensus Development Conference on endoscopic repair of groin hernias. Surg Endosc 27:3505–3519CrossRefGoogle Scholar
  15. 15.
    Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nation-wide questionnaire study. Ann Surg 233:1–7CrossRefGoogle Scholar
  16. 16.
    Kalliomäki ML, Meyerson J, Gunnarson U et al (2008) Long-term pain after inguinal hernia repair in population-based cohort, risk factor and interference with daily activities. Eur J Pain 12:214–225CrossRefGoogle Scholar
  17. 17.
    Tolver MA, Rosenberg J, Bisgaard T (2012) Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review. Acta Anaesthesiol Scand 56:549–557CrossRefGoogle Scholar
  18. 18.
    Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19(2):188–199CrossRefGoogle Scholar
  19. 19.
    Wittenbecher F, Scheller-Kreinsen D, Roettger J, Busse R (2013) Comparison of hospital costs and length of stay associated with open-mesh, totally extraperitoneal inguinal hernia repair, and transabdominal preperitoneal inguinal hernia repair: an analysis of observational data using propensity score matching. Surg Endosc 27(4):1326–1333CrossRefGoogle Scholar
  20. 20.
    The HerniaSurge Group (2018) International guidelines for groin hernia management. Chapter 6. Koeckerling F, Tran H, Chen D. Lichtenstein or TAPP/TEP? Hernia 22:1–165CrossRefGoogle Scholar
  21. 21.
    The HerniaSurge Group (2018) International guidelines for groin hernia management. Chapter 6. Bittner R, Koeckerling F, Kukleta JF, Tumtavitikul S, Misra M. Is TEP or TAPP the preferred laparo-endoscopic technique? Hernia 22:1–165CrossRefGoogle Scholar
  22. 22.
    Bracale U, Melillo P, Pignata G et al (2012) Which is the best laparoscopic approach for inguinal hernia repair: TEP or TAPP? A systematic review of the literature with a network metaanalysis. Surg Endosc 26:3355–3366CrossRefGoogle Scholar
  23. 23.
    Antoniou SA, Antoniou GA, Bartsch DK et al (2013) Transabdominal preperitoneal versus totally extraperitoneal repair of inguinal hernia: a meta-analysis of randomized studies. Am J Surg 206:245–252CrossRefGoogle Scholar
  24. 24.
    Köckerling F, Simons MP (2018) Current concepts of inguinal hernia repair. Visc Med 34:145–150CrossRefGoogle Scholar
  25. 25.
    Köckerling F, Bittner R, Jacob DA, Seidelmann L, Keller T, Adolf D, Kraft BKA (2015) TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc 29(12):3750–3760CrossRefGoogle Scholar
  26. 26.
    Gass M, Banz VM, Rosella L, Adamina M, Candinas D, Güller U (2012) TAPP or TEP? Population based analysis of prospective data on 4,552 patients undergoing endoscopic inguinal hernia repair. World J Surg 36(12):2782–2786CrossRefGoogle Scholar
  27. 27.
    Wei FX, Zhang YC, Han W, Zhang YL, Shao Y, Ni R (2015) Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP). Surg Laparosc Endosc Percutan Tech 25(5):375–383CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik Im Park, Hirslanden GroupZurichSwitzerland

Personalised recommendations