Efficacy of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair in the treatment of bilateral inguinal hernia: a systematic review and meta-analysis
- 1Department of Surgical Care, Dazhou Central Hospital, Dazhou, Sichuan, China
- 2Department of General Surgery, Dazhou Central Hospital, Dazhou, Sichuan, China
Abstract
Background and objective: Inguinal hernia is a common general-surgical disease. Laparoscopic repair is widely used for bilateral cases. The practical trade-offs between laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair remain debated, and most existing publications focus on unilateral inguinal hernia.
Methods: We searched multiple domestic and international databases for comparative studies of TAPP versus TEP for bilateral inguinal hernia. Literature retrieval covered records from database inception to April 6, 2026. Evaluated outcomes included general complications, special complications, recurrence, postoperative pain, operative time, and length of hospital stay. Statistical analyses were performed with RevMan 5.3 and Stata 18.
Results: Nine eligible studies involving 1,319 patients were included (846 patients in the TAPP group and 473 in the TEP group). Pooled data show no significant between-group differences for general complications, special complications, postoperative pain, operative time, and length of hospital stay (all P > 0.05). The overall pooled result indicated a trend toward lower short-term recurrence with TAPP, which was largely driven by retrospective non-randomized cohort data. Although the RCT subgroup yielded a borderline nominally significant result, this signal derived from very limited trial data and does not establish a genuine between-group difference in recurrence risk. Given the maximum follow-up of 12 months across eligible studies, this recurrence-related finding warrants cautious interpretation.
Conclusion: TAPP and TEP deliver comparable short-term safety and efficacy for bilateral inguinal hernia repair. The observed trend of lower short-term recurrence for TAPP relies heavily on observational cohort data and receives no support from RCT evidence. We cannot draw definitive conclusions about recurrence benefits. Further large-sample, long-term high-quality studies are needed.
Related
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- Risk factors for postoperative pain after laparoscopic transabdominal preperitoneal repair of inguinal hernia: a prospective observational study.
- Laparoscopic transabdominal preperitoneal repair of Spigelian hernia in a single-center case series
- “Mesh on the Move” Transabdominal Preperitoneal Mesh Erosion into the Urinary Bladder after Laparoscopic Inguinal Hernia Repair
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BibTeX
@article{pan2026efficacy,
title = {{Efficacy of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair in the treatment of bilateral inguinal hernia: a systematic review and meta-analysis}},
author = {Yulin Pan and Xiao Pang and Pan Shen and Fenglan Liu},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1942077},
url = {https://doi.org/10.3389/fsurg.2026.1942077},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Efficacy of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair in the treatment of bilateral inguinal hernia: a systematic review and meta-analysis
AU - Yulin Pan
AU - Xiao Pang
AU - Pan Shen
AU - Fenglan Liu
PY - 2026
DA - 2026/10/13
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1942077
UR - https://doi.org/10.3389/fsurg.2026.1942077
AB - Background and objective: Inguinal hernia is a common general-surgical disease. Laparoscopic repair is widely used for bilateral cases. The practical trade-offs between laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) repair remain debated, and most existing publications focus on unilateral inguinal hernia. Methods: We searched multiple domestic and international databases for comparative studies of TAPP versus TEP for bilateral inguinal hernia. Literature retrieval covered records from database inception to April 6, 2026. Evaluated outcomes included general complications, special complications, recurrence, postoperative pain, operative time, and length of hospital stay. Statistical analyses were performed with RevMan 5.3 and Stata 18. Results: Nine eligible studies involving 1,319 patients were included (846 patients in the TAPP group and 473 in the TEP group). Pooled data show no significant between-group differences for general complications, special complications, postoperative pain, operative time, and length of hospital stay (all P > 0.05). The overall pooled result indicated a trend toward lower short-term recurrence with TAPP, which was largely driven by retrospective non-randomized cohort data. Although the RCT subgroup yielded a borderline nominally significant result, this signal derived from very limited trial data and does not establish a genuine between-group difference in recurrence risk. Given the maximum follow-up of 12 months across eligible studies, this recurrence-related finding warrants cautious interpretation. Conclusion: TAPP and TEP deliver comparable short-term safety and efficacy for bilateral inguinal hernia repair. The observed trend of lower short-term recurrence for TAPP relies heavily on observational cohort data and receives no support from RCT evidence. We cannot draw definitive conclusions about recurrence benefits. Further large-sample, long-term high-quality studies are needed.
SN - 2296-875X
ER -