AUTHOR=Lorenz Ralph , Akkersdijk Willem , De Oliveira Gabriel Paiva , Soler Marc , Gillion Jean-Francois , Lourenço Augusto , Da Costa Rui Soares , Pelissier Edouard , Ugahary Franz , Berrevoet Frederik 

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

JOURNAL=Journal of Abdominal Wall Surgery

VOLUME=Volume 4 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/journal-of-abdominal-wall-surgery/articles/10.3389/jaws.2025.13990

DOI=10.3389/jaws.2025.13990

ISSN=2813-2092

ABSTRACT=Introduction: Both 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 expertise and competence are available. However, although numerous surgical open preperitoneal techniques have been developed, only a few comparative studies comparing the different open preperitoneal techniques are available. Because of the lack of scientific evidence and standarization the aim of this article is to define comparable standards and compare four frequently used open preperitoneal techniques. Method: Using a Delphi-consensus process among both the authors and experts in the field various key steps for each procedure, indications, as well as outcome parameters were set to allow adequate comparison of different open preperitoneal techniques. Results: We present for 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) a clear binding and comparable standard regarding the best indication, different procedural steps, the use of meshes and fixation, the learning curve and possible complications and limitations. We could identify for the techniques some similarities but also specific differences on different topics. Conclusion: Both development, validation and implementation of these standards for the various open preperitoneal techniques are essential both for education and training as well as for future comparative studies.