Dear Editor,
The terminology of abdominal wall surgery has long been dominated by historical acronyms such as TAPP, TEP, IPOM, or MILOS. While widely adopted, these acronyms often fail to convey critical information regarding mesh type, fixation, or precise anatomical plane. In addition, the same surgical technique is frequently described by two or more different acronyms, creating unnecessary heterogeneity. This ambiguity not only confuses readers but also complicates evidence synthesis, hampering meta-analyses and guideline development by making the retrieval and classification of studies more difficult. The recently proposed Muysoms nomenclature addresses these issues by providing a rationalized framework that codes each procedure through five elements: approach, hernia type, mesh position, mesh type, and fixation [1].
To explore its feasibility, we retrospectively applied this system to a pilot sample of 13 published studies (16 treatment arms) covering groin, ventral, and robotic approaches [2–14]. Each technique was reclassified from its traditional acronym into the new format (e.g., TAPP → l-GPSpX).
Our analysis revealed:
Approach and hernia type were always identifiable (100%) once the full text was reviewed, but remained ambiguous when relying on acronyms alone. For instance, eTEP could indicate ventral, incisional, or umbilical repairs. Moreover, the same technique was sometimes described using two or more different acronyms (TARUP aka TARM), further increasing heterogeneity.
Mesh position was consistently inferred from the acronym (e.g., TAPP = preperitoneal, IPOM = intraperitoneal).
Mesh type and fixation were rarely specified by acronyms, and required careful reading of the methods or looking at the figures; they remained missing in 19% and 25% of cases, respectively.
These findings highlight both the limitations of legacy acronyms and the added value of the Muysoms nomenclature, which captures essential technical features in a standardized, machine- and human-readable format. Importantly, the system allows retroactive mapping of historical literature, paving the way for harmonized meta-analyses and registry integration.
Furthermore, beyond our pilot findings, the value of this system lies in its conceptual design. As highlighted by Muysoms et al., more than one hundred acronyms have been introduced in hernia surgery, many inconsistently applied to the same techniques. By replacing acronym proliferation with a modular combination of five elements, the Muysoms nomenclature offers a future-proof, unambiguous, and machine-readable framework. This ensures that both current and novel procedures can be consistently reported, thereby facilitating registries, meta-analyses, and guideline development.
We suggest that future studies, registry fields, and guideline documents progressively adopt this nomenclature. Our pilot supports its feasibility and underscores its potential to unify reporting standards in hernia surgery. Ongoing projects will further explore its reliability, scalability, and integration into research and clinical practice, ultimately consolidating its role as a reference standard.
Sincerely,
Francesco Brucchi, MD
University of Milan
Statements
Data availability statement
The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.
Author contributions
FB conceived the study concept, performed the literature analysis, and drafted the manuscript. GD provided critical supervision, conceptual guidance, and substantial revisions to the final version. All authors contributed to the article and approved the submitted version.
Funding
The author(s) declare that no financial support was received for the research and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
1.
Muysoms F Vierstraete M . Are Abbreviations and Acronyms to Describe Hernia Repair Techniques Overused and Helpful? A Proposal for Rationalisation. Cir Esp Engl Ed (2023) 101:S19–S23. 10.1016/j.cireng.2023.01.011
2.
Arias-Espinosa L Claus CM Malcher F Valenzuela Alpuche HA . Robotic Preperitoneal Extended Totally Extraperitoneal (R-PeTEP) Technique Description for Ventral Hernia Repair: Preliminary Results. Updat Surg (2024) 76:2715–22. 10.1007/s13304-024-02002-2
3.
Abulfaraj M . Robotic Transabdominal Preperitoneal Versus Laparoscopic Intraperitoneal Onlay Mesh plus Repair for Small to Medium Primary Ventral Hernias: A propensity-matched Cohort Study. J Robot Surg (2025) 19:637. 10.1007/s11701-025-02817-0
4.
Andreuccetti J Sartori A Lauro E Crepaz L Sanna S Pignata G et al Extended Totally Extraperitoneal Rives–Stoppa (eTEP-RS) Technique for Ventral Hernia: Initial Experience of the Wall Hernia Group and a Surgical Technique Update. Updat Surg (2021) 73:1955–61. 10.1007/s13304-021-01067-7
5.
Brucchi F Ferraina F Masci E Ferrara D Cassini D Faillace G . To Close, Not to Close, or to Act Bigger? Managing the Defect of Large Direct Inguinal Hernia to Reduce the Risk of Recurrence During Laparoscopic TAPP Repair: A Retrospective Cohort Study. Updat Surg (2024) 76:2395–402. 10.1007/s13304-024-01870-y
6.
Deshpande GA Tirpude B Bhanarkar H Akulwar V Kodape G Gajbhiye R . Prospective, Observational Study of Intraperitoneal Onlay Mesh Repair With Defect Closure Versus SCOLA for Primary Ventral Hernia. J Minimal Access Surg (2024) 20:397–402. 10.4103/jmas.jmas_223_23
7.
Ferraro L Formisano G Salaj A Giuratrabocchetta S Petz W Toti F et al Robotic Trans-abdominal Retromuscular Hernia Repair for Medium-Sized Midline Hernias: Midterm Outcomes and Surgical Site Occurrence (SSO) Analysis in 120 Patients. J Robot Surg (2024) 19:26. 10.1007/s11701-024-02184-2
8.
Hirohara M Tsuchida H Uemura S Ozaki Y Saida S Koike N . Should Occult Hernia Be Repaired in TAPP?Surg Endosc (2025). 10.1007/s00464-025-12262-7
9.
Ko H Lee SM Chang HK Min SY Cho K Park M-S . Laparoscopic Total Extra-Peritoneal (TEP) Inguinal Hernia Repair Under Local Anesthesia by Topical Lidocaine Injection. Hernia (2022) 27:113–8. 10.1007/s10029-022-02653-3
10.
Morrell ALG Morrell AC Cavazzola LT Pereira GSS Mendes JM Abdalla RZ et al Robotic Assisted Etep Ventral Hernia Repair: Brazilian Early Experience. Hernia (2021) 25:765–74. 10.1007/s10029-020-02233-3
11.
Muysoms F Van Cleven S Kyle-Leinhase I Ballecer C Ramaswamy A . Robotic-Assisted Laparoscopic Groin Hernia Repair: Observational Case-Control Study on the Operative Time During the Learning Curve. Surg Endosc (2018) 32:4850–9. 10.1007/s00464-018-6236-7
12.
Rege SA Churiwala JJ Kaderi ASA Kshirsagar KF Dalvi AN . Comparison of Efficacy and Safety of the enhanced-view Totally Extraperitoneal (Etep) and Transabdominal (TARM) Minimal Access Techniques for Retromuscular Placement of Prosthesis in the Treatment of Irreducible Midline Ventral Hernia. J Minimal Access Surg (2021) 17:519–24. 10.4103/jmas.JMAS_145_20
13.
Signorini FJ Chamorro ML Soria MB Salazar P Marani M Obeide L et al Preaponeurotic Endoscopic Repair (REPA) Indication in Men Could Be Controversial. Hernia (2022) 27:431–8. 10.1007/s10029-022-02716-5
14.
Skoczek AC Ruane PW Holland AB Hamilton JK Fernandez DL . Robotic Transversus Abdominis Release (TAR) for Ventral Hernia Repairs Is Associated With Low Surgical Site Occurrence Rates and Length of Stay Despite Increasing Modifiable Comorbidities. Hernia (2024) 28:1727–35. 10.1007/s10029-024-03044-6
Summary
Keywords
hernia, classification, acronyms, abdominal wall surgery, surgical taxonomy
Citation
Brucchi F and Dionigi G (2025) From Laparoscopic TAPP to l-GPSpX: A Pilot Reclassification of Hernia Surgery Acronyms Using the Muysoms Nomenclature. J. Abdom. Wall Surg. 4:15705. doi: 10.3389/jaws.2025.15705
Received
07 October 2025
Accepted
31 October 2025
Published
07 November 2025
Volume
4 - 2025
Updates
Copyright
© 2025 Brucchi and Dionigi.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Francesco Brucchi, francesco.brucchi@unimi.it
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.