Work

Learning curve and early outcomes of transabdominal preperitoneal inguinal hernia repair after structured training: a 3-center study

Year: 2026

Type: article

Abstract: INTRODUCTION: Transabdominal preperitoneal (TAPP) repair is an established technique for inguinal hernia repair, but technical complexity and safety concerns during the learning curve may limit its adoption. AIM: Our objective was to describe early operative safety and performance of 3 participating surgeons from 3 centers following training in the national "Hernia Master" program. MATERIALS AND METHODS: This multicenter retrospective study included 207 patients who underwent 240 elective TAPP groin hernia repairs during 207 sessions, including 33 bilateral procedures. Three trainees contributed 84, 63, and 60 sessions, respectively. Operative time (OT) was assessed using locally weighted scatterplot smoothing (LOWESS) and by comparing chronological halves. Postoperative complications were graded using the Clavien-Dindo classification, whereas intraoperative events and conversions were recorded separately. Surveillance was extended to 3 months, without standardized assessment of recurrence or chronic postoperative inguinal pain. RESULTS: = 0.09). LOWESS curves indicated continued improvement without a clear plateau. CONCLUSIONS: This selected 3-surgeon cohort demonstrates early safety and operative performance following structured training. The findings cannot establish the effectiveness of the program as a whole, a threshold for proficiency, or long-term treatment quality. Prospective evaluation of all trainees, with standardized assessments of recurrence and chronic postoperative inguinal pain, is needed.

Source: Videosurgery and Other Miniinvasive Techniques

DOI: 10.20452/wiitm.2026.18052