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CC BY 4.0 · Surg J (N Y) 2025; 11: a26777528
DOI: 10.1055/a-2677-7528
Original Article

Clinical Comparison of New Peritoneal Suture and Traditional Suture in Transabdominal Preperitoneal Prosthetic Operation for Inguinal Hernia

Qiu Jian Qin‡   *
1   Department of General Surgery, Laibin People's Hospital, Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China
,
Hong Xue Li‡   *
2   Department of Interventional Therapy, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
,
Zhong Hui Qin
1   Department of General Surgery, Laibin People's Hospital, Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China
,
Si Wen Luo
1   Department of General Surgery, Laibin People's Hospital, Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China
,
Hang Zheng
1   Department of General Surgery, Laibin People's Hospital, Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China
,
Shang Hui Huang
1   Department of General Surgery, Laibin People's Hospital, Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China
,
Yu Ting Liao
3   Department of Hepatobiliary Surgery, Central South University Xiangya Medical College Affiliated Haikou Hospital, Haikou, People's Republic of China
,
Wen Liang Zhu 
2   Department of Interventional Therapy, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China
› Author Affiliations
Funding This study has received funding from the Natural Science Foundation of Laibin (fund number: 211911).
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Abstract

Objectives

This study aimed to assess the efficacy of intraperitoneal suturing for peritoneal closure in preventing adhesions and improving clinical outcomes during laparoscopic transabdominal preperitoneal prosthetic (TAPP) hernia repair for inguinal hernia.

Materials and Methods

A retrospective cohort study of 126 patients undergoing TAPP herniorrhaphy between November 2021 and November 2022 compared intraperitoneal suture technique (n = 64) versus conventional suturing (n = 62) for peritoneal flap closure. Evaluated parameters included demographic characteristics (age, sex, body mass index [BMI]), operative metrics (suture count, peritoneal closure time), procedural efficacy (complete peritoneal closure rate), and postoperative outcomes encompassing Visual Analog Scale (VAS) pain scores, adhesion formation, seroma incidence, recurrence rates, and intestinal obstruction occurrence.

Results

The intraperitoneal suture group achieved significantly higher complete internal inversion success rates (57 [89.1%] vs. 5 [8.1%]; p < 0.001), lower peritoneal adhesion incidence (1 [1.6%] vs. 9 [14.5%]; p = 0.018), and shorter peritoneal suture time (481.20 ± 47.91 vs. 584.77 ± 70.77 minutes; p < 0.001) compared with the traditional suture group. No significant intergroup differences were identified in age, sex, BMI, stitch counts, VAS scores, seroma, recurrence rates, or ileus incidence.

Conclusion

The application of the intraperitoneal suture technique in TAPP to prevent peritoneal adhesion is effective, safe, and easy to learn, with good clinical effect and deserves promotion and application.

Keywords

laparoscope - peritoneal suture - TAPP - peritoneal adhesion

Data Availability Statement

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.


Ethical Approval

This retrospective study was performed by the Declaration of Helsinki of the World Medical Association. It was waived by the Ethics Committee of Laibin People's Hospital, and the informed consent of patients was waived because of its retrospective study.


* These authors contributed equally to this work. The co-first authors.


Supplementary Material



Publication History

Received: 20 June 2025

Accepted: 06 August 2025

Article published online:
25 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Qiu Jian Qin, Hong Xue Li, Zhong Hui Qin, Si Wen Luo, Hang Zheng, Shang Hui Huang, Yu Ting Liao, Wen Liang Zhu. Clinical Comparison of New Peritoneal Suture and Traditional Suture in Transabdominal Preperitoneal Prosthetic Operation for Inguinal Hernia. Surg J (N Y) 2025; 11: a26777528.
DOI: 10.1055/a-2677-7528
 

  • References

  • 1 Okamoto H, Maruyama S, Wakana H, Kawashima K, Fukasawa T, Fujii H. Feasibility and validation of single-port laparoscopic surgery for simple-adhesive or nonadhesive ileus. Medicine (Baltimore) 2016; 95 (04) e2605
    Search in Google Scholar
  • 2 Oguz H, Karagulle E, Turk E, Moray G. Comparison of peritoneal closure techniques in laparoscopic transabdominal preperitoneal inguinal hernia repair: a prospective randomized study. Hernia 2015; 19 (06) 879-885
    Search in Google Scholar
  • 3 Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 2010; 97 (01) 4-11
    Search in Google Scholar
  • 4 HerniaSurge Group. International guidelines for groin hernia management. Hernia 2018; 22 (01) 1-165
    Search in Google Scholar
  • 5 Andresen K, Rosenberg J. Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev 2024; 7 (07) CD004703
    Search in Google Scholar
  • 6 Gavriilidis P, Davies RJ, Wheeler J, de'Angelis N, Di Saverio S. Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials. Hernia 2019; 23 (06) 1093-1103
    Search in Google Scholar
  • 7 Köckerling F, Lorenz R, Hukauf M. et al. Influencing factors on the outcome in female groin hernia repair: a registry-based multivariable analysis of 15,601 patients. Ann Surg 2019; 270 (01) 1-9
    Search in Google Scholar
  • 8 Yang B, Xie C, Lv Y, Wang Y. Effect of laparoscopic inguinal hernia repairs on inflammatory factors, oxidative stress levels and postoperative recovery. J Inflamm Res 2024; 17: 7929-7937
    Search in Google Scholar
  • 9 Wan J, Yuan XQ, Wu TQ. et al. Laparoscopic vs open surgery in ileostomy reversal in Crohn's disease: a retrospective study. World J Gastrointest Surg 2021; 13 (11) 1414-1422
    Search in Google Scholar
  • 10 Krielen P, Stommel MWJ, Pargmae P. et al. Adhesion-related readmissions after open and laparoscopic surgery: a retrospective cohort study (SCAR update). Lancet 2020; 395 (10217): 33-41
    Search in Google Scholar
  • 11 Duron JJ. Postoperative intraperitoneal adhesion pathophysiology. Colorectal Dis 2007; 9 (Suppl. 02) 14-24
    Search in Google Scholar
  • 12 Ellis H. The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 1971; 133 (03) 497-511
    Search in Google Scholar
  • 13 Ellis H, Moran BJ, Thompson JN. et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 1999; 353 (9163) 1476-1480
    Search in Google Scholar
  • 14 Menzies D, Ellis H. Intestinal obstruction from adhesions–how big is the problem?. Ann R Coll Surg Engl 1990; 72 (01) 60-63
    Search in Google Scholar
  • 15 Jani K, Contractor S. Retrorectus sublay mesh repair using polypropylene mesh: cost-effective approach for laparoscopic treatment of ventral abdominal wall hernias. J Minim Access Surg 2019; 15 (04) 287-292
    Search in Google Scholar
  • 16 Arita NA, Nguyen MT, Nguyen DH. et al. Laparoscopic repair reduces incidence of surgical site infections for all ventral hernias. Surg Endosc 2015; 29 (07) 1769-1780
    Search in Google Scholar
  • 17 Wu Q, Ma W, Wang Q, Liu Y, Xu Y. Comparative effectiveness of hybrid and laparoscopic techniques for repairing complex incisional ventral hernias: a systematic review and meta-analysis. BMC Surg 2023; 23 (01) 346
    Search in Google Scholar
  • 18 Huerta S, Varshney A, Patel PM, Mayo HG, Livingston EH. Biological mesh implants for abdominal hernia repair: US Food and Drug Administration approval process and systematic review of its efficacy. JAMA Surg 2016; 151 (04) 374-381
    Search in Google Scholar
  • 19 Köckerling F, Bittner R, Kuthe A. et al. TEP or TAPP for recurrent inguinal hernia repair-register-based comparison of the outcome. Surg Endosc 2017; 31 (10) 3872-3882
    Search in Google Scholar
  • 20 Tolver MA, Rosenberg J, Juul P, Bisgaard T. Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc 2013; 27 (08) 2727-2733
    Search in Google Scholar
  • 21 Wirth U, Saller ML, von Ahnen T, Köckerling F, Schardey HM, Schopf S. Long-term outcome and chronic pain in atraumatic fibrin glue versus staple fixation of extra light titanized meshes in laparoscopic inguinal hernia repair (TAPP): a single-center experience. Surg Endosc 2020; 34 (05) 1929-1938
    Search in Google Scholar
  • 22 Zhu Y, Liu Y, Wang M. A new suture technique for peritoneal flap closure in TAPP: a prospective randomized controlled trial. Surg Laparosc Endosc Percutan Tech 2020; 30 (01) 18-21
    Search in Google Scholar
  • 23 Köhler G, Mayer F, Lechner M, Bittner R. Small bowel obstruction after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report and review of the literature. Hernia 2015; 19 (03) 389-394
    Search in Google Scholar
  • 24 Sigel B, Golub RM, Loiacono LA. et al. Technique of ultrasonic detection and mapping of abdominal wall adhesions. Surg Endosc 1991; 5 (04) 161-165
    Search in Google Scholar
  • 25 Lienemann A, Sprenger D, Steitz HO, Korell M, Reiser M. Detection and mapping of intraabdominal adhesions by using functional cine MR imaging: preliminary results. Radiology 2000; 217 (02) 421-425
    Search in Google Scholar
  • 26 Gerner-Rasmussen J, Donatsky AM, Bjerrum F. The role of non-invasive imaging techniques in detecting intra-abdominal adhesions: a systematic review. Langenbecks Arch Surg 2019; 404 (06) 653-661
    Search in Google Scholar
  • 27 Yasemin A, Mehmet B, Omer A. Assessment of the diagnostic efficacy of abdominal ultrasonography and cine magnetic resonance imaging in detecting abdominal adhesions: a double-blind research study. Eur J Radiol 2020; 126: 108922
    Search in Google Scholar
  • 28 Limperg T, Chaves K, Jesse N, Zhao Z, Yunker A. Ultrasound visceral slide assessment to evaluate for intra-abdominal adhesions in patients undergoing abdominal surgery - a systematic review and meta-analysis. J Minim Invasive Gynecol 2021; 28 (12) 1993-2003.e10
    Search in Google Scholar
  • 29 Arung W, Meurisse M, Detry O. Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol 2011; 17 (41) 4545-4553
    Search in Google Scholar
  • 30 Zwicky SN, Stroka D, Zindel J. Sterile injury repair and adhesion formation at serosal surfaces. Front Immunol 2021; 12: 684967
    Search in Google Scholar
  • 31 Ito T, Shintani Y, Fields L. et al. Cell barrier function of resident peritoneal macrophages in post-operative adhesions. Nat Commun 2021; 12 (01) 2232
    Search in Google Scholar
  • 32 Sarate RM, Hochstetter J, Valet M. et al. Dynamic regulation of tissue fluidity controls skin repair during wound healing. Cell 2024; 187 (19) 5298-5315.e19
    Search in Google Scholar
  • 33 Xie HY, Chen B, Shen J, Wang YP, Shen WC, Dai CS. Risk factors and clinical impact of seroma formation following laparoscopic inguinal hernia repair: a retrospective study. BMC Surg 2024; 24 (01) 274
    Search in Google Scholar
  • 34 Balthazar da Silveira CA, Rasador ACD, Marcolin P. et al. The evolving applications of laparoscopic intracorporeal rectus aponeuroplasty (LIRA) in ventral hernia repair-a systematic review. J Abdom Wall Surg 2024; 3: 13497
    Search in Google Scholar