Does Inguinal TAPP Repair Increase the Rate of Midline Supraumbilical Trocar Site Hernia?-A Single-Center...

Background/Objectives: This study aimed to determine the inguinal hernia recurrence rate after transabdominal preperitoneal (TAPP) repair, particularly considering the effect of simultaneous umbilical hernia repair. The secondary aim was to assess whether closing the 10 mm midline supraumbilical port-site fascia affects the incidence of trocar-site hernia (TSH) following inguinal TAPP. Methods: We reviewed medical records of consecutive patients undergoing inguinal TAPP at the Department of Surgery, University Hospital Centre Zagreb, between 1 January 2014 and 30 June 2022, and supplemented the data with telephone follow-up. Demographic, clinical, and operative variables were compared between patients who did and did not report inguinal hernia recurrence. Patients were also grouped by operating surgeon to compare TSH rates. Surgeon A routinely closed the 10 mm supraumbilical fascial defect with a single suture, while Surgeon B mostly did not, deciding on a case-by-case basis. Results: The analysis included 281 patients with a median follow-up of 60 months. The overall recurrence rate was 10.6%. Baseline demographic and clinical characteristics did not differ significantly between patients who reported recurrence and those who did not. A prior hernia repair was more common in the recurrence group (34.1% vs. 17.2%; p = 0.007). Concomitant umbilical hernia repair was performed in 12.5% of cases. Patient-reported recurrence was higher after combined TAPP and umbilical hernioplasty than after TAPP alone (14.3% vs. 12.2%), but this difference was not statistically significant (p = 0.784). Surgeon A had a lower observed TSH rate than Surgeon B (1.0% vs. 3.6%), although this difference did not reach statistical significance (p = 0.242). Conclusions: Concurrent TAPP and umbilical hernioplasty is not associated with a higher recurrence rate, but further research on a larger cohort is necessary. Routine closure of the 10 mm midline supraumbilical fascial defect could reduce the TSH rate, although the difference was not statistically significant. The side of the hernia does not influence recurrence after TAPP.