Inguinal hernia repair with the trabucco technique: A multicenter analysis with 5-year follow-up
Alberto Aiolfi1, Piero Giovanni Bruni2, Davide Bona3,4
1Division of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Via C. Belgioioso, 173, 20157, Milan, Italy. alberto.aiolfi86@gmail.com.
Introduction:
Over the past three decades, the surgical management of inguinal hernia has undergone considerable advancement. In the setting of open inguinal hernia repair, the Liechtenstein tension-free technique continues to be regarded as the standard treatment; parallelly the Trabucco technique has attracted attention due to its sutureless mesh fixation. This study presents a multicenter evaluation of the Trabucco repair, with an emphasis on hernia recurrence, postoperative complications, chronic pain, and cosmetic outcomes over a five-year follow-up period.
Methods:
Multicenter retrospective study using a prospectively maintained database from March 2019 to December 2024. The study included all patients who underwent Trabucco repair for monolateral, uncomplicated groin hernia classified as M1-2 or L1-2. Exclusion criteria comprised patients with L3/M3 groin hernias, those undergoing surgery for hernia recurrence, and cases lost to follow-up. The primary outcome was hernia recurrence determined on both clinical and imaging confirmation.
Results:
Overall, 1,846 patients completed 1-year follow-up and were included in the analysis; follow-up compliance was 92% (1095/1190) at 3 years and 88% (573/658) at 5 years. Hernia recurrence occurred in 2.1% of patients, with 5-year recurrence-free probabilities of 0.95 (95%CI 0.94-0.97). Age- and hernia size-adjusted hazard analysis showed the greatest recurrence risk within the first 2 years after surgery. Chronic pain was reported in 1.1% of patients. Patient-reported outcomes, including pain, activity restriction, cosmetic concerns, and total EuraHS-QoL score, improved significantly from baseline throughout follow-up (). No mesh-related complications were observed during short- or long-term follow-up.
Conclusions:
In selected patients with uncomplicated unilateral M1-2 or L1-2 inguinal hernia, Trabucco repair appeared to be associated with favorable 5-year outcomes, including low recurrence and chronic pain rates and sustained improvement in quality of life.
