Tailored surgical planning in TEP inguinal hernia repair: a multivariate analysis of obesity and hernia defect size.

Abstract

Objective: This study investigates the relationship between body mass index (BMI), hernia defect diameter, and early postoperative complications in total extraperitoneal (TEP) hernia repair.

Methods: Of 306 patients undergoing endoscopic inguinal hernia repair between January 2022 and December 2024, 285 patients with completed TEP procedures performed by a single surgeon constituted the final study cohort. Patients were stratified by BMI and hernia defect size. Early postoperative complications within 30 days, including seroma and hematoma, were recorded. Multivariable logistic regression analysis was conducted to identify independent predictors of early complications. All analyses were performed using SPSS version 26.0.

Results: Within the 30-day postoperative period, seroma occurred in 36 patients (12.6%) and hematoma in 21 patients (7.4%). Obesity (BMI ≥ 30 kg/m²) was independently associated with increased odds of early postoperative complications (OR 2.8, 95% CI 1.3-5.9, p = 0.02), whereas overweight BMI was not statistically significant (OR 1.2, 95% CI 0.6-2.4, p = 0.34). Hernia defect size ≥ 25 mm was also identified as an independent predictor (OR 2.9, 95% CI 1.4-6.1, p = 0.03). Age > 65 years showed a non-significant trend toward higher complication risk (p = 0.08).

Conclusion: Obesity and large hernia defects are independent predictors of early complications following TEP hernia repair. Focusing on these factors during preoperative planning may enhance patient safety and outcomes.