Hernia最新文献

{"title":"Midline single-port eTEP stoppa repair for bilateral inguinal hernia: How I do it.","authors":"Yuji Konishi, Tadayuki Kobayashi, Hirotaka Shoji, Hironori Kasai, Hideki Kawamura, Akinobu Taketomi","doi":"10.1007/s10029-026-03709-4","DOIUrl":"https://doi.org/10.1007/s10029-026-03709-4","url":null,"abstract":"<p><strong>Background: </strong>Early bilateral extraperitoneal unification through a midline single-port eTEP approach enables the creation of a wide, continuous lower abdominal working cavity without crossover manipulation. We evaluated the feasibility and outcomes of this technique for primary bilateral inguinal hernia repair.</p><p><strong>Methods: </strong>This retrospective case series represents the complete institutional experience with midline single-port eTEP Stoppa repair between January 2020 and December 2025. Primary bilateral hernias were included; recurrent, incarcerated, and large scrotal hernias were excluded. Operative outcomes, complications (Clavien-Dindo classification), and follow-up data were analyzed.</p><p><strong>Surgical technique: </strong>Through a transverse infraumbilical midline incision, the bilateral retrorectus and preperitoneal spaces are unified at the beginning of the procedure, and a single-port device is inserted to establish a wide extraperitoneal working cavity. Bilateral inguinal dissection is then performed without crossover manipulation, followed by deployment of a single large mesh according to Stoppa principles.</p><p><strong>Results: </strong>Forty-four consecutive patients underwent the procedure. Median operative time was 121 min. No conversions occurred. Intraoperative peritoneal injury occurred in 12 patients and was repaired laparoscopically. No Clavien-Dindo grade ≥ II complications were observed. Median length of stay was 2 days (range 1-3). Median follow-up was 565 days (IQR 287-1050), with no recurrences or incisional hernias detected.</p><p><strong>Conclusions: </strong>Midline single-port eTEP Stoppa repair establishes early bilateral extraperitoneal continuity, creating a wide lower abdominal operative field and eliminating crossover manipulation. This technique may represent a structurally distinct alternative to conventional bilateral TEP and may offer potential ergonomic advantages.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative CT-based quantitative assessment of hernial SAC predicts early recurrence following primary hiatal hernia repair.","authors":"Takahiro Ochiai, Masanobu Nakajima, Masatoshi Nakagawa, Junki Fujita, Shuhei Takise, Yu Ueta, Masaki Yoshimatsu, Noboru Inoue, Hiroto Muroi, Shinji Morita, Kazuyuki Kojima","doi":"10.1007/s10029-026-03703-w","DOIUrl":"https://doi.org/10.1007/s10029-026-03703-w","url":null,"abstract":"<p><strong>Background: </strong>Recurrence of hiatal hernia after primary repair is a major concern, particularly early recurrence related to technical factors. Reliable preoperative predictors are essential for optimal surgical strategies. Because the hernial sac area can also affect operative complexity, this study aimed to evaluate early recurrence-associated factors and their relationship with operative time using quantitative computed tomography (CT).</p><p><strong>Methods: </strong>We retrospectively analyzed 48 patients who underwent laparoscopic hiatal hernia repair between July 2012 and July 2025. Preoperative CT was used to measure the maximum diameter and area of the hernial sac in the axial and coronal planes. We examined the association between these parameters and surgical outcomes including recurrence.</p><p><strong>Results: </strong>Early recurrence was observed in four patients (8.3%), all of whom required reoperation within 3 days. Patients with early recurrence had longer operative times and larger axial hernial sac areas (p < 0.05). Receiver operating characteristic (ROC) curve analysis demonstrated that the axial maximum diameter provided the highest predictive performance for early recurrence (area under the curve [AUC] = 0.89), with an optimal cutoff value of 117.6 mm. Other parameters, including axial area, coronal area, coronal diameter, and hiatal width, showed moderate predictive ability but none exceeded axial diameter accuracy.</p><p><strong>Conclusion: </strong>Axial hernial sac measurements are associated with early recurrence. Preoperative CT-based quantitative assessments may provide valuable information for predicting surgical complexity and recurrence, thereby supporting preoperative risk stratification and surgical planning. Therefore, prospective validation using a larger cohort is warranted.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parainguinal or spigelian hernia: a clinically important distinction. Author's Reply.","authors":"Shanxuan Yu, Nazim Bhimani MBiostat, Nicola Dodds, Edmund Sweeney, Simon Wickins, Anthony Glover, Thomas J Hugh","doi":"10.1007/s10029-026-03697-5","DOIUrl":"https://doi.org/10.1007/s10029-026-03697-5","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject: submission of manuscript entitled \"integrating eTEP ventral hernia repair into bariatric surgery: technical insights and clinical outcomes from an institutional experience\".","authors":"Pradeep Joshua Christopher, Saravana Kumar S, Akhilesh Manchala, Jayanth Leo Xl, Prabhakaran S, Praveen Raj Palanivelu, Palanivelu Chinnusamy","doi":"10.1007/s10029-026-03692-w","DOIUrl":"https://doi.org/10.1007/s10029-026-03692-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a well-established risk factor for ventral hernia, and concomitant repair during bariatric surgery offers the advantage of a single-stage solution. While the intraperitoneal onlay mesh (IPOM) technique has been the traditional approach, the enhanced-view totally extraperitoneal (eTEP) repair provides a biomechanically superior, retro-muscular alternative. However, its integration with bariatric surgery has not been previously described.</p><p><strong>Objective: </strong>The primary objective of this study was to evaluate the feasibility and safety of integrating enhanced-view totally extraperitoneal (eTEP) ventral hernia repair into bariatric surgery and describing its technical nuances. Secondary objectives included reporting early hernia-related and metabolic outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 35 consecutive patients who underwent concomitant eTEP ventral hernia repair with bariatric procedures between July 2021 and January 2025. Of these, 23 underwent eTEP without transversus abdominis release (TAR) and 12 required TAR for posterior fascial closure. Bariatric procedures included laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis/mini-gastric bypass (OAGB-MGB). Perioperative outcomes, complications, and follow-up data were analyzed.</p><p><strong>Results: </strong>Among 23 patients without TAR, 12 underwent LSG, 5 RYGB, and 6 MGB. Among the 12 TAR cases, 6 underwent LSG, 3 RYGB, and 3 MGB. The mean operative time was 157 ± 23 min, and the mean hospital stay was 3 ± 1 days. There were no intraoperative conversions or mesh-related infections. Two patients developed seroma managed conservatively. No hematomas, posterior rectus sheath ruptures, or recurrences were observed during a minimum follow-up of six months (mean 17 ± 3 months).</p><p><strong>Conclusions: </strong>This study demonstrates that concomitant eTEP ventral hernia repair can be safely integrated with bariatric surgery when performed in a standardized, contamination-safe manner. The detailed technical framework presented here provides a reproducible roadmap for surgeons adopting this approach in complex obese patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of general anesthesia vs. local anesthesia with monitored anesthesia care for elective umbilical hernia repair in adults: a propensity score- matched analysis.","authors":"Sergio Huerta, Crystal Phung, Jared McAllister, Sri Tummala, Shirling Tsai","doi":"10.1007/s10029-026-03704-9","DOIUrl":"https://doi.org/10.1007/s10029-026-03704-9","url":null,"abstract":"<p><strong>Introduction: </strong>There are no randomized controlled trials comparing general anesthesia (GA) to local anesthesia with monitored anesthesia care (LA + MAC) for adult patients undergoing elective umbilical hernia repair (UHR). We hypothesized that LA + MAC would be associated with fewer postoperative complications without increasing recurrence.</p><p><strong>Methods: </strong>A retrospective analysis of a prospectively maintained database was performed, including consecutive Veteran patients undergoing elective open primary UHR at a single institution between August 2005 and June 2025. Patients undergoing emergent repair, laparoscopic repair, incisional hernia repair, or epigastric hernia repair were excluded. Primary outcomes were recurrence, 30-day postoperative complications, and operative room times in patients receiving GA vs. LA + MAC. Variables significant on univariable analysis were included in a propensity score-matched analysis.</p><p><strong>Results: </strong>A total of 602 patients underwent UHR with GA (n = 427) or LA + MAC (n = 175). PSMA yielded 143 patients in the GA and 175 patients in the LA + MAC group. In the unmatched cohort, recurrence was higher after GA than LA + MAC (4.7% vs. 1.1%, p < 0.01), but this difference was not significant after matching (2.8% vs. 1.1%, p = 0.30). Overall, 58 complications occurred (54 GA vs. 4 LA + MAC). In the unmatched cohort, complication rates were higher with GA (12.6% vs. 2.3%, p < 0.01), and this difference persisted after matching (9.8% vs. 2.3%, p < 0.01). Operative room time was modestly shorter with LA + MAC (mean difference = 5.3 min).</p><p><strong>Conclusions: </strong>LA + MAC was associated with significantly fewer postoperative complications and modestly shorter operative time, without increased recurrence. These findings support consideration of LA + MAC for elective open UHR.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the radiology report: a multi-criteria decision analysis to define essential CT parameters for abdominal wall reconstruction : STAMP-C framework for preoperative hernia imaging.","authors":"Fahim Kanani, Narmin Zoabi, Benjamin T Miller, Lucas R A Beffa, Clayton C Petro, Ajita S Prabhu, Guy Lahat, Eran Nizri, Yonatan Lessing, Adam Abu-Abeid, Michael J Rosen, Nir Messer","doi":"10.1007/s10029-026-03706-7","DOIUrl":"https://doi.org/10.1007/s10029-026-03706-7","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive preoperative CT assessment is essential for ventral hernia repair, yet no standardized reporting framework exists. This study evaluated the completeness of preoperative abdominal CT reports and developed an evidence-based protocol to guide standardized reporting for abdominal wall reconstruction (AWR).</p><p><strong>Methods: </strong>We conducted a systematic evaluation of CT reporting completeness in 834 patients who underwent elective transversus abdominis release (TAR) at the Cleveland Clinic Center for Abdominal Core Health between January 2020 and December 2024. A panel of AWR experts defined 16 CT-based parameters deemed essential for surgical planning, and their clinical relevance was validated through a global survey of 61 AWR surgeons. Radiologic reports were assessed for documentation of these parameters and compared with intraoperative findings and registry data from the Abdominal Core Health Quality Collaborative (ACHQC). Parameters were classified as either generalizable or patient specific. A Multi-Criteria Decision Analysis using the Analytic Hierarchy Process was applied to prioritize features for standardized reporting.</p><p><strong>Results: </strong>Overall documentation completeness was limited, with a median of 34.4%. Although surgeons rated defect width as the most critical parameter for operative planning, it was documented in only 32.6% of CT reports. Patient-specific findings demonstrated higher overall reporting rates (median 87.8%), though key features such as mesh presence and anatomical mesh plane were documented in only 36.2% and 1.7% of applicable cases, respectively. Multi-Criteria Decision Analysis identified defect Size, Tanaka index, Anatomical hernia location, presence of prior Mesh, old mesh Plane and Concurrent inguinal or stomal site hernia as the most critical parameters for preoperative evaluation.</p><p><strong>Conclusion: </strong>Substantial gaps exist between CT reporting and the informational needs of AWR surgeons. We propose the \"STAMP-C\" framework as a pragmatic, consensus-driven model to standardize ventral hernia CT assessment and improve multidisciplinary alignment in preoperative planning. Prospective validation of this framework across diverse institutional settings and hernia subtypes is needed before universal adoption can be recommended.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can preoperative optimization improve abdominal wall surgery outcomes? a qualitative systematic review.","authors":"Marina Eguchi, Mariana de Macedo Torves, Caroline Wilmsen, Júlia Duarte, Raquel Nogueira, Valberto Sanha, Leandro Cavazzola, Flavio Malcher, Diego L Lima","doi":"10.1007/s10029-026-03694-8","DOIUrl":"https://doi.org/10.1007/s10029-026-03694-8","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia repair (VHR) is commonly performed in patients with multiple modifiable risk factors. Preoperative rehabilitation programs aim to optimize these risk factors and improve surgical outcomes; however, their implementation and effectiveness remain variable. This systematic review evaluates current evidence on the role of preoperative optimization in patients undergoing VHR.</p><p><strong>Materials and methods: </strong>Cochrane Central, Embase, and PubMed were searched for studies comparing preoperative interventions versus standard care in patients undergoing VHR. The primary outcome was characterization of rehabilitation strategies. Secondary outcomes included surgical utilization, emergent repair, readmission, surgical site infection (SSI), surgical site occurrence (SSO), recurrence, reoperation, and mortality.</p><p><strong>Results: </strong>Six studies were included, comprising a total of 3,556 patients, of whom 1,805 (50.7%) underwent preoperative optimization. Preoperative optimization interventions were highly heterogeneous and primarily consisted of multidisciplinary programs focused on exercise, weight loss, and lifestyle modification. Control groups varied widely, precluding formal meta-analysis. Studies requiring predefined optimization targets reported unsuccessful rehabilitation rates of 5.1%-45%. Emergent repair occurred in 6.8% of intervention patients in one study. SSI rates seemed lower and ranged from 4.2% to 11.8% in intervention groups versus 11.0%-16.7% in controls, SSO and reoperation rates were generally lower in optimization groups.</p><p><strong>Conclusion: </strong>Structured preoperative optimization pathways may be associated with improved short-term outcomes in select patients undergoing VHR. However, the current literature is heterogeneous, and standardized protocols and prospective studies are needed to better define optimal implementation strategies and long-term effectiveness.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incisional hernia and the risk of incident depression: a population-based propensity score-matched cohort study.","authors":"Andreas Krieg, Sarah Krieg, Karel Kostev","doi":"10.1007/s10029-026-03696-6","DOIUrl":"https://doi.org/10.1007/s10029-026-03696-6","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernia is a common long-term complication of abdominal surgery and is traditionally seen as a structural defect. However, recent patient-centered research suggests that abdominal wall pathology may also impose substantial psychological burden. Whether incisional hernia is associated with an increased risk of clinically diagnosed depression at the population level remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the German Disease Analyzer database (IQVIA). Adults with a first documented diagnosis of incisional hernia (ICD-10: K43.0-K43.2) between 2005 and 2024 were identified. Individuals with recent psychiatric disorders were excluded to assess incident depression. Patients were matched 1:1 to controls without hernia using propensity scores based on age, sex, index year, consultation frequency, somatic comorbidities, and remote history of depression. The primary outcome was incident depression (ICD-10: F32, F33) within five years. Associations were analyzed using conditional Cox regression.</p><p><strong>Results: </strong>A total of 10,075 patients with incisional hernia were matched to 10,075 patients without hernia. During five years of follow-up, 18.4% of patients with and 16.5% without incisional hernia were diagnosed with depression. Incisional hernia was associated with a slightly increased risk of incident depression (hazard ratio 1.12; 95% confidence interval 1.04-1.20). The association was more pronounced among women and among individuals without prior depression.</p><p><strong>Conclusion: </strong>Incisional hernia is associated with a slightly increased risk of clinically diagnosed depression. These findings indicate a modest statistical association between incisional hernia and subsequent depression diagnoses in routine care. While the magnitude of the association was small, awareness of potential psychosocial comorbidity may be relevant in selected clinical contexts.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical examination of musculoskeletal groin pain: a simple protocol for hernia surgeons (Groin-MAP).","authors":"Daniel O'Connor, Nazim Bhimani MBiostat, Amanda Turner, Thomas J Hugh","doi":"10.1007/s10029-026-03693-9","DOIUrl":"https://doi.org/10.1007/s10029-026-03693-9","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with groin pain are often referred to hernia surgeons because of imaging-detected inguinal abnormalities, even when no hernia is palpable. Many of these patients have musculoskeletal pathology that would not benefit from surgical intervention. This project aimed to develop a rapid, evidence-informed musculoskeletal screening protocol for use as an adjunct to routine hernia assessment.</p><p><strong>Methods: </strong>The protocol was developed in four phases: (1) Structured PubMed search for clinical examination tests relevant to each of the entities defined by the 2016 Doha agreement classification system; (2) QUADAS-2 appraisal and extraction of individual tests based on reliability, diagnostic accuracy, and prevalence; (3) consultation with a sports physiotherapist and a high-volume hernia surgeon; and (4) protocol synthesis.</p><p><strong>Results: </strong>From seven eligible studies, 79 techniques were considered. Thirteen fulfilled our criteria for diagnostic utility and were refined into a six-item protocol. This was titled the Groin Musculoskeletal Assessment Protocol (Groin-MAP). The Groin-MAP screens for adductor-, pubic-, iliopsoas-, and hip-related groin pain. The protocol prioritises low-intra-abdominal-pressure manoeuvres and can be completed in approximately 100 s during simulated testing.</p><p><strong>Conclusion: </strong>Groin-MAP is a fast and simple musculoskeletal screening adjunct to routine hernia assessment. It requires no equipment or pre-requisite knowledge and clearly explains each test and the positioning of the patient and clinician. Prospective validation will be required to determine its diagnostic performance and impact on clinical decision making.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for postoperative seroma after TEP inguinal hernia repair: a retrospective analysis of 477 patients.","authors":"Ferman Tevfik Ozyalvac, Nurettin Sahin, Turgut Donmez, Ozden Canoz, Muhsine Merve Ozturk, Direnc Ersan Berksel, Alpen Yahya Gumusoglu, Ahmet Surek","doi":"10.1007/s10029-026-03695-7","DOIUrl":"https://doi.org/10.1007/s10029-026-03695-7","url":null,"abstract":"<p><strong>Background: </strong>Postoperative seroma remains one of the most common early complications after laparoscopic inguinal hernia repair. Although total extraperitoneal (TEP) repair is widely used due to favorable outcomes, data on independent predictors of seroma formation are inconsistent, and large single-center analyses with standardized technique are limited.</p><p><strong>Methods: </strong>This retrospective study included 477 adult patients who underwent elective TEP inguinal hernia repair between January 2018 and December 2024 at a tertiary referral center. Seroma was defined as a clinically evident fluid collection within 30 days postoperatively and was confirmed by ultrasonography. Demographic, clinical, and operative variables were evaluated. Variables associated with seroma in univariate analysis were included in multivariate logistic regression.</p><p><strong>Results: </strong>Postoperative seroma developed in 48 patients (10.1%). In the univariate analysis, higher body mass index (BMI), recurrent hernia, bilateral hernia, scrotal hernia, longer operative time, and conversion to open surgery were significantly associated with seroma formation. In the multivariate analysis, scrotal hernia (OR 5.85; 95% CI 2.03-16.85; p = 0.001) and bilateral hernia (OR 1.67; 95% CI 1.09-2.55; p = 0.018) were identified as independent risk factors. Primary hernia was associated with a significantly lower risk of seroma formation (OR 0.342; 95% CI 0.159-0.732; p = 0.006), indicating that recurrent hernia represents an independent risk factor. BMI did not remain significant after adjustment.</p><p><strong>Conclusion: </strong>Seroma formation after TEP repair is mainly driven by anatomical and technical factors. Scrotal hernia, bilateral repair, and recurrent hernia represent high-risk features and should be considered during preoperative risk assessment and perioperative planning.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}