Watchful waiting versus totally extraperitoneal (TEP) hernia repair for occult inguinal hernia and pain (EFFECT trial)—a multicenter, non-inferiority, randomized controlled trial

This trial failed to demonstrate non-inferiority of WW compared to TEP repair for pain relief at 3 months post-intervention in patients with groin pain and an occult inguinal hernia. However, this result does not confirm that WW is inferior, as secondary outcomes were comparable up to 3 months and upfront TEP repair carried a risk of overtreatment. Therefore, a WW strategy for at least 3 months may be justified as a diagnostic tool to determine which patients may benefit from surgery.