Application of cephalad approach laparoscopic transabdominal preperitoneal mesh repair in mid-lower abdominal incisional hernias

Abdominal incisional hernia is a common complication following abdominal surgery. With disease progression, it can severely compromise patients’ quality of life and even threaten their lives, Among these, the surgical treatment of large incisional hernias remains both challenging and uncertain. As a standard surgical procedure for inguinal hernia, transabdominal preperitoneal (TAPP) repair has been adopted worldwide and achieved satisfactory results. Based on this experience, we applied the TAPP procedure to small- and medium-sized incisional hernias in the middle and lower abdomen and achieved promising outcomes. A retrospective statistical analysis was conducted on all patients with median incisional hernias treated with TAPP repair between January 2022 and December 2024. Demographic data, hernia classification, operation time, postoperative complications (such as seroma, hematoma, and incision site infection), readmission rate, and recurrence rate were analyzed. A total of 75 patients with incisional hernias underwent TAPP surgery. The operative time ranged from 92 to 141 min, with an average of 112.5 min. The visual analog scale score ranged from 2 to 5 points, with an average of 3.3 points. The postoperative hospital stay ranged from 2 to 4 days, averaging 2.7 days. Seromas occurred in eight patients but had no adverse effect on the final outcome; all cases resolved spontaneously during the 2-month follow-up. No hematoma, incision site infection, or chronic pain was reported. None of the patients required readmission within a short period, and no recurrence was observed during 4–30 months of follow-up. Cephalad approach TAPP repair is a safe and effective technique for the treatment of small- and medium-sized incisional hernias in the lower abdomen and warrants further investigation.