TAPP surgery for inguinal hernia

Laparoscopic TAPP is my preferred method for repairing inguinal hernias. Through small access points, I can assess the groin region from the inside and reinforce it with a sufficiently large mesh. Hernias on both sides can also be treated through the same access points in a single operation.

Appointments for both practices: +43 1 40180 7010 · Surgery dates and medical questions: +43 680 330 11 45

What does TAPP mean?

TAPP stands for transabdominal preperitoneal repair. The groin region is accessed through the abdominal cavity. The mesh is then placed between the peritoneum and the abdominal wall. The peritoneum is then closed again over the mesh, so that the mesh is separated from the abdominal contents.

How does TAPP surgery work?

The operation is performed under general anaesthesia. I insert a camera through a small access at the upper edge of the navel. Two further access points, each about 8–10 mm in size, about 10 cm to the side of the navel on each side, allow me to work with fine instruments. Carbon dioxide temporarily creates the necessary working space.

After opening the peritoneum, I carefully expose the affected groin region and push the hernia contents back. I then place a sufficiently large mesh that covers the hernia site and the other potential weak spots of the groin region over a large area.

Whereas in the past the mesh was often fixed with tissue-penetrating tackers that could cause pain, I use a medical tissue adhesive for gentle mesh fixation.

Finally, I close the peritoneum over the mesh. This prevents the mesh from coming into direct contact with the intestine or other internal organs. The mesh then grows into the surrounding tissue of the abdominal wall.

The skin incisions are then closed with sutures and covered with shower-proof dressings.

What are the benefits of TAPP surgery?

Good overview and large-area reinforcement

The view from the inside allows me to assess the entire groin region precisely. The mesh not only covers the existing hernia site but also reinforces the adjacent potential weak spots.

Repairing both groins through the same access points

With a hernia on both sides, both sides can be treated in the same operation. No additional skin incisions are needed for this.

Small access points and quick recovery

The small access points allow a quick recovery in many patients. Walking and light everyday activity are usually possible – and indeed desirable – just a few hours after the operation.

Better long-term results

Statistically, patients operated on with the TAPP method have chronic groin pain significantly less often than after open surgery with mesh.

Also possible for a recurrent inguinal hernia

After previous open inguinal hernia surgery, TAPP can be particularly useful because access is from the other side of the abdominal wall and therefore often through less scarred tissue.

Even after previous TAPP surgery, a further repair using TAPP is usually possible. For planning, the current findings and the previous surgical report are particularly helpful.

What are the risks?

When the operation is performed carefully and with the appropriate expertise, serious complications are very rare. Minor bruising, fluid collections in the area of the former hernia sac and temporary swelling of the lower abdomen are among the possible, usually harmless side effects of the operation and generally subside by themselves.

Rarely, injuries to blood vessels, nerves or internal organs are possible. In addition, there are the general risks of surgery and general anaesthesia. Discomfort or pain can persist for longer; a recurrence is also possible. I inform you personally about your individual risks and the ways to reduce them before the operation.

After TAPP surgery

Many patients can leave the hospital on the day of surgery or the following day. We adjust the time of discharge to how you feel and the course of the operation.

In the first few days, mild wound pain in the area of the incisions or puncture sites as well as a pulling sensation or feeling of tension in the groin area may occur. You receive pain management tailored to your needs.

Before discharge, you receive detailed advice on wound care, showering and handling the dressings. When you can return to work or sport depends on your occupation, your constitution and the size of the hernia. Together we discuss gradually increasing your physical activity.

At the follow-up check, I check the wounds, remove the skin sutures and am available for further questions. Even after the treatment has been completed, I remain available for your questions.

Further information on aftercare →

Frequently asked questions about TAPP surgery

Does the mesh have to be removed later?

No. The mesh is intended to remain in place permanently and grows into the surrounding tissue. Routine removal is not necessary.

Can I feel the mesh after the operation?

The mesh lies deep between the peritoneum and the abdominal wall and normally cannot be felt from the outside. During the healing phase, a pulling sensation or feeling of tension may occur; this does not mean that you are feeling the mesh itself.

Is TAPP possible after previous abdominal operations?

Yes, this is often possible. A previous abdominal operation does not rule out TAPP in principle. The decisive factors are the type and extent of the previous operation and any adhesions. Existing surgical reports help me with planning.

Is a surgical robot required for TAPP?

No. Laparoscopic TAPP can be performed without a robot for most inguinal hernias. In my view, robotic assistance often offers no decisive additional benefit here. For selected complex findings, it can be useful.

Information on treatment by Priv. Doz. Dr. Emanuel Sporn – specialist in surgery, visceral surgery and vascular surgery, specialist in hernia surgery in Vienna.