ReviewOpen preperitoneal groin hernia repair with mesh: A qualitative systematic review

•There seem to be a benefit of placing the mesh for groin hernia repair in the preperitoneal plane.•Nine different methods were identified through systematic search and screening of the literature.•This review provides an overview of open preperitoneal techniques, along with available evidence and technical descriptions.•Placement of a mesh through an open approach is promising compared with the standard anterior techniques.

BackgroundFor the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique.Data sourcesA systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh technique.ConclusionsA total of 67 articles were included, describing nine different methods: Kugel, TREPP, TIPP, Onstep, Horton/Florence, Nyhus, Ugahary, Read, and Stoppa. In general, results regarding pain, recurrences and complications seem promising. It was not possible to conduct a meta-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes.