ArticleHernia : the journal of hernias and abdominal wall surgery2026
Association between umbilicus-symphysis pubis distance and operative time in transabdominal preperitoneal (TAPP) inguinal hernia repair.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe transabdominal preperitoneal (TAPP) approach is a widely used minimally invasive technique for laparoscopic inguinal hernia repair. However, operative time and technical difficulty may vary depending on patient-related anatomical factors. This study evaluated the effect of the umbilicus–symphysis pubis (USP) distance on operative time and investigated whether this superficial anatomical measurement could guide patient selection.
methodsIn this retrospective study, data from 767 patients who underwent TAPP repair at Gazi University Hospital between January 2015 and June 2022 were reviewed. After applying the exclusion criteria, 341 male patients were included. Of these, 272 had unilateral and 69 had bilateral inguinal hernia. The distance between the umbilicus and symphysis pubis was measured preoperatively in all patients. The relationship between USP distance and operative time was analyzed using the Python-based Maximally Selected Rank Statistics (MaxStat) method, and optimal cut-off values were determined.
resultsThe age range of the study group was 18.00–77.00 years, with a median age of 44.00 years. The USP distance ranged from 9.70 to 23.50 cm in unilateral cases and from 11.10 to 22.30 cm in bilateral cases. MaxStat analysis identified optimal cut-off values of 15 cm for unilateral and 16 cm for bilateral hernia cases. In unilateral cases, operative time was significantly longer in patients with a USP distance ≤ 15 cm (p < 0.001). Similarly, in bilateral cases, operative times were significantly longer when the USP distance was ≤ 16 cm (p < 0.001).
conclusionUSP distance may serve as a simple and easily measurable anatomical parameter associated with surgical duration, particularly in unilateral TAPP repairs. As patients with a shorter USP distance were associated with longer operative times, this association warrants further prospective validation before USP distance can be considered a routine parameter in preoperative planning.
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