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Background and objective: Laparoscopic transabdominal preperitoneal (TAPP) repair for midline hernias offers advantages such as reduced postoperative pain, faster recovery, improved cosmetic outcomes, preservation of abdominal wall anatomy, and the ability to identify occult hernias. Preperitoneal mesh placement avoids direct contact with the intestines and may reduce adhesions. Although robotic TAPP is increasingly used, limited availability and higher costs may restrict its use for small- to mid-size hernias. This study evaluates the outcomes of laparoscopic midline TAPP repairs performed by a single surgeon at a tertiary centre.

Method: All patients undergoing laparoscopic TAPP repair for midline hernias between October 2022 and February 2026 were prospectively recorded. Patient demographics, hernia characteristics, perioperative details, and postoperative outcomes were analysed.

Result: 35 patients were included (18 male, 17 female), with a median age of 51 years. The mean hernia defect size was 2.3 cm (range 0.8–4.5 cm). Conversion to open surgery was required in 2 cases (5.7%). Median operative time was 112 minutes, and median postoperative hospital stay was 24 hours. Postoperative complications included one hematoma and one seroma (2.8% each), both managed conservatively. In one converted case, mesh explantation was necessary due to mesh infection. After a mean follow-up of 15.4 months, no hernia recurrences were observed.

Summary: Laparoscopic TAPP allows preservation of the abdominal wall and safe extraperitoneal mesh placement, making it an effective option for small- to mid-size ventral hernia repair. When performed by experienced surgeons, TAPP can be applied safely with low complication rates and excellent short- to mid-term outcomes.