ABSTRACT Purpose The secure tacking against recurrence (STAR) technique is a modification of preperitoneal (TAPP) repair that allows tack fixation within the trapezoid of disaster while avoiding critical structures. This study aimed to evaluate whether the STAR technique reduces recurrence after TAPP repair. Methods We conducted a retrospective analysis of consecutive patients who underwent TAPP repair at our institution between 2015 and 2024. Patients were divided into two groups according to the fixation technique used: the STAR group (425 patients; 513 hernias) and the conventional group (615 patients; 756 hernias). Recurrence was defined as the primary endpoint, while postoperative pain and other complications were also reviewed. Results A total of 1040 patients (1269 hernias) were analyzed. Recurrence was observed in 3 hernias (0.58%) in the STAR group and 6 hernias (0.79%) in the conventional group, with no significant difference ( p = 0.925). Early postoperative pain occurred less frequently in the STAR group, while no severe neuropathic pain or chronic pain requiring intervention was identified in either group. Conclusion This retrospective analysis showed no evidence that the STAR technique reduces recurrence after TAPP repair, indicating no clear preventive advantage over the conventional method.
Bessho et al. (Thu,) studied this question.