To investigate the conversion to open surgery and related risk factors in patients with incarcerated inguinal hernia undergoing laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) hernioplasty.

A total of 101 patients with incarcerated inguinal hernia who were hospitalized in the Department of Hernia and Abdominal Wall Surgery, Huadu District People's Hospital of Guangzhou from January 1, 2020 to December 30, 2024 were selected. Among them, 79 patients underwent complete TAPP surgery and 22 patients were in the laparoscopic conversion to open surgery group. Clinical data of the two groups were analyzed to explore the status of conversion to open surgery in TAPP for incarcerated inguinal hernia. Univariate and multivariate analyses were used to identify relevant risk factors for conversion to open surgery, and a predictive model was established accordingly.

The conversion to open surgery in TAPP for incarcerated inguinal hernia was correlated with gender, smoking history, onset time of hernia, hernia ring diameter, peritoneal effusion, C-reactive protein (CRP), intestinal obstruction, and hernia size. Binary multivariate logistic regression analysis revealed that CRP (OR=1.43, 95% CI 1.18-1.72) and peritoneal effusion (OR=1.24, 95% CI 1.01-3.18) were independent risk factors for conversion to open surgery in patients with incarcerated inguinal hernia undergoing TAPP. The predictive model established based on these risk factors showed good consistency with actual observation results after 500 model validations, indicating statistical significance.

Conversion to open surgery in incarcerated inguinal hernia is correlated with gender, smoking history, onset time of hernia, hernia ring diameter, peritoneal effusion, CRP, intestinal obstruction, and hernia size. Early surgical treatment is recommended for incarcerated inguinal hernia. When a patient's CRP level exceeds 11.85 mg/L, or when peritoneal effusion is present, preparations for open surgery should be made in advance.