Postoperative Pain and Recurrence after Mesh Fixation with Absorbable versus Non-Absorbable Tacks in Patients undergoing Laparoscopic Transabdominal Inguinal Hernia Repair: A Comparative Study

Hany, Dina; Gamal, Mohamed

doi:10.21608/asjs.2018.178205

Cited by 1 publication

(2 citation statements)

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“…This was evaluated in 2018 by Hany et al . [ 16 ] in an RCT of 30 patients undergoing TAPP repair. At six months and at 1 year, there was no statistically significant difference in the pain scores between patients with permanent versus absorbable fixation.…”

Section: Discussionmentioning

confidence: 99%

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The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair

Woo,

Ellis,

Maskal

et al. 2024

Surg Endosc

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Introduction Fixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up. Methods This is a post hoc analysis of a randomized controlled trial in patients undergoing laparoscopic inguinal hernia repair (NCT03835351). All patients were contacted at maximum follow-up after surgery to administer EuraHS quality of life (QoL) surveys. The pain and restriction of activity subdomains of the survey were utilized. The primary outcome was rate of CGP, as defined by a EuraHS QoL pain domain score ≥ 4 measured at ≥ 1 year postoperatively. The secondary outcomes were pain and restriction of activity domain scores and hernia recurrence at maximum follow-up. Results A total of 338 patients were contacted at a mean follow-up of 28 ± 11 months. 181 patients received permanent tacks and 157 patients received absorbable tacks during their repair. At maximum follow-up, the rates of CGP (27 [15%] vs 28 [18%], P = 0.47), average pain scores (1.78 ± 4.38 vs 2.32 ± 5.40, P = 0.22), restriction of activity scores (1.39 ± 4.32 vs 2.48 ± 7.45, P = 0.18), and the number of patients who reported an inguinal bulge (18 [9.9%] vs 15 [9.5%], P = 0.9) were similar between patients with permanent versus absorbable tacks. On multivariable analysis, there was no significant difference in the odds of CGP between the two groups (OR 1.23, 95% CI [0.60, 2.50]). Conclusion Mesh fixation with permanent tacks does not appear to increase the risk of CGP after laparoscopic inguinal hernia repair when compared to fixation with absorbable tacks. Prospective trials are needed to further evaluate this relationship.

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Section: Discussionmentioning

confidence: 99%

“…The effect of permanent versus absorbable fixation on chronic post-herniorrhaphy groin pain after inguinal hernia repair has been assessed in only a handful of studies with small patient cohorts [ 16 , 17 ]. Comparatively, it has been evaluated in more studies in incisional or ventral hernias.…”

mentioning

confidence: 99%