Self-gripping mesh in laparoscopic inguinal hernia repair: A comparative study about surgical time, post-operative pain and recurrence

Introduction: In laparoscopic inguinal hernia repair (LIHR), fixation means for meshes (FMMs) are commonly used to reduce hernia recurrence risk. Their use may result in post-operative pain (PP) and may even increase surgical time (ST). Recently, self-gripping meshes (SGMs) have been developed, which leave aside fixation devices; they could potentially reduce PP and even decrease ST. Our primary outcome was to compare ST, PP and recurrence rates in LIHR using SGM versus FMM.

Patients and methods: A comparative retrospective study with prospective case registry was conducted. All patients who underwent LIHR with transabdominal pre-peritoneal approach from January to December 2022 in a high-volume centre were analysed. Patients were divided into two groups according to the type of mesh used in surgery (SGM vs. FMM). Demographic variables, hernia type and size, mesh type and size, ST, PP, recurrence and other morbidities were compared between the groups.

Results: A total of 411 LIHRs were performed during the period, of which 283 were included in the study. Of these, 234 patients were repaired with FMM and 49 with SGM. ST had a statistically significant reduction in the SGM group (P = 0.0004) with a mean time of 58.9 min (±13.6), compared to 68.1 min (±18.9) for the FMM group. A trend towards lower PP in the SGM group was noted (P = 0.08). No recurrences were found in the SGM group with a median follow-up of 18 months (interquartile range: 3).

Conclusions: SGMs have proven to be a safe, efficient and fast for LIHR in our series. They are a feasible alternative for LIHR, reducing ST and potentially reducing PP. Prospective randomised trials are needed to confirm this trend, along with a longer follow-up period to determine potential advantages in terms of recurrences.