Is the self-adhesive mesh a solution for chronic postoperative inguinal pain after TAPP: A single centre preliminary experience?

Abstract

Background: Minimally invasive surgery for groin hernia has expanded significantly over the last two decades and has demonstrated better outcomes in terms of pain and quality of life. A major contributing factor related to chronic post-operative inguinal pain (CPIP) is mesh fixation. An alternative to the standard fixation methods is the self-adhesive surgical mesh. Patients and Methods: Prospective data analysis was performed of all patients undergoing laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair in a single centre for the period 1st January, 2022–15th December, 2022. A standardised surgical technique was used with a lightweight self-adhesive mesh without additional fixation. The analysis has encompassed early and late post-operative complications as well as the assessment of pain with an emphasis on CPIP. Results: The study enrolled 52 patients where a total number of 64 elective hernia repairs were performed: 92.2% (n = 59) primary and 7.8% (n = 5) recurrent. Fifty-one patients received post-operative follow-up: 100% at 1 month and 78.8% (n = 41) at 3 months. The incidence of early postoperative complications was 7.7% (n = 4): one patient developed a seroma, two patients – port site hematomas and one a transient subileus that were all managed conservatively. No patients suffered a recurrence. The average pain score according to the Visual Analogue Scale was 3.3 (0–8) at discharge, 0.6 (0–4) at 1 month and there was no incidence of CPIP after the 3rd month. Conclusion: Laparoscopic TAPP repair for inguinal hernia with a self-adhesive mesh is an adequate surgical technique with the potential to reduce CPIP, but more research is needed to evaluate this method.

Keywords

• chronic post-operative inguinal pain
• laparoscopic hernia surgery
• self-adhesive mesh
• transabdominal pre-peritoneal repair