Chronic pain after complete extraperitoneal inguinal hernia repair: a randomised controlled trial comparing glue and absorbable tackers

Aim: After having an inguinal hernia fixed, approximately 20% of people endure chronic pain. The underlying mechanism most likely involves sensory nerve damage and abnormal recovery, which may be influenced by the materials employed to secure the mesh. The major purpose of this study was to look at the impact of glue and absorbable tackers on the occurrence of residual discomfort after surgery in people who had Totally Extra Peritoneal inguinal hernia repair (TEP).

Methods: Patients having (TEP) inguinal hernia surgery were randomly assigned to either absorbable tackers (hold STRAP Johnson & Johnson) or glue to hold the mesh (LIQUIBAND secure 8 Neopharm) in a single-blind clinical trial. A validated 4-point verbal-rank scale with the categories "none," "mild," "moderate," and "severe" was used to score pain at one week, one month, six months, and a year after surgery. Chronic painful hernial location that persists for more than 6 months.

Results: 218 patients were subjected to analyses. The groups differed just slightly in terms of age, gender, and hernia side. After 6 months, 31.7% (66/208) and 13% (29/208) of those who reported chronic pain of any intensity continued to do so, respectively. There were no different changes between the both categories in post surgery pain with the two methods ,  only patients suffering with significant discomfort , glue-using was still less uncomfortable than tacker-based fixation (log-rank p = 0.025). After a year, four symptomatic recurrence hernias were detected in individuals whose mesh was patched with absorbable tackers.

Conclusions: Patients who had mesh put into place for TEP inguinal hernia surgery reported less pain.

 

Keywords: Inguinal Hernia; Chronic Pain; Endoscopic Hernia Repair