Incidence of chronic pain after single stitch mesh fixation in open inguinal hernia repair: An observational prospective study, a case series

Abstract Aim Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to identify predictors of low Quality of Life (QoL) after open inguinal hernia repair, to guide practice and inform patients at high risk. Material and Methods Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results 893 patients were included from 33 hospitals. The majority were men (89.9% [800/891]), had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair (52.9% [472/893]). The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3 months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). Conclusions This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

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Patient-reported chronic pain after open inguinal hernia repair with lightweight or heavyweight mesh: a prospective, patient-reported outcomes study

British Journal of Surgery ◽

10.1002/bjs.11755 ◽

2020 ◽

Author(s):

M. Melkemichel ◽

S. Bringman ◽

H. Nilsson ◽

B. Widhe

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Patient Reported Outcomes ◽

Patient Reported ◽

Heavyweight Mesh ◽

Open Inguinal Hernia Repair ◽

Outcomes Study

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Fibrin Glue Mesh Fixation (GMF) Vs Sutures Mesh Fixation (SMF) In Human Open Inguinal Hernia Repair (OIHR): Surgically and Histologically

International Journal of Surgery and Research ◽

10.19070/2379-156x-1700016 ◽

2017 ◽

pp. 75-81

Author(s):

Ghonimi WAM ◽

◽

Elhorbity MA ◽

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Fibrin Glue ◽

Mesh Fixation ◽

Open Inguinal Hernia Repair

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Mesh fixation techniques for inguinal hernia repair: an overview of systematic reviews of randomised controlled trials

Hernia ◽

10.1007/s10029-021-02546-x ◽

2021 ◽

Author(s):

A. Alabi ◽

N. Haladu ◽

N. W. Scott ◽

M. Imamura ◽

I. Ahmed ◽

...

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Systematic Reviews ◽

Randomised Controlled Trials ◽

Mesh Fixation ◽

Controlled Trials ◽

Fixation Techniques ◽

Randomised Controlled

Abstract Purpose Inguinal hernia repair using surgical mesh is a very common surgical operation. Currently, there is no consensus on the best technique for mesh fixation. We conducted an overview of existing systematic reviews (SRs) of randomised controlled trials to compare the risk of chronic pain and recurrence following open and laparoscopic inguinal hernia repairs using various mesh fixation techniques. Methods We searched major electronic databases in April 2020 and assessed the methodological quality of identified reviews using the AMSTAR-2 tool. Results We identified 20 SRs of variable quality assessing suture, self-gripping, glue, and mechanical fixation. Across reviews, the risk of chronic pain after open mesh repair was lower with glue fixation than with suture and comparable between self-gripping and suture. Incidence of chronic pain was lower with glue fixation than with mechanical fixation in laparoscopic repairs. There were no significant differences in recurrence rates between fixation techniques in open and laparoscopic mesh repairs, although fewer recurrences were reported with suture. Many reviews reported wide confidence intervals around summary estimates. Despite no clear evidence of differences among techniques, two network meta-analyses (one assessing open repairs and one laparoscopic repairs) ranked glue fixation as the best treatment for reducing pain and suture for reducing the risk of recurrence. Conclusion Glue fixation may be effective in reducing the incidence of chronic pain without increasing the risk of recurrence. Future research should consider both the effectiveness and cost-effectiveness of fixation techniques alongside the type of mesh and the size and location of the hernia defect.

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Light vs heavy weight mesh in Lichtenstein’s open inguinal hernia repair: A prospective study

International Journal of Surgery Science ◽

10.33545/surgery.2019.v3.i1a.05 ◽

2019 ◽

Vol 3 (1) ◽

pp. 12-15

Author(s):

Dr. Srinivas N. M ◽

Dr. Karan K Shetty

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Prospective Study ◽

Inguinal Hernia Repair ◽

Heavy Weight ◽

Open Inguinal Hernia Repair ◽

A Prospective Study

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Mesh Fixation versus Non Fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair

QJM ◽

10.1093/qjmed/hcaa050.027 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A B Lachin ◽

A A Abdrabbu ◽

A A F Darwish ◽

M M K Ali

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Mesh Fixation ◽

Operation Time ◽

Fixation Group ◽

Transabdominal Preperitoneal ◽

Transabdominal Preperitoneal Inguinal Hernia

Abstract Background inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Several studies have shown that laparoscopic repair offers the advantage of minimally invasive surgery to the patient. The mesh can be placed without fixation or can be fixed into place with tuckers. Aim of the Work this study aimed to compare mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia, as regards the operation time, hospitalization, postoperative complication, recurrence and chronic pain. Patients and Methods sixty adult males with inguinal hernia were repaired with laparoscopic transabdominal preperitoneal inguinal hernia repair, divided into; mesh fixation group (n = 35) versus non-fixation group (n = 25), and certain parameters were assessed during the operative, postoperative and follow-up periods. Results mean operation time and mean hospital stay time were significantly higher in mesh fixation group than non-fixation group. VAS scores 2days, 3months, and 6months postoperative were less for non-fixation group. Non-significant difference was found between both groups regarding intraoperative injury, hernia recurrence, wound seroma, mesh infection, chronic pain, return to physical activity. Conclusion TAPP inguinal hernioplasty without mesh fixation does not increase recurrence rate, but reduces operative duration, hospital stay duration and decreases the incidence of postoperative pain.

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