Comparison of post-operative pain in laparoscopic extended-view total extraperitoneal inguinal hernioplasty using self-gripping mesh versus polypropylene mesh fixed with absorbable tackers - A parallel-arm, double-blinded randomised control trial.

Abstract

<h4>Introduction</h4>To compare short- and mid-term outcomes in patients undergoing laparoscopic extended-view totally extraperitoneal (eTEP) inguinal hernia repair using either self-gripping mesh or polypropylene mesh with absorbable tackers.<h4>Patients and methods</h4>A prospective, parallel-arm, double-blinded randomised controlled trial was conducted at a tertiary care centre between April 2023 and July 2024. Adults with primary unilateral uncomplicated inguinal hernias were randomly assigned to receive self-gripping or polypropylene mesh with tackers. Pain was assessed using the Visual Analogue Scale (VAS) at 12 h and on post-operative days 1, 2, 7, 30 and at 3 months. The secondary outcomes included short-term complications, chronic pain, recurrence and quality of life (QoL) using the HerQLes questionnaire. Data were analysed using t-tests or Mann-Whitney U-test for the continuous variables and Chi-square or Fisher's exact tests for the categorical variables. P < 0.05 was considered statistically significant.<h4>Results</h4>Sixty-two patients were randomised equally. The mean VAS score at 12 h was 4.68 ± 0.94 in the polypropylene mesh group versus 4.58 ± 0.92 in the self-gripping mesh group (P = 0.657). No statistically significant difference in pain was observed at any assessed time point. Chronic pain at 3 months was negligible (mean VAS <1), and no recurrences were detected. Short-term complications and quality-of-life scores (HerQLes) were comparable between the two groups.<h4>Conclusions</h4>Laparoscopic eTEP hernia repair with either self-gripping mesh or polypropylene mesh fixed with absorbable tackers yields similar short- and mid-term outcomes regarding post-operative pain, complications, recurrence and QoL. Both techniques are safe and effective for primary unilateral inguinal hernia repair.