Clinical Consensus on the Role of Self-Fixating Mesh in Laparoscopic Inguinal Hernia Repair

The global burden of inguinal hernia (IH) has significantly increased. Mesh with self-fixating technology helps provide superior tissue integration, reducing the need for additional fixation compared to conventional mesh. Benefits include shorter operative time, reduced hospital stay, lower recurrence rates, and improved quality of life. However, variability remains in its adoption and application. To address this, a panel of Asian hernia experts convened to develop a consensus and formulate recommendations on self-fixating mesh (SFM) use in IH repair.

A panel of 13 hernia experts participated in the consensus discussion and manuscript development. A comprehensive literature review was conducted using PubMed, Embase, and Google Scholar to identify relevant articles and formulate statements. Consensus was assessed using a modified three-step Delphi method, with an acceptance level of > 80%.

In phase 1 of consensus development, 11 statements were reviewed, with 9 reaching consensus and 1 facing disagreement. Five additional statements were introduced based on expert input. Phase 2 reviewed all 16 statements, with one failing to reach consensus. In phase 3, an online reassessment of the revised version of the failed statement in the previous round was conducted via Microsoft Forms, leading to consensus on all 16 statements.

SFM offers significant advantages over conventional sutured meshes in IH repair. However, further research and multicenter trials are recommended to refine surgical protocols. Based on expert recommendations, SFM may be preferred in IH repair, and structured training can enhance its adoption, improving patient outcomes.