Mesh Fixation Strategy and Recovery Trajectories after Unilateral Totally Extraperitoneal Inguinal Hernia Repair: A...

Area of Science:

• Minimally invasive surgery
• Surgical innovation
• Hernia repair outcomes

Background:

• Mesh fixation is a key factor in postoperative recovery after totally extraperitoneal (TEP) inguinal hernia repair.
• Self-fixating meshes aim to reduce pain by avoiding penetrating fixation, but their impact on recovery is not fully understood.

Purpose of the Study:

• To compare the recovery trajectories of self-fixating mesh versus traditional polypropylene mesh with tacks in TEP inguinal hernia repair.
• To evaluate the influence of mesh fixation strategy on early and short-term multidimensional recovery.

Main Methods:

• Retrospective cohort study of 134 adult patients undergoing unilateral TEP repair.
• Comparison of self-fixating mesh versus polypropylene mesh with absorbable tacks.
• Assessment of recovery using Quality of Recovery-15 (QoR-15) and visual analog scale (VAS) pain scores at multiple time points.

Main Results:

• Early recovery (postoperative week 1) was similar between fixation groups.
• Both groups showed significant recovery improvement over time, with no overall difference attributed to fixation strategy.
• Self-fixating mesh showed higher QoR-15 scores in larger defects (≥20 mm) and slightly lower pain scores.

Conclusions:

• Mesh fixation strategy has a limited impact on overall early and short-term recovery in unilateral TEP repair.
• Self-fixating mesh may offer modest recovery advantages for larger inguinal hernia defects (≥20 mm).
• The effect of mesh fixation strategy appears context-dependent, particularly concerning defect size.