O15 LESS PAIN AFTER TACK FIXATION OF MESH THAN WITH SELF-GRIPPING MESH FOLLOWING LAPAROSCOPIC INGUINAL HERNIA REPAIR: A RANDOMIZED CLINICAL TRIAL

Abstract

Aim: Acute pain following transabdominal preperitoneal inguinal hernia repair (TAPP) may be attributed to mesh fixation. The aim of the present study was to determine short and long‐term complications following laparoscopic TAPP repair using either a self‐gripping mesh or a tacked mesh. Material and Methods: Healthy male subjects referred for unilateral inguinal hernia repair were randomized to a TAPP procedure using either a tacked mesh (Parietix, Medtronic; AbsorbaTack, Medtronic) or a self‐gripping mesh (ProGrip™, Medtronic). Acute postoperative pain and short and long‐term complications were recorded using an e‐mail generated questionnaire preoperatively and at days 1 and 7 and at 1, 3, 6 and 12 months postoperatively. Acute pain was assessed using the visual analogue scale (VAS). Results: A total of 333 male subjects underwent elective repair of a medial (n=107, 32%) or a lateral (n=226, 68%) inguinal hernia. Patients were randomized to either a tacked (T=178) or non‐tacked procedure (N=155). Mean follow‐up time was 141 days. Mean number of tacks applied was 2.7 per operation. Mean preoperative VAS score was 2.21 (T) vs 1.78 (N) (P=0.06). Postoperatively, the mean VAS‐score (average within the observation period) was 2.80 (T) vs 3.12 (N) (P<0.01), resulting in a 10% lower VAS‐score following the tacked repair compared to the self‐gripping mesh (P<0.01). Patient‐reported signs of recurrence at 12 months was 4.7% (T) vs 7.5% (N) (P=0.35). Conclusions: Postoperative acute pain after laparoscopic inguinal hernia repair is lower following a tacked than a non‐tacked (self‐adhesive mesh) procedure. Patient‐reported recurrence did not differ between groups.