Meta-analysis of randomized trials comparing nonpenetrating vs mechanical mesh fixation in laparoscopic inguinal hernia repair

American Journal of Surgery
Stavros A AntoniouFrank-Alexander Granderath

Abstract

Evidence for open groin hernia repair demonstrates less pain with bioglue mesh fixation compared with invasive methods. This study aimed to assess the short- and long-term effects of laparoscopic groin hernia repair with noninvasive and invasive mesh fixation. A systematic review of MEDLINE, CENTRAL, and OpenGrey was undertaken. Randomized trials assessing the outcome of laparoscopic groin hernia repair with invasive and noninvasive fixation methods were considered for data synthesis. Nine trials encompassing 1,454 patients subjected to laparoscopic hernia repair with mesh fixation using biologic or biosynthetic glue were identified. Short-term data were inadequate for data synthesis. Chronic pain was less frequently reported by patients subjected to repair with biologic glue fixation than with penetrating methods (odds ratio .46, 95% confidence interval .22 to .93). Duration of surgery, incidence of seroma/hematoma, morbidity, and recurrence were similar. Laparoscopic groin hernia repair with bioglue mesh fixation was associated with a reduced incidence of chronic pain compared with mechanical fixation, without increasing morbidity or recurrence. Longer term data on recurrence are necessary.

Citations

Nov 28, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·Kelli TavaresChristopher Yheulon
Apr 13, 2017·Innovative Surgical Sciences·Henning Niebuhr, Ferdinand Köckerling
Jun 6, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·G KöhlerA Szyszkowitz
Jul 22, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·R N VillalobosJ J Olsina
Jan 22, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S TishA Prabhu
Jul 24, 2020·Journal of Surgical Case Reports·René Gordon Holzheimer, Nikolai Gaschütz
May 11, 2020·Cirugía española·Raúl Medina VelázquezMaría José Luque García
Jun 17, 2021·Scientific Reports·Felipe GirónRicardo Nassar
Sep 24, 2021·ANZ Journal of Surgery·James O'BrienRichard Turner

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