What question did this study set out to answer?

This trial aimed to assess early postoperative pain and quality of life associated with three mesh fixation techniques in laparoscopic TAPP hernia repair.

June 11, 2026Open Access

Early postoperative pain and quality of life with different modalities of mesh fixation in laparoscopic trans-abdominal pre-peritoneal repair of inguinal hernia: a randomized controlled trial

Key Points

This trial aimed to assess early postoperative pain and quality of life associated with three mesh fixation techniques in laparoscopic TAPP hernia repair.
Single-center, prospective, randomized controlled trial
75 adult patients randomized to glue, suture, or tack fixation groups
Primary outcomes included pain intensity (VAS) and quality of life (CCS) assessed at multiple postoperative intervals.
Tack fixation group had significantly higher pain levels on postoperative day 1 and at one month (P < 0.001).
Glue fixation resulted in lower mesh sensation and better CCS scores at all time points compared to sutures and tacks (P < 0.001).
All groups had comparable low VAS scores by the 3rd and 6th months with no significant differences.

Abstract

Compared with open inguinal hernia repair, laparoscopic approaches, including Transabdominal Preperitoneal (TAPP) and Totally Extraperitoneal (TEP), improve recovery and reduce pain. However, optimal mesh fixation remains unclear due to limited high-quality comparative evidence. We aimed to evaluate early postoperative pain and quality of life with different mesh fixation modalities (glue, tacks, and sutures) in laparoscopic TAPP inguinal hernia repair. A single-center, prospective, randomized controlled trial was conducted on 75 eligible adult patients with primary inguinal hernia scheduled for elective TAPP repair. Patients were randomized in a 1:1:1 ratio to glue ( n = 25), suture ( n = 25), or tack ( n = 25) fixation. Primary outcomes were postoperative pain intensity (visual analogue scale, VAS) and hernia-specific quality of life (Carolinas Comfort Scale, CCS) assessed at postoperative day 1 1, 3, and 6 months. Secondary outcomes included operative time, length of hospital stay, time to return to work, complications, recurrence, and procedural cost. Compared with the glue and suture fixation groups, the tack fixation group had substantially higher pain levels on the first day after the operation and at one month ( P < 0.001). Over the 3rd and 6th months, VAS scores were low and comparable across all groups, with no significant differences. The glue group had significantly lower mesh sensation and total CCS scores at all time points compared to the suture and tack groups ( P < 0.001). In the early postoperative period following laparoscopic TAPP inguinal hernia repair, mesh fixation with surgical glue results in superior pain control, better quality of life, and faster return to work compared to sutures and tacks, without increasing early complication rates. ClinicalTrials.gov Identifier: NCT07401082 (Registered February 6, 2026; retrospectively registered after completion of enrollment).

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Cite This Study

Aziz et al. (Tue,) studied this question.

synapsesocial.com/papers/6a2a51d780c8f91e7f39e069 https://doi.org/https://doi.org/10.1186/s12893-026-03801-7

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