Conference Coverage

Mesh fixation method had no impact on chronic postop pain in TAPP


 

– Mesh fixation technique is not a factor in persistent pain after transabdominal preperitoneal (TAPP) groin hernia surgery, a study showed.

“Persistent pain is a well-known phenomenon after groin hernia surgery,” said Jakob Burcharth, MD, of University Hospital of Sjaelland Koge (Denmark). “The way that we fixate the mesh in laparoscopic surgery has been hypothesized to have an [impact] on the risk of persistent pain.”

In a study presented by Dr. Burcharth and his associates at the American College of Surgeons Clinical Congress, a total of 1,421 patients were examined. Each patient completed a validated pain questionnaire through the Danish Hernia Database from 2009 to 2012. The patients were divided into two groups: Group 1 had spray fibrin sealant (34%) for mesh fixation, and group 2 had tacks (66%). The results showed no difference between the groups in terms of pain in getting up from a chair, sitting or standing for more than 30 minutes, walking stairs, driving a car, or exercising, or in the need for postoperative analgesics or postoperative sick leave (all P greater than .20).

Surgeons operating ©monkeybusinessimages/Thinkstock
A total of 18.4% in group 1 and 20.3% in group 2 reported pain during the previous week at follow-up, and 6.1% and 7.3%, respectively, reported pain not possible to ignore (P = .44). One out of five patients reported daily pain 3 years after a laparoscopic hernia procedure.

Dr. Burcharth concluded that a high number of patients reported persistent pain regardless of mesh fixation technique, which emphasizes the need for preoperative information.

Dr. Burcharth reported having no relevant financial disclosures.

Recommended Reading

Underlay mesh for hernia repair yields better postop pain outcomes
MDedge Surgery
Risk model predicts chronic postop pain for VHR patients
MDedge Surgery
Patients want surgery for ventral hernia despite risks and comorbidity obstacles
MDedge Surgery
The mesh tradeoff: Lower recurrence risk vs. complicaitons
MDedge Surgery
Simulation model favors hernia surgery over watchful waiting
MDedge Surgery
Ultrasound effective in diagnosing occult hernia in women
MDedge Surgery
Risk models for hernia recurrence don’t hold up to external validation
MDedge Surgery
Light and heavy mesh deliver similar outcomes and QOL for lap inguinal repair
MDedge Surgery
Telephone calls improve long-term follow-up after hernia repair
MDedge Surgery
Pain after hernia repair shows improvement at 6 months
MDedge Surgery