WASHINGTON (FRONTLINE MEDICAL NEWS) – 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).

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.


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