Chronic groin pain following inguinal hernia repair in the laparoscopic era: Systematic review and meta-analysis

Am J Surg. 2022 Oct;224(4):1135-1149. doi: 10.1016/j.amjsurg.2022.05.005. Epub 2022 May 21.

Abstract

Background: The impact of laparoscopic inguinal hernia repair (IHR) on chronic groin pain (CGP) prevalence, risk and daily activities compared to open IHR is still unclear.

Methods: A meta-analysis of randomised controlled trials comparing CGP rates in laparoscopic and open IHR was performed.

Results: 22 trials were included. CGP prevalence decreases significantly 1-2 years post-op and reaches rates as low as 4.69% (laparoscopic) and 6.91% (open) at >5 years. There is a significantly lower risk of CGP following totally extraperitoneal (TEP) than open mesh repair at all follow-up periods (p < 0.05) except for >5 years (p = 0.32). The same trend is not seen when compared to open non-mesh repair or for transabdominal pre-peritoneal repair (TAPP). There is no difference between techniques when CGP is described as moderate and/or affecting daily activities (p = 0.08).

Conclusion: CGP rates continue to decrease at >5 years follow up. TEP consistently results in a reduction in CGP rates compared to open mesh repair however, this is not functionally significant.

Keywords: Chronic groin pain; Inguinal hernia repair; Open; TAPP; TEP.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chronic Pain* / epidemiology
  • Chronic Pain* / etiology
  • Chronic Pain* / surgery
  • Groin
  • Hernia, Inguinal* / surgery
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Surgical Mesh / adverse effects