Short-term clinical outcomes of laparoscopic trans-abdominal pre-peritoneal repair using Parietex™ Lap.ProGrip™: a 10-year retrospective study.

PURPOSE: The efficacy of self-fixating mesh in laparoscopic inguinal hernia repair remains controversial, and its use is not yet explicitly recommended by international guidelines. The short-term outcomes of patients who underwent trans-abdominal pre-peritoneal (TAPP) repair using Parietex™ Lap.ProGrip™ (Lap.ProGrip) during a 10-year period, were retrospectively analyzed, to evaluate its effectiveness at reducing recurrence and chronic post-operative inguinal pain (CPIP).

METHODS

Data from 965 patients (1,129 hernias), aged ≥ 18 years, who underwent TAPP with Lap.ProGrip between November 2014 and October 2024, were retrieved. The standard post-operative follow-up period was 6 months. The primary endpoint was post-operative recurrence, specifically for large direct hernias (Japan Hernia Society [JHS] M3 type). The secondary endpoint was CPIP, which was defined, based on international guidelines, as pain that persisted for ≥ 3 months, required intervention, and interfered with daily activities. The intra-operative videos of all patients with CPIP were reviewed to identify potential procedural causes.

RESULTS

The 6-month follow-up completion rate was 88.4%. Although 478 hernias (42.3%) had a defect size ≥ 3 cm, including 149 hernias (13.2%) of JHS M3 type, no early recurrences occurred. Four patients (0.5%) had CPIP. Intra-operative video review revealed that in three of the four patients, electrocautery for hemostasis within the "trapezoid of disaster" was performed, suggesting nerve injury, and no mesh-related displacement or folding was observed.

CONCLUSIONS

The self-fixating mesh provides reliable short-term stability, even for large direct hernias. CPIP appears to be more closely associated with intra-operative hemostatic maneuvers than with the mesh.