ZenToks Publication

Chapter 22

Mesh Fixation Techniques for Inguinal Hernia Repair: A Review

Abstract/Preface

Inguinal hernia repair ranks among the most commonly performed surgical procedures globally. The advent of prosthetic mesh has markedly decreased recurrence rates; nonetheless, chronic postoperative inguinal pain persists as a significant issue. Mesh fixation plays a pivotal role in hernia repair, affecting mesh stability, recurrence, postoperative pain, procedural costs, and patient recovery. Various fixation techniques have been developed by researchers, including sutures, staples, tacks, fibrin glue, cyanoacrylate glue, self-gripping meshes, and non-fixation strategies. Current evidence indicates that atraumatic fixation methods may alleviate postoperative and chronic pain while maintaining recurrence rates similar to those of traditional mechanical fixation. Recent systematic reviews and international guidelines advocate for selective rather than routine mesh fixation in numerous laparoscopic repairs, especially for small to medium-sized defects. This chapter explores current mesh fixation techniques in both open and laparoscopic inguinal hernia repair, assesses their advantages and disadvantages, and reviews contemporary evidence concerning clinical outcomes.