BACKGROUND: Laparoscopic inguinal hernia surgery leads to rapid recovery and low complication rates. An alternative to fixate the mesh is using a self-fixated mesh. METHODS: From April 2021 to June 2024, we conducted a randomized controlled trial comparing self-adhesive mesh (Adhesix™) with self-gripping mesh (Progrip™) in laparoscopic inguinal hernia surgery (TAPP and TEP). Adult patients scheduled for day surgery were included in the study with a 1-year follow up. The primary endpoint was the number of analgesics (Paracetamol or Ibuprofen) used during the first post-operative week. Secondary outcomes were pain-related issues, complications, and recurrence rate. RESULTS: A total of 174 patients participated
90 received Adhesix™ (group A) and 84 Progrip™ (Group P). Forty-six (26.4%) patients had recurrent hernia, 68 (39.1%) had unilateral and 60 (34.5%) had bilateral primary hernias. A total of 156 (90%) patients completed follow up. The number of analgesics during the first post-operative week was comparable between groups (P 22.9, A 21.2 tablets, p = 0.461). Group P used more analgesics during day 1, after which no difference was observed. In general, all participants used analgesics after surgery regularly for 10.8 days (SD 10.6) and occasionally for 15.9 days (SD 16.9). Time to return to work and normal activities was 16.1 days (SD 10.8) and 16.6 days (SD 9.6), respectively. More patients in group P reported moderate or severe pain (numeric rating scale >
3) during exercise 3 months after surgery (P 15.4%, A 3.1%, p = 0.035), although no difference was observed at 1 year after surgery. Both groups had significantly improved quality of life measures in physical aspects of the RAND-36 Item Health Survey after 3 months. Two recurrences, one in each group (1.1%) occurred. CONCLUSION: The use of Adhesix was non-inferior to Progrip in laparoscopic surgery. Surgery using either mesh led to rapid recovery and improved quality of life. This trial was registered in ClinicalTrials.gov (NCT05091853).