SynthesisSurgical endoscopy2023
No evidence for fixation of mesh in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Pooled it
- Standard TAPP with flat mesh versus TAPP with flat mesh plus mesh plug for inguinal hernia repair: a preliminary single-center randomized experience.Langenbeck's archives of surgery · 2026Trial
- Prospective, randomized, controlled trial comparing self-gripping and conventional mesh in laparoscopic totally extra peritoneal inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Trial
- Self-gripping mesh without fixation versus anatomical mesh with tack fixation for laparoscopic TAPP inguinal hernia repair: a retrospective cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Mesh-fixation combinations and chronic postoperative inguinal pain after laparoscopic groin hernia repair: nationwide cohort study.BJS open · 2026Article
- Transabdominal pre-peritoneal hernia repair: risk of operation for recurrence depends on choice of both mesh and fixation device. A study from the Danish Hernia Database.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Comment on: Is the self-adhesive mesh a solution for chronic postoperative inguinal pain after TAPP: A single centre preliminary experience?Journal of minimal access surgery · 2025Article
- Efficacy of intraperitoneal positive pressure gas expulsion in laparoscopic transabdominal preperitoneal hernioplasty: a retrospective cohort study.BMC surgery · 2025Article
- Recurrence and complications after laparoscopic inguinal hernia repair using a self-adherent mesh: a patient-reported follow-up study.Surgical endoscopy · 2025Article
- Comparison of anatomical polyester mesh without fixation and conventional flat mesh with fixation in laparoscopic total extraperitoneal repair for inguinal hernia.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Penetrating versus non-penetrating mesh fixation in laparoscopic groin hernia repair.The Cochrane database of systematic reviews · 2025Review
- A new approach to mesh fixation in laparoscopic transabdominal technique, "suture passer", superior or not?Updates in surgery · 2024Article
- Clinical application of the dissection of the preperitoneal space without electrocoagulation in laparoscopic transperitoneal inguinal hernia repair throughout of the whole process.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the differences in hernia recurrence and chronic postoperative inguinal pain (CPIP) in randomized, controlled trials comparing fixation and non-fixation of the mesh in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.
methodsA multi-database systematic search was conducted for randomized, controlled trials comparing fixation versus non-fixation of the mesh in TAPP inguinal hernia repair. All eligible papers were assessed for risk of bias using the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). Quality of evidence was evaluated using the GRADE system. Meta-analyses were performed regarding recurrence and CPIP using RevMan.
resultsSeven prospective, randomized controlled trials were included. Laparoscopic TAPP inguinal hernia repair was performed in 1732 patients with 737 procedures performed without fixation and 995 procedures with fixation of the mesh. Despite all trials being RCTs, the trials were limited by substantial bias and the quality of evidence was low regarding hernia recurrence and very low regarding CPIP. Pooled estimates from meta-analyses were an OR of 2.80 (95% CI 0.61-12.77) for hernia recurrence and a mean difference in visual analogue scale (VAS) of 0.17 (95% CI 0.90-1.24) for CPIP, respectively.
conclusionThe current evidence is very uncertain and mesh fixation may have little to no effect regarding hernia recurrence and chronic postoperative inguinal pain in patients operated with TAPP inguinal hernia repair.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.