Quality of Life and Postoperative Pain After Tapp Hernia Repair With Self-Fixating Mesh: A Prospective Observational Study
Keywords:
TAPP, Inguinal Hernia, Self-Fixating Mesh, Postoperative Pain, Quality of Life, EQ-5D, Carolinas Comfort ScaleAbstract
Postoperative pain and long-term quality of life (QoL) are critical outcomes after laparoscopic transabdominal preperitoneal (TAPP) hernia repair. Self-fixating mesh has been proposed to reduce fixation-related discomfort and chronic pain. This prospective observational study aimed to evaluate pain progression and QoL following TAPP with self-fixating mesh using validated instruments. A total of 312 adult patients undergoing elective TAPP with self-fixating mesh were enrolled from January 2023 to December 2024. Pain was assessed preoperatively and at 1, 3, and 6 months postoperatively using the Numeric Rating Scale (NRS) and the Brief Pain Inventory (BPI). Quality of life was measured using the EuroQol-5D (EQ-5D) and the Carolinas Comfort Scale (CCS). Repeated measures ANOVA evaluated changes over time. Mean age was 52.3 ± 11.7 years, and 280 (89.7%) were male. Mean NRS pain scores decreased significantly from baseline (4.1 ± 1.6) to 1 month (3.4 ± 1.8), 3 months (2.1 ± 1.2), and 6 months (1.3 ± 0.9) (p<0.001). EQ-5D index improved from 0.76 ± 0.12 preoperatively to 0.88 ± 0.11 at 6 months (p<0.001). CCS scores demonstrated significant reductions in mesh-related discomfort (p<0.001). Chronic pain prevalence at 6 months was 3.5%. TAPP with self-fixating mesh is associated with significant reductions in pain and improvements in quality of life up to 6 months postoperatively. These findings support its use to optimize patient-centered outcomes.
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