ARE THERE DIFFERENCES IN CHRONIC PAIN AFTER LAPAROSCOPIC INGUINAL HERNIA REPAIR USING THE TRANSABDOMINAL TECHNIQUE COMPARING WITH FIXATION OF THE MESH WITH STAPLES, WITH GLUE OR WITHOUT FIXATION? A CLINICAL RANDOMIZED, DOUBLE-BLIND TRIAL
Bibliographic record
Abstract
BACKGROUND: Regarding postoperative pain, it remains unclear whether non-fixation of the polypropylene prosthesis in transabdominal preperitoneal inguinal hernia repair produces the same outcomes as mesh fixation with glue or tackers. In addition, hernia recurrence is another aspect to be assessed in the comparison between non-fixation and mesh-fixation techniques (tackers and glue). AIMS: This study aimed to evaluate the incidence, quality of pain, and recurrence in patients undergoing laparoscopic inguinal hernioplasty (transabdominal preperitoneal) technique, comparing the fixation of the mesh with tackers versus with glue versus without fixation. METHODS: This is a prospective, double-blind study in which 63 patients presenting with primary unilateral inguinal hernia underwent laparoscopic transabdominal preperitoneal inguinal hernia repair and were randomized into three groups: no mesh fixation (n=21), mesh tacked (n=21), and mesh fixed with fibrin glue (n=21). Patients also responded to questionnaires in order to assess pain and pain quality and were followed up for 2 years. RESULTS: Neither mesh-fixation nor non-fixation techniques were found to affect postoperative chronic pain (p=0.535), but patients undergoing tacker fixation reported more pain descriptors (p=0.0021) and a higher pain index (p=0.002) on the McGill scale in the first 15 postoperative days (T0 and T1). No hernia recurrences were observed. CONCLUSIONS: Both mesh-fixation techniques (tackers and glue) used with the transabdominal preperitoneal approach did not influence the onset of inguinodynia, but tacker fixation was more likely to increase patient sensitivity to pain. Mesh placement without fixation produced the same pain and recurrence outcomes as mesh-fixation techniques. Also, no recurrence was observed in patients without mesh fixation in this study. Consequently, it has become an alternative therapy deserving consideration for hernia repair.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".