Slit mesh technique in laparoscopic inguinal hernia repair: a retrospective analysis.

Introduction: Slit mesh (SM) is a technical modification used in laparoscopic total extraperitoneal (TEP) inguinal hernia (IH) repair. It aims to reduce recurrence by improving mesh anchoring and preventing cranial migration. However, its clinical effectiveness remains controversial.

Aim: The aim of this study was to compare clinical outcomes of SM and nonslit mesh (NSM) techniques in laparoscopic TEP IH repair.

Materials and methods: This retrospective study included 155 patients who underwent standardized TEP repair between June 2022 and February 2023. The patients were divided into 2 groups: SM (n = 80) and NSM (n = 75). Demographics, hernia characteristics, operative time, recurrence, complications, and postoperative pain were evaluated. Pain was assessed using the visual analogue scale (VAS) on postoperative day 1 (VAS1D), at 1 month (VAS1M), and 3 months (VAS3M).

Results: No significant differences were found in baseline characteristics. Median (interquaritle range [IQR]) operation time was longer in the SM group (46.5 [40-55] vs 38 [30-45] min; P <⁠0.001). Recurrence was observed in 6 SM and 3 NSM patients (odss ratio, 1.95; 95% CI, 0.47-8.08; P = 0.497). Median (IQR) VAS scores were: 4 (2-6) for VAS1D; 0 (0-1) for VAS1M; 0 (0-0) for VAS3M, with no significant differences. Complication and chronic postoperative inguinal pain rates were similar.

Conclusions: Although the SM technique was designed to improve outcomes, our findings show no it has no notable advantage over the NSM technique in reducing recurrence or postoperative pain. Moreover, the prolonged operation time associated with the SM method may represent a clinical drawback. Further research with larger cohorts and longer follow-up is needed to better clarify the potential risks and benefits of SM apporoach.