Chronic groin pain following inguinal hernia repair in the laparoscopic era: Systematic review and meta-analysis

The impact of laparoscopic inguinal hernia repair (IHR) on chronic groin pain (CGP) prevalence, risk and daily activities compared to open IHR is still unclear. A meta-analysis of randomised controlled trials comparing CGP rates in laparoscopic and open IHR was performed. 22 trials were included. CGP prevalence decreases significantly 1–2 years post-op and reaches rates as low as 4.69% (laparoscopic) and 6.91% (open) at >5 years. There is a significantly lower risk of CGP following totally extraperitoneal (TEP) than open mesh repair at all follow-up periods (p 5 years (p = 0.32). The same trend is not seen when compared to open non-mesh repair or for transabdominal pre-peritoneal repair (TAPP). There is no difference between techniques when CGP is described as moderate and/or affecting daily activities (p = 0.08). CGP rates continue to decrease at >5 years follow up. TEP consistently results in a reduction in CGP rates compared to open mesh repair however, this is not functionally significant. •Chronic groin pain prevalence post inguinal hernia repair decreases at >5 years.•Surgical management may be delayed until then.•TEP versus open mesh reduces risk of chronic groin pain at all follow up durations.•Reduced chronic groin pain risk between techniques is not clinically relevant.