Abstract

Background: Inguinal hernia repair is one of the most used medical surgeries within the world, and there is a still remains of controversy as to the best method though minimalizing recurrence and subsequent complications of a surgical procedure. Mesh-based repair and non-mesh (tissue-based) repair have two key approaches, which offer different results in the short and long term. Mesh repair, with such innovations as self-gripping and non-fixation methods, is used to decrease recurrence and increase recovery, and non-mesh repair does not introduce the foreign material but can have an association with increased recurrence.
Purpose: To perform a systematic review of clinical outcome-based comparisons of mesh and non-mesh inguinal hernia repair in terms of recurrence experience, postoperative pain and operative time, length of stay, complications, and patient satisfaction.
Methods: Prospective and randomized clinical studies by 2023-2025 were systematically identified in PubMed, Scopus, and Web of Science. The studies incorporated adult patients who are undergoing primary or recurring inguinal hernia repair using either the mesh or non-mesh technique and reporting at least one of the following outcomes. The extraction and analysis of data included operative efficiency, pain reduction, recovery time, recurrence, and patient-centered outcomes.
Findings: 8 studies were found with more than 1,000 patients. Mesh repair has always proven to have lower recurrence rates, less chronic pain, less recovery time with greater patient satisfaction than non-mesh repair. Sutureless or self-gripping mesh designs also enhanced decreased operation time and early postoperative pain without augmenting complications. Non-mesh repair was also effective in some instances but had more recurrence rates and slower rates of recovery to normal activities.
Conclusion: Mesh-based inguinal hernia repair has better results in prevention of recurrence, recovery, and patient satisfaction. Non-mesh repair can be used in a select group of patients or in case of mesh contraindications. More quality multicenter studies should be done to normalize the results and improve the long-term outcomes.

Key words: Inguinal hernia, Hernia repair, Mesh repair, Non-mesh repair, Sutureless mesh, Self-gripping mesh, Recurrence rate, Postoperative pain, Laparoscopic repair, Clinical outcomes.