Effect of Postoperative Hernia Truss Use on Complications Following Laparoscopic Inguinal Hernia Repair

Abstract

Inguinal hernia repair is common, but postoperative complications such as pain, seroma, and recurrence remain concerns. Hernia belts have been proposed to provide external support and reduce these risks, though evidence is inconsistent. This study aimed to evaluate whether routine postoperative hernia belt use following laparoscopic transabdominal preperitoneal (TAPP) repair influences complication rates and recovery compared with standard care alone. This quasi-experimental study was conducted at Sina Hospital, Tehran University of Medical Sciences, between June 2023 and June 2024. Adult patients with primary inguinal hernia undergoing elective laparoscopic TAPP repair with mesh placement were enrolled and followed for 12 months. Participants were allocated to an intervention group (standard care plus hernia belt for six weeks) or a control group (standard care only). Primary outcomes included seroma, acute pain, hematoma, surgical site infection (SSI), chronic postoperative inguinal pain (CPIP), and recurrence. Secondary outcomes were length of hospital stay and time to return to normal activity. Statistical analyses included Fisher’s exact test, Poisson regression, and Mann-Whitney U test, with significance set at P<0.05. A total of 82 patients were included (52 in the hernia belt group, 30 in the control group). Baseline demographic and clinical characteristics were comparable between groups. Rates of complications were not significantly different: seroma (23.1% vs. 20.0%, P=0.790), acute pain (23.1% vs. 10.0%, P=0.235), hematoma (17.3% vs. 3.3%, P=0.084), SSI (7.7% vs. 3.3%, P=0.648), CPIP (17.3% vs. 20.0%, P=0.774), and recurrence (7.7% vs. 20.0%, P=0.159). The hernia belt group had a significantly longer median hospital stay (2 vs. 1 days, P=0.001) and a non-significant delay in return to normal activity (5 vs. 4 days, P=0.062). Postoperative hernia belt use following laparoscopic TAPP inguinal hernia was not associated with a statistically significant difference in complication rates and was associated with prolonged hospital stay. Routine use of hernia belts is not supported by current findings, though selective use in high-risk patients may warrant further investigation. Selective application in subgroups such as obese patients or those with large hernia defects may warrant further evaluation in multicentric trials.