Randomised controlled trials in which tacker mesh fixation was compared to no-mesh fixation in patients who underwent laparoscopic surgery for the repair of inguinal hernias were eligible for inclusion. Eligible trials were required to report data on postoperative outcomes.
The included studies were conducted in the United States, India, China, Spain, United Kingdom and Australia between 1999 and 2011. Patient age ranged from 14 to 100 years; in most studies the mean age of the patients was between 46.4 and 61 years. Patients presented with unilateral or bilateral primary inguinal hernias, primary and recurrent pantaloon and femoral hernias. In most trials the total extraperitoneal approach was used for the hernia repair surgery under either general or spinal anaesthesia. One study used the transabdominal preperitoneal approach. In the comparison groups the same approaches were used except that the polypropylene mesh was not fixed with staples. Outcomes assessed were operative time in minutes, postoperative pain, complications, chronic groin pain, recurrence and days of hospital stay.
Two reviewers performed the study selection.