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Background: Totally extraperitoneal inguinal hernia repair (TEP-IHR) offers advantages over conventional open IHR. ProGripTM self-fixating mesh delivers a tack-free fixation repair. Using ProGripTM during TEP-IHR may lead to decreased postoperative pain and/or complications compared to fixating mesh with titanium clips. Methods: A randomized, prospective, single-blinded study compared ProGripTM mesh versus regular Prolene mesh with titanium tack fixation. A total of 38 patients underwent 65 TEP-IHR at our institution. All repairs were completed with either Prolene mesh (Group TT = 19 patients) with tack fixation or ProGripTM self-fixating mesh (Group PG = 19 patients). Blinded patients were asked to rate their level of pain according to a Likert scale (0=no pain, 5=severe pain) preoperatively, and at 1 and 4 weeks postoperatively. Results: Thirty eight men underwent 65 TEP-IHR with a mean age of 55 years (SD±11), mean BMI of 30 kg/m2 (SD±9) and mean ASA of 1.9 (SD±0.5). Most repairs were bilateral (TT=16, PG=11). Operative times (TT=65 min±18; PG=77 min±31, p=0.1), hospital length of stay (15.7 vs 14.4 hours, p=0.63), and urinary retention (TT=1, PG=1, p=NS) were similar. No significant differences occurred in the level of pain or limitation of movement pre-op and 4 weeks postop. The patients in TT group reported more pain and limitation of movement than the patients in PG group at 1 week postop (p=0.02). Conclusions: ProGripTM self-fixating mesh for TEP-IH repair appears safe and effective; it has similar performance to Prolene mesh using titanium tack fixation. Yazan Al Jamal*, Eee LN Buckarma, Becca Gas and David Farley Department of General Surgery, Mayo Clinic, Rochester, Minnesota, USA

Randomized Prospective Single-Blinded Study of TEP Inguinal Hernia Repair: Tacking Mesh versus Self- Fixating Mesh