{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T15:03:32Z","timestamp":1789916612884,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Mesh fixation strategy is a modifiable intraoperative factor that may influence postoperative recovery following totally extraperitoneal (TEP) inguinal hernia repair. Although self-fixating meshes were developed to avoid penetrating fixation and potentially reduce pain, their effect on multidimensional recovery trajectories remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included consecutive adults undergoing elective unilateral TEP repair at a tertiary referral center. Patients were grouped according to fixation strategy: self-fixating mesh or polypropylene mesh secured with absorbable tacks. The primary outcome was early quality of recovery measured using the Quality of Recovery-15 (QoR-15) questionnaire at postoperative week 1. Secondary outcomes included longitudinal QoR-15 and visual analog scale (VAS) pain scores at postoperative months 1 and 3, analgesic consumption, and time to functional recovery. Recovery trajectories were analyzed using linear mixed-effects models, with additional stratification by defect size (&lt;20 mm versus \u226520 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 134 patients were included (56 tack fixation, 78 self-fixating mesh). Early recovery at week 1 was comparable between groups. Mixed-effects modeling demonstrated significant improvement over time in both groups, without an independent association between fixation strategy and overall QoR-15 trajectory. However, in defects \u226520 mm, self-fixating mesh was associated with higher QoR-15 scores. Pain scores improved over time in both groups, with small but statistically significant differences favoring self-fixating mesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In unilateral TEP repair, fixation strategy does not substantially influence overall early and short-term recovery. However, in larger defects (\u226520 mm), self-fixating mesh may provide modest recovery advantages, suggesting a context-dependent rather than uniform effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261450042","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T02:11:17Z","timestamp":1778119877000},"page":"819-827","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mesh Fixation Strategy and Recovery Trajectories after Unilateral Totally Extraperitoneal Inguinal Hernia Repair: A Defect-Size\u2013Stratified Analysis"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1863-0011","authenticated-orcid":false,"given":"Kanan","family":"Ismayilzada","sequence":"first","affiliation":[{"name":"Department of General Surgery, Medicana International Atasehir Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koray","family":"Topgul","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Medicana International Izmir Hospital, Izmir, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babek","family":"Tabandeh","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Medicana International Atasehir Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/S10029-017-1668-X"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2013.11.018"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464-014-3917-8"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/S10029-011-0798-9"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.03.001"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9006"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14966-5"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.03.009"},{"key":"e_1_3_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0B013E318289B84B"},{"key":"e_1_3_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464-013-2797-7"},{"key":"e_1_3_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"issue":"4","key":"e_1_3_6_13_1","first-page":"457","article-title":"Randomized prospective study of totally extraperitoneal inguinal hernia repair: Fixation versus no fixation of mesh","volume":"10","author":"Koch CA","year":"2006","unstructured":"12.Koch CA, , Greenlee SM, , Larson DR, et al. Randomized prospective study of totally extraperitoneal inguinal hernia repair: Fixation versus no fixation of mesh. 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