MEsh FIxation STudy in Laparoendoscopic Repair of M3 Inguinal Hernias: multicenter, double-blind, randomized controlled trial - MEFISTO Trial.

Objective: To evaluate the efficacy of non-fixation versus fixation of meshes in laparoendoscopic repair of M3 inguinal hernias in terms of recurrence, postoperative pain, and surgical complications.

Summary Background Data: International guidelines recommend mesh fixation for large M3 inguinal hernias during laparoendoscopic repairs due to high recurrence rates. However, emerging experimental and registry data suggest that anatomically shaped, rigid and three-dimensional meshes may maintain stability without fixation.