Chronic postoperative pain is a common complication after the Lichtenstein procedure, which is the classic surgical approach for open hernia repair. A multicenter prospective randomized controlled trial by Rönkä et al. investigated whether different patch fixation methods, such as adhesive fixation, self-adhesive fixation and suture fixation, have an effect on postoperative chronic pain after hernia repair and found no effect of adhesive fixation, self-adhesive fixation and suture fixation on postoperative chronic pain. The results were published in a recent issue of Annals of Surgery. The study involved eight hospitals from Finland and randomized 650 eligible adult inguinal hernia patients from January 2012 to December 2013 to surgery with adhesive fixation, self-adhesive fixation, and suture fixation. Of these, 216 were in the adhesive fixation group, 202 were in the self-fixation group, and 207 were in the suture fixation group. The surgery was performed by physicians with more than 100 cases of inguinal hernia surgery. The patients in the three groups were well matched and had similar basic conditions, with similar size and type of hernia. The follow-up period was 1 year, and the number of patients who successfully completed the follow-up was 208 in the adhesive fixation group, 193 in the self-fixation group, and 198 in the suture fixation group. Statistics were taken at 1, 7, 30 days and 1 year postoperatively, and the main observations included incisional complications, pain, hernia recurrence and patient discomfort. The operative time was 34±13, 32±9 and 38±9 minutes in the adhesive fixation, self-adhesive fixation and suture fixation groups, respectively, and the differences were not statistically significant. In terms of postoperative pain response and the need for pain medication, the differences between the three groups were not statistically significant. A total of 2 (0.3%) incisional infections, 31 (5.0%) incisional subcutaneous effusions, and 4 (0.6%) recurrent hernias occurred in all patients at 1 year of follow-up. A total of 25 cases (4.2%) required occasional use of pain medication for chronic pain. The results of this study showed that Lichtenstein hernia repair with adhesive fixation, self-adhesive fixation, or suture fixation had no effect on postoperative chronic pain. However, adhesive fixation and self-adhesive fixation as opposed to suture fixation are also feasible for non-suture fixation. The operative time for non-suture fixation was slightly shorter relative to suture fixation, but not statistically significant.