Comparative study of mesh fixation versus without mesh fixation in laparoscopic inguinal hernia repair by TAPP approach

Authors

  • Naveenraj R. Department of General Surgery, GMERS Medical College, Vadodara, Gujarat, India
  • Bhavin Patel Department of General Surgery, GMERS Medical College, Vadodara, Gujarat, India
  • Jaydip Kavathiya Department of General Surgery, GMERS Medical College, Vadodara, Gujarat, India
  • Shubham Samdani Department of General Surgery, GMERS Medical College, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20241136

Keywords:

Inguinal hernia, TAPP, Laparoscopic procedure, Recurrence, Operative time, Complications mortality, Mesh fixation, Post-operative pain

Abstract

Background: An inguinal hernia is a protrusion of abdominal contents through the inguinal canal. Laparoscopic TAPP inguinal hernia repair without mesh fixation is comparitively easy and safer than TAPP with mesh fixation with no increase in recurrence rate. Hence the current study was conducted to analyse complications after laparoscopic inguinal hernia repair (TAPP) with mesh fixation vs without mesh fixation in patients with inguinal hernia. Patients has provided informed consent for publication.

Methods: It was an observational cohort study, comparing the outcome in 60 patients undergoing laparoscopic TAPP for inguinal hernia, where patients were randomly allotted into two groups as 30 with mesh fixation and 30 without mesh fixation over a period of two years October 2020 to September 2022.

Results: In the current study, we observed that recurrence was reported among 3.33% study subjects without mesh fixation. While Recurrence reported among 6.67% study subjects with mesh fixation. However, the difference in the observations was statistically not found to be significant and there is significant reduction in postoperative pain, operation duration and hospital stay duration in laparoscopic TAPP without mesh fixation group.

Conclusions: It was observed that laparoscopic TAPP repair without mesh fixation does not increase recurrence rate but reduces operative duration, hospital stay duration and decreases the incidence of postoperative pain compared to laparoscopic TAPP with mesh fixation.

References

Decker E, Currie A, Baig MK. Prolene hernia system versus Lichtenstein repair for inguinal hernia: a meta-analysis. Hernia. 2019;23(3):541-6.

Muschaweck U, Koch A. Sportsmen's groin: Definition, differential diagnosis and treatment. Radiologe. 2019;59(3):224-33.

Sun L, Shen YM, Chen J. Laparoscopic versus Lichtenstein hernioplasty for inguinal hernias: a systematic review and Meta-analysis of randomized controlled trials. Minim Invasive Ther Allied Technol. 2020;29(1):20-7.

Li J, Gong W, Liu Q. Intraoperative adjunctive techniques to reduce seroma formation in laparoscopic inguinal hernioplasty: a systematic review. Hernia. 201;23(4):723-31.

Yang XF, Liu JL. Anatomy essentials for laparoscopic inguinal hernia repair. Ann Transl Med. 2016;4(19):372.

Hernia Surge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165.

Suguita FY, Essu FF, Oliveira LT, Iuamoto LR, Kato JM, Torsani MB, et al. Learning curve takes 65 repetitions of totally extraperitoneal laparoscopy on inguinal hernias for reduction of operating time and complications. Surg Endosc. 2017;31(10):3939-45.

Rekhi HS, Mittal S, Arora S, Khosa A. Fixation and Non-Fixation of MESH in Transabdominal Preperitoneal Hernia Repair: A Randomized Study. Int J Med Res Prof. 2020; 6(1):187-91.

Amirzargar MA, Mohseni M, Poorolajal J. Mesh fixation compared with nonfixation in transabdominal preperitoneal laparoscopic inguinal hernia repair. Surg Technol Int. 2013;23:122-5.

Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc. 1999;13(8):804-6.

Nahid AK, Rahman S, Veerapatherar K, Fernandes R. Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: a comparative study. Turk J Surg. 2021;37(1):1-5.

Awad SS, Qahtani FH, Alsulaimani FS, Khalid AH, Alharthi QM, AlThomali MA, et al. Perioperative Outcome and Cost-utility of Mesh Fixation vs Non-fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernioplasty: A Prospective Randomized Controlled Trial. World J Lap Surg. 2023;16(3):169-72.

Downloads

Published

2024-04-29

Issue

Section

Original Research Articles