Laparoscopic totally extraperitoneal repair of inguinal hernia using three-dimensional mesh: a 5 years experience at a tertiary care hospital in Kashmir, India

Iqbal Saleem Mir; Tajamul Rashid; Irfan Nazir Mir; Suhail Nazir; Imtiyaz Ali; Mansoor Ul Haq

doi:10.18203/2349-2902.isj20180822

Authors

Iqbal Saleem Mir Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
Tajamul Rashid Department of Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
Irfan Nazir Mir Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
Suhail Nazir Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
Imtiyaz Ali Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India
Mansoor Ul Haq Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180822

Keywords:

Hernia, Mesh fixation, TEP

Abstract

Background: Inguinal hernia repair by laparoscopy is gaining acceptance worldwide. A flat mesh used in laparoscopic inguinal hernia repair is associated with more complications especially early and late postoperative pain owing to the need of mechanical fixation of this mesh. A three-dimensional mesh in this context is an emerging alternative which needs no or minimal fixation.

Methods: A retrospective study of 123 patients was carried out from July 2012 to August 2017. All patients who underwent TEP by a single surgical team using three-dimensional mesh were included in the study. Data collected was analysed retrospectively.

Results: Out of a total of 123 patients, 114 patients had unilateral hernia and 9 had bilateral hernia. A total of 132 laparoscopic hernia repairs were done using three-dimensional mesh. All the patients were male aged 29 to 75 years with a mean age of 51.5 years. Indirect hernias were more common comprising of 87.7%. The mean operative time was 46.9 minutes. The average mesh fixation time was 12.6 minutes. No major intraoperative complications were noted in any of the patients. Three patients (2.45%) experienced severe postoperative pain. Most of the patients 117 (95.12%) were discharged within 24 hours of surgery. Mean hospital stay in our study was 1 day. The mean length of follow-up was 12 months. Mild persistent groin pain was found in four patients (3.25%). Seroma was noted in five patients (4.06%). Hematoma and wound infection was noted in none. One patient (0.81%) had recurrence after completion of follow up. We found use of 3D mesh costly.

Conclusions: Laparoscopic inguinal mesh hernioplasty using 3D mesh is a viable alternative of hernioplasty with minimal post-operative pain and recurrence and using 3D mesh has a technical advantage of easy insertion in an anatomically correct position with minimal fixation.

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