Commencing Mesh Fixation with Sutures versus Non-Fixation Technique in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 17, Issue 4, October 2024, Page 309-315 PDF (379.96 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ASJS.2024.307585.1152 | ||||
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| Authors | ||||
| Ibrahim Hamdy Bayan* 1; Sobhy Rezk Ahmed Teama2; Ahmed Ragab Sabek1; Mohamed Ibrahim Monier1 | ||||
| 1Department of General Surgery, Armed Forces Collage of Medicine (AFCM), Cairo, Egypt | ||||
| 2Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Laparoscopic inguinal hernial repair, including the “transabdominal preperitoneal repair” (TAPP), has become popular in Egypt. Nonetheless, mesh fixation during that procedure has been questioned. Some surgeons believe that the fixation step is essential to prevent mesh migration and recurrence, whereas others believe that fixation carries more risk of chronic postoperative pain. Herein, we compared the outcomes of mesh fixation versus non-fixation in such cases. Patients and methods: Forty patients scheduled for TAPP were enrolled in our randomized prospective trial. Two approaches were used: mesh fixation (20 patients) and non-fixation (20 patients). The main outcome was the operative duration, whereas secondary ones included early and late postoperative adverse events (within a one-year follow-up). Results: We noted no notable differences regarding patient and hernia parameters when comparing the two groups. When mesh fixation was omitted, the operative time significantly decreased (45 vs. 80 minutes in the other group – p = 0.002). No patients developed wound infection, testicular atrophy, or postoperative recurrence during the one-year follow-up. The occurrence of seroma and hematoma was similar in statistical terms across both groups. Nonetheless, mesh fixation yielded a significant rise (p = 0.035) in chronic postoperative inguinodynia (20%) while not encountered in the other group (0%). That made patient satisfaction better in the non-fixation group (p = 0.040). Conclusion: Omitting mesh fixation during the TAPP procedure does not add significant risks to the perioperative and one-year outcomes. Contrarily, it yielded significant benefits, including shorter operative time, less incidence of inguinodynia, and better satisfaction. | ||||
| Keywords | ||||
| Inguinal hernia; TAPP; Mesh fixation; Non-fixation | ||||
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