Fixation Versus Non-Fixation of MESH in Laparosopic Transabdominal Preperitoneal (TAPP) Hernia Repair | ||
The Egyptian Journal of Surgery | ||
Volume 44, Issue 3, July 2025, Pages 821-827 PDF (274.78 K) | ||
Document Type: Original Article | ||
DOI: 10.21608/ejsur.2024.338107.1291 | ||
Authors | ||
Mohamed Abo Elfetouh Ahmed Abdelkhalek1; Zahraa Futooh Mohammed1; Elhussein Elsayed Abou Elseoud* 2 | ||
1Department of General Surgery, Faculty of Medicine for Girls- Al-Azhar University, Egypt | ||
2Department of General Surgery, Maadi Military Hospital, Egypt | ||
Abstract | ||
Background: Inguinal hernia repair is one of the most frequently performed operations worldwide. Laparoscopic transabdominalpreperitoneal (TAPP) repair is widely used, but the necessity of mesh fixation remains controversial. This study comparedfixation versus non-fixation of mesh in TAPP repair with respect to postoperative pain, operative time, hospital stay, andrecurrence. Methods: A prospective randomized controlled trial was conducted on 40 patients with primary inguinal hernia undergoinglaparoscopic TAPP repair. Patients were randomized into two groups: Group A (n= 20) with mesh fixation using tackers, and Group B (n= 20) with mesh placement without fixation. Outcomes measured included operative time, pain (1 week, 3 and 6 months), complications, recurrence, and recovery time. Results: Operative time was significantly longer in the fixation group (p= 0.044). Pain was higher at 1 week in Group A (p= 0.018)but comparable at 3 months, with no pain reported at 6 months. No recurrences occurred in either group. Hospital stay wassimilar, but return to normal activity was significantly delayed in Group A (p= 0.019). Conclusions: Mesh fixation prolongs surgery and increases early postoperative pain without improving long-term outcomes. Non-fixation appears safe, reducing operative time and enhancing recovery. | ||
Keywords | ||
Hernia; Inguinal; Laparoscopic; Transabdominal preperitoneal repair; Total extraperitoneal repair | ||
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