Factors guarantee competence of laparoscopic repair of inguinal hernia

Abstract

Aim: To evaluate the impact of age, type of hernia, size of the mesh used, and fixation of the mesh on the competence of laparoscopic repair of inguinal hernia. Materials and methods: Randomized controlled clinical study carried out from November 2016 to July 2017 in 98 patients with inguinal hernias admitted to surgery Department of Minia University Hospital. Patients were divided into two groups randomly. Group I includes 49 patients who underwent laparoscopic transabdominal preperitoneal (TAPP) hernioplasty and group II includes 49 patients who underwent laparoscopic totally extra peritoneal (TEP) hernioplasty with and without fixation of the mesh. Results: Operative time in group I ranges between 40 minutes and 110 minutes with mean time of about 66.85 minutes, while in group II ranges between 20 minutes and 105 minutes with mean time of about 52.65 minutes. This difference was statistically significant. Pain was 8.2% in group I and 10.2% in group II. Scrotal edema was 0% in all patients in both groups. Urinary retention was 2% in group I and 4.1% in group II. Seroma was the same (6.1%) in both groups. Recurrence after 6-month follow-up was 2% in both groups. All recurrent cases are nonfixed. Conclusion: There is no difference between TEP and TAPP, but TAPP technique appears to be superior to the TEP repair in patients undergoing unilateral inguinal hernia repair. Clinical significance: The TEP approach can be offered to patients with bilateral and recurrent hernias. TEP procedure was associated with more adverse events during surgery but less postoperative pain, faster recovery of daily activities, quicker return to work, and less impairment of sensibility after 1 year.