Comparison of mesh fixation and nonfixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia

Abstract

Introduction: Application of preperitoneal mesh method in the treatment of inguinal hernia can be regarded as one of the successful methods in this regard. However, the impact of mesh fixation or nonfixation on the recurrence of hernia and the incidence of its complications have not been thoroughly investigated.The present study aimed at comparing the effect of mesh fixation and nonfixation on transabdominal preperitoneal (TAPP) laparoscopy for inguinal hernia repair. Materials and Methods: In this study, eighty patients with inguinal hernia underwent TAPP laparoscopy with mesh fixation (n = 41) and nonfixation (n = 39). Mesh was fixed using a suture in Group A and nonfixed in Group B. Then, the duration of operation, length of in-hospital stay, complications and recurrence of hernia, and pain severity 1 day after the surgery, during discharge, at the 1st and 2nd weeks, and at 1 and 6 months after the surgery were compared between the two groups. Results: The length of in-hospital stay and return to work in Group B was statistically significantly lower than that of Group A (P < 0.05). Neuralgia and urinary retention were statistically significantly higher in Group A as compared with Group B (P < 0.05). There were no and 5.1% hernial recurrence in Group A and Group B, respectively (P > 0.05). The level of pain was generally higher in Group A and was statistically significant 1 and 2 weeks after the surgery (P < 0.05). Conclusion: Mesh nonfixation causes less postoperative complications and pain in patients undergoing TAPP repair; however, in long-term follow-up, the level of chronic pain following the application of mesh fixation and non-fixation methods is not different.