Short term outcome of laparoscopic trans-abdominal preperitoneal (Tapp) inguinal hernia repair without mesh fixation, a comparative study

Abstract

Background: Laparoscopic repair of groin hernia is gaining popularity, most surgeons follow up the consensus of mesh fixation especially by tissue penetrating methods, as mesh fixation helps prevent recurrence it also, may cause nerve injuries leading to acute and/or chronic postoperative pain, many alternatives for mesh fixation do exists as use of self-gripping mesh, use of absorbable tacks, use of fibrin glue and the mesh placement in the extra-peritoneal space without fixation as we tried to investigate in this study. Patient and method: 46 patients undergoing laparoscopic trans-abdominal preperitoneal repair of groin hernia were randomly allocated into two equal groups, A (group of mesh fixation with absorbable tacks) and B (group of mesh no fixation). Preoperative, operative, and postoperative data in both groups, namely recurrence rate, acute and chronic pain, and local complications were statistically analyzed in comparison to each other. Results: Throughout the analysis of the data there were no statistically significant differences between both groups regarding demographic data, hernia side, and hernia type. the operative time, acute pain score, and incidence of chronic pain were longer in the fixation group without statistical significance, we recorded one case of recurrence in the non-fixation group but without statistical significance. Conclusion: Mesh placement in the preperitoneal space during laparoscopic trans-abdominal pre-peritoneal repair of inguinal hernia is a safe efficient method as it is not associated with increased recurrence rate or postoperative pain.