Two-point Fixation for Biological Mesh in Laparoscopic Inguinal Hernia Repair

Abstract

Objective: To evaluate the clinical outcomes and safety of two-point fixation for biological mesh in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Study Design: Case series. Place and Duration of Study: The first Affiliated Hospital of Fujian Medical University Hospital, Fuzhou, China, from January to December 2019. Methodology: A total of 38 patients with a primary inguinal hernia who underwent laparoscopic TEP repair with a small intestine submucosal matrix biological mesh were included. A novel two-point fixation method was performed at the level of 2 cm above the upper margin of the hernia ring. The mesh was fixed at 3 cm medial and lateral to the inferior epigastric artery. The recurrence rate, surgical site infection rate, postoperative chronic pain, hematoma/seroma, and chronic pain were evaluated. Results: There was no conversion to open procedure. The surgical time was 60.0 (range 35–72) min, and the time of mesh fixation was 4.00 (range 2.5–6.0) minutes. All patients were discharged on the first postoperative day and had similar pain scores (VAS score = 1). Hematoma/seroma was detected in only three (7.9%) patients. No infection or recurrence was observed. Conclusion: The two-point fixation for biological mesh is reliable and easy to perform. Further study with a larger sample size may be needed to validate it.