Comparison between Mesh Fixation and Non‑Fixation in Patients Undergoing Total Extraperitoneal Inguinal Hernia Repair

Abstract

Background: The most important advantages of laparoscopic hernia repair include less postoperative pain, good cosmetic results, and early return to daily activities. Different methods and mesh types are used in inguinal hernia repair.

Aims: The objective of this study was to evaluate the complications and recurrence rates in patients who underwent laparoscopic inguinal hernia repair with and without mesh fixation.

Subjects and Methods: A total of 183 patients who underwent total extraperitoneal (TEP) inguinal hernia repair in the general surgery clinic  between January 2012 and January 2015 patients operated due to inguinoscrotal hernia and those lost to follow‑up were excluded from the study. Patients were divided into two groups. Group 1 consisted of patients in whom 3D (Bard 3D Max) mesh was used and fixed with symphysis pubis absorbable tucker, while group 2 included patients without mesh fixation. All statistical analyses were performed using SPSS 22.0 statistical package software. The differences were considered statistically significant if the P value was less than 0.05.

Results: In the study, 178 patients were included. The median age was 48 years. Of all patients, 98 had right‑sided, 72 left‑sided, and eight bilateral  hernias. The mean follow‑up duration was 45 months. The demographic data between the groups were similar. Operation time was 51.82 ± 18.87 min in group 1 and 52 ± 19.92 in group 2 (P = 0.089). No statistically significant difference was found between both groups in terms of the development of early and late complications. Intraoperative complications, port‑site hernia, and mortality were not seen in any patient.

Conclusion: TEP seems to be a safe and effective surgical approach in inguinal hernia treatment  with acceptable operation times and postoperative results. It was determined that not performing mesh fixation in the TEP application did not cause a statistical increase in morbidity and recurrence rates.

Keywords: Extraperitoneal, hernia, inguinal, mesh, total extraperitoneal