Laparoscopic TEP inguinal hernia repair - Are we overdoing it? A comprehensive study of 25 cases of TEP inguinal hernia repair done without the use of electrocautery and without any mesh fixation.

Dr Kaundinya Kiran B

Volume : VIII, Issue : I, January - 2019

Laparoscopic TEP inguinal hernia repair - Are we overdoing it? A comprehensive study of 25 cases of TEP inguinal hernia repair done without the use of electrocautery and without any mesh fixation.

Dr Kaundinya Kiran B

Abstract :

Objectives: As one of the most effective and accepted minimally invasive techniques for inguinal hernia repair Laparoscopic Totally ExtraPeritoneal (TEP) repair is met with a learning curve and caution towards injury of major vessels/nerves and mesh migration. Less experienced surgeon may tend to use excessive cautery and overzealous mesh fixation. Such practices in surgery can be avoided without any changes in immediate or late outcomes of the procedure.

Methods: Our case series of 25 patients who underwent the laparoscopic TEP inguinal hernia repair without use of cautery and without mesh fixation done over 2 years suggest the efficacy and outcomes of such practices allowing smooth and uneventful postoperative recovery and encouraging day care surgery.

Results: Assessment of patients for the outcomes of the said practice in laparoscopic TEP surgery included pain score assessment along with identification of early and late complications like post operative pain, seroma, infection, groin pain, and recurrence. Apart from a few patients having post operative pain responding to NSAIDs (non steroidal anti inflammatory drugs), none of the other complications were seen in the patient group.

Conclusion: Laparoscopic TEP for inguinal hernia repair does not need excessive cautery for plane dissection and also does not need mesh fixation necessarily. These practices have negligible outcome on hernia recurrence and enable smooth post operative recovery