Retrospective study of Totally Extraperitoneal Inguinal Hernia Repair: Fixation Versus No Fixation of Mesh

Dr Mahendra H Goswami; Dr Vidhyasagar M Sharma

Volume : VI, Issue : V, May - 2017

Retrospective study of Totally Extraperitoneal Inguinal Hernia Repair: Fixation Versus No Fixation of Mesh

Dr Mahendra H Goswami, Dr Vidhyasagar M Sharma

Abstract :

Background: Fixation of the mesh during laparoscopic TEP inguinal hernia repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative pain and lead to an increased risk of complications. We questioned whether elimination of mesh fixation during TEP inguinal hernia repair leads to decreased postoperative pain or complications, or both, without an increased rate of recurrence. Methods: A retrospective study was carried out in 40 patients who underwent laparoscopic TEP inguinal hernia repair during january 2013 till december 2015 with or without mesh fixation. Results: Patients in whom the mesh was not fixed had shorter hospital length of stay (8.3 vs 16.0 hours), used less postoperative analgesia, and were less likely to develop urinary retention. No significant differences occurred in the level of pain, time to return to normal activity, or the difficulty of the operation between the two groups. No hernia recurrences were observed in either group (follow–up range, 6 to 24 months, median=17). Conclusions: Elimination of tack fixation of mesh during laparoscopic TEP inguinal hernia repair significantly reduces the use of postoperative analgesia, length of stay in hospital, and the development of postoperative urinary retention without significant reduction in postoperative pain or increased recurrence rate.