Comparing laparoscopic totally extraperitoneal inguinal hernia repair with and without mesh fixation

Abstract

AIM: To compare totally extraperitoneal (TEP) repair in uncomplicated primary inguinal hernia patients with and without mesh fixation using tack in terms of peri- and post-operative complications, recurrence, return to work, and hospital stay.

MATERIAL AND METHODS: We retrospectively analyzed the medical records of patients who underwent TEP repair of uncomplicated primary inguinal hernia (American Society of Anesthesiologists score I/II) at our institute from January 2008 to December 2017.

RESULTS: In total, 354 patients were included in this study. There was no statistical difference in the body mass index (BMI) and duration of operation between patients with and without fixation. The mean number of days to return to work was significantly (p=0.000) higher in patients with use mesh fixation (9.06+1.749) compared to patients without mesh fixation (7.31+2.097). There was no difference between the two groups in terms of post-operative complications, except for seroma of the inguinal region, subcutaneous emphysema, and post-operative pain (p<0.05). The mean number of days of hospital stay was significantly (p=0.002) higher in patients with mesh fixation (1.11+0.329) compared to patients without mesh fixation (1.02+0.149). Evaluation of peri- and post-operative complications in BMI groups showed that obese patients and other groups had no significant difference (p>0.05).

CONCLUSIONS: Non-mesh fixation laparoscopic TEP repair is safe and feasible for primary and relapsed inguinal hernias. Patients experienced less chronic pain, shorter hospital stay, and shorter time to return to work. Furthermore, it might be safe in obese patients but requires additional study to confirm.