Comparison between mesh fixation and non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair
Keywords:Hernia, Inguinal, Laparoscopy, Peritoneal cavity, Surgical fixation, Surgical mesh
Background: Laparoscopic hernia surgery, in particular, has been extensively studied and proven to be a viable alternative to, and in some cases superior to, the traditional open mesh repair technique.
Objectives: To compare mesh fixation and non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair in terms of recurrence rate with mesh folding and non-folding.
Methods: A comparative randomized controlled trial was conducted between October 2022 and March 2023 at General Surgery Department, Akbar Niazi Teaching Hospital, Islamabad. The study included a consecutively 100 patients who underwent inguinal hernia surgery. The patient population was divided randomly into two groups. Group-A (Mesh fixation) was administered as a prolene mesh 6 x 11cm and fixed with cooper ligament and pubic symphysis, whereas Group-B (Non-fixation) was administered with the same mesh and placed in the fruchaud myopectineal orifice. The study endpoint in terms of recurrence rate, and mesh folding and non-folding between two groups was measured. The data was analyzed through SPSS v 23.
Results: The patients overall mean average age was 36.43Â±10.81 years. Unilateral hernia in all patients, 60% had right sided, and 40% had left sided. The recurrence rate, and mesh folding was evaluated in both groups during 1 month, 3rd month, and after 6 months completion of follow-up period. No patient developed recurrence in mesh fixation group-A, whereas three patients developed recurrence with mesh folding in non-fixation group-B (p â‰¥ 0.05). The chronic pain was lowest and statistically significant difference in non-fixation group-B as compared to mesh fixation group-A (p â‰¤ 0.05).
Conclusion: Mesh fixation in transabdominal preperitoneal inguinal hernias should be recommended for patients with inguinal hernias less than 4.0 cm in diameter.
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