Comparison Between Mesh Fixation and Non-Fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair

Authors

  • Waleed Akbar Senior Registrar Akbar Niazi Teaching Hospital/IMDC, Islamabad
  • Rizwan Aziz Professor & HOD Surgery Akbar Niazi Teaching Hospital/IMDC, Islamabad
  • Sohaib Haider Associate Professor Akbar Niazi Teaching Hospital/IMDC, Islamabad
  • Munazzah Aziz Assistant Professor Akbar Niazi Teaching Hospital/IMDC, Islamabad
  • Atiq Ur-Rehman Senior Registrar, Akbar Niazi Teaching Hospital/IMDC, Islamabad
  • Tahira Hameed Senior Registrar, Akbar Niazi Teaching Hospital/IMDC, Islamabad

DOI:

https://doi.org/10.48036/apims.v19i4.861

Keywords:

Hernia, Inguinal, Laparoscopy, Peritoneal cavity, Surgical fixation, Surgical mesh

Abstract

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.

Methodology: A comparative randomized controlled trial was conducted between October 2022 and March 2023 at General Surgery Department, Akbar Niazi Teaching Hospital, Islamabad. 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 36.43±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 ? 0.05). The chronic pain was lowest and statistically significant difference in non-fixation group-B as compared to mesh fixation group-A (p ? 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.

Author Biographies

Waleed Akbar, Senior Registrar Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

Rizwan Aziz, Professor & HOD Surgery Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

Sohaib Haider, Associate Professor Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

Munazzah Aziz, Assistant Professor Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

Atiq Ur-Rehman, Senior Registrar, Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

Tahira Hameed, Senior Registrar, Akbar Niazi Teaching Hospital/IMDC, Islamabad

 

 

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Published

2024-01-09

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Section

Original Articles