ISSN: 2578-482X
Authors: Kumari TA and Aslam M*
Background: The necessity of mesh fixation in laparoscopic totally extra peritoneal (TEP) inguinal hernia repair remains controversial. We performed a single-center prospective study to compare the effectiveness of mesh fixation versus nonfixation in laparoscopic TEP repair. Materials and Methods: This study was conducted in the Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India, from August 2021 to July 2023. All patients admitted to the General surgical unit with uncomplicated inguinal hernias were included. A total of 96 patients were included in the study, of which 44 patients underwent TEP repair with fixation of mesh using tacks (GROUP A) and the remaining 52 patients whose mesh was not fixed (GROUP B). Results: Ninety-six patients were randomized to fixation or non-fixation group in TEP. The pain scores at 24 hours, 72 hours, 7 days, 1 month, and 3 months were comparable, but not statistically significant (Day 1 Fixation, 2.7 ± 0.79; Non-fixation 2.48 ± 0.78, P = 0.104, 1 week (Fixation, 0.02 ± 0.15; Non-fixation, 0.08 ± 0.27, P = 0.236). The length of hospital stay (Fixation, 2.07 ± 0.59 days; Non-fixation, 2.1 ± 0.41 days, P = 0.785) and days taken to resume normal activities (Fixation, 3.7 ± 1.02 days; Non-fixation, 3.54 ± 0.94 days, P = 0.41) were also similar for both groups. There was no recurrence in either group at a minimum follow-up of 12 months. The cost of surgery was significantly different between the fixation group and the nonfixation group with a p-value <0.0001. Conclusion: There was no statistical significance between the fixation and non-fixation groups in terms of postoperative pain, requirement and dosage of analgesics, duration of in-hospital stay, time to return to normal activity, complications, recurrence of hernia, except the cost of surgery which was higher in the fixation group.
Keywords: Peritoneal Inguinal Hernia; Mesh; Laparoscopic Repair Techniques
