Comparative Study between the Use of Self-Fixating Mesh and Non-Self-Fixating Mesh in Laparoscopic Inguinal Hernia Repair Transabdominal Preperitoneal (TAPP) Technique

Abstract

Abstract Background Groin hernia repair is considered to be one of the most commonly performed operations by general surgeons however; there is no "gold standard" operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, and type of anesthesia, occupation, and leisure activities. Objective to compare between self fixating mesh and fixation of non self fixating mesh with absorbaple tacks in laparoscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence. Patients and Methods Our study is a randomized prospective study. It was conducted in El Demerdash, Ain-Shams University Hospital on 08 patients with inguinal hernia who were operated upon between january 2020 and December 2020 with minimal follow up of 3 months. Results Based on our prospective randomized study, a few preliminary conclusions can be made. There was no significant difference in operative time between patients who underwent self gripping mesh fixation and those who underwent mesh fixation by absorpable tacks in TAPP reapir. The postoperative pain assessment at 1 week, 4 weeks and 3 months shows that no significant difference between the two groups confirming the atraumatic nature of the self gripping mesh. We found that both surgical approaches had almost the same Postoperative Hospital stay where the mean postoperative hospital stay was 1.5 days versus 1.6 days in Group A and Group B, respectively and all patients returned to normal activity with mean time 7 ± 2 versus 8 ± 2 days in Group A and Group B respectively. We found that no statistically difference as regard the recurrence between the use of Self Gripping mesh versus fixation of by non absorpable tacks. Conclusion After this comparative study, both the use of SGM and fixation of mesh by non absorpable tacks approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.