LAPAROSCOPIC TOTAL EXTRAPERITONEAL REPAIR OF INGUINAL HERNIA DIRECT: NONFIXATION OF THREE-DIMENSIONAL MESH

Abstract

Introduction: Laparoscopic inguinal hernia repair frequently is performed with mechanical fixation of a flat polypropylene mesh. Mechanical fixation is associated with pain syndromes and mesh migration may occur without fixation of flat protheses. An anatomically contoured mesh 3D-Max (3DMAX Mesh/Bard-Davol, France) using no fixation would avoid these problems. The objective of this study is to demonstrate the effectiveness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair with nonfixation of three-dimensional mesh. Materials and methods: A prospective analysis of patients, admitted for groin hernia type direct and operated by laparoscopic TEP hernia repair with nonfixation of 3D mesh (3DMAX Mesh), performed between June 2010 and June 2015. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this method. Results: 36 patients/42 hernias type direct underwent laparoscopic totally extraperitoneal (TEP) repair with nonfixation of 3D mesh. The results show with an average age of 59,5±13,2 years (range 36–85 years); peritoneal laceration was noticed during dissection in 7,1%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 54,5±18,1 minutes (range 30–115 minutes), bilateral hernia was 88,3±24,6 (range 65-120 minutes). All of these patients in the study were controlled with 2,4% had pain post-op at 3 months follow-up postoperative, but at 12 months and 24 months follow-up, there were no complication, no recurrences. Conclusions: The laparoscopic (TEP) repair of inguinal hernia with nonfixation of three-dimensional mesh is safe and effective. Keywords: groin hernia – TEP hernioplasty - laparoscopy