Mesh fixation in laparoscopic totally extraperitoneal inguinal hernioplasty by percutaneous subcutaneous suture technique

Abstract

Aim: The method of mesh fixation remains an issue of argument in laparoscopic totally extraperitoneal inguinal hernia repair. Laparoscopic staplers, bioactive tissue glues and tacks had been used by various institutions for the same purpose. In the present article, we describe the percutaneous subcutaneous suture technique, which is an inexpensive method of mesh fixation in laparoscopic inguinal hernia repair.Methods: We carried out a retrospective case series review of cases with laparoscopic totally extraperitoneal inguinal hernia repair carried out in Pok Oi Hospital, Hong Kong from 19 November 2008 to 4 June 2009. Mesh fixation by percutaneous subcutaneous suture technique was carried out for patients with large hernial defects (≥ 4 cm), bilateral or recurrent hernias.Results: One out of 31 hernioplasties (3.2%) carried out with mesh fixation was complicated by recurrence up to 3 months of median follow up.Conclusion: We describe our alternative method of mesh fixation by percutaneous subcutaneous suture technique in laparoscopic totally extraperitoneal inguinal hernia repair. However, further clinical studies are required to elaborate the benefits and long‐term results of this method.