Mesh splitting versus nonsplitting in laparoscopic transabdominal preperitoneal inguinal hernia repair

Abstract

Aim Our research was performed to determine the effects of mesh tailoring and splitting to enclose the spermatic cord and to equate this technique in terms of risks, quality of life, and recurrence rate to the conventional transabdominal preperitoneal (TAPP) procedure. Patients and methods A total of 40 patients with mean age of 33.6±8.8 years, ranging from 18 to 60 years, underwent laparoscopic hernia repair (TAPP), where group I underwent repair with mesh splitting technique, whereas group II underwent the standard TAPP approach without mesh splitting. All patients participated in the study completed 2 years of follow-up. Full clinical assessment for all patients was performed, and any postoperative complications such as postoperative pain, wound infection, seroma, hematoma, or recurrence were recorded. After 1 year, testicular perfusion was assessed as well. For evaluation of the quality of life, MOS 36-Health Survey (SF-36) was used. Results There was no significant difference between the two groups in terms of recovery time to normal physical activity. All patients reported that their chronic groin pain was reduced over time and completely disappeared after 6 months. The most common encountered complication was postoperative seroma, which occurred in 22 (55%) patients. In terms of incidence of recurrence, only one case was reported in group II after 3 months of follow-up. Conclusions No difference in postoperative complaints or complications was demonstrated with mesh splitting and fashioning in laparoscopic hernia repair. Moreover, proper surgical handling and reduction of suturing and fixation in addition to avoiding nerve and vessels injuries are the main keys to prevent posthernioplasty chronic pain. Additionally, this study could not demonstrate any effects on the testicular integrity from implantation of splitted or nonsplitted mesh.