Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Felipe Girón,Roberto Javier Rueda-Esteban,Juan David Hernandez,Lina Rodríguez,Andres Mauricio García,Alberto Ricaurte,Ricardo Nassar,Juan David Linares

doi:10.1038/s41598-021-92063-9

Felipe Girón, Roberto Javier Rueda-Esteban + Show 6 more

Open Access

https://doi.org/10.1038/s41598-021-92063-9

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Abstract

Inguinal hernia (IH) repair is one of the most common procedures in general surgery around the world. Minimizing postoperative acute and chronic pain without increasing recurrence has been a critical point, giving place to different strategies like self-fixation mesh. The current study aimed to describe a group of patients who underwent IH repair by Totally Extraperitoneal (TEP) technique with self-gripping mesh at a fourth level hospital between 2012 and 2019. Retrospective review of a prospectively collected database including patients who underwent laparoscopic TEP approach with self-fixation mesh for IH repair. Follow up data was obtained at 12, 24, 36, 48, and 60 months post surgical intervention. 207 hernia repairs were performed in 142 patients, with a total of 66 patients with bilateral IH. 10.6% required hospitalization due to either concomitant procedure performed or cardiovascular comorbidities, with a mean hospital stay of 1.6 days. Median and late follow up was up to 5 years. 88.9% of patients complete a year, 86% two years, and 36.7% with a 5 year follow-up. IH repair using the TEP technique and self-fixation mesh showed to be an excellent approach, demonstrating satisfactory results in follow up and complications.

Highlights

Inguinal hernia (IH) repair is one of the most common procedures in general surgery around the world
First cases of minimally invasive inguinal hernia repair were reported in 19927, with progressive implementation due to its benefits such as decreased postoperative pain and faster recovery with low recurrence rates[2,8]
Multiple studies have found that use of mesh in inguinal hernia repairs reduces the risk of recurrence compared to non-mesh approaches[9,10,11,12]

Summary

Introduction

Inguinal hernia (IH) repair is one of the most common procedures in general surgery around the world. Inguinal hernias (IH) are a very common pathology, originated from a defect in the abdominal wall and/or the inguinal canal, at a collagenous naturally weak region of the abdominal wall referred to as the myopectineal orifice[1,2] Repair of this defect is one of the most frequently performed procedures in general surgery[3]. TEP technique, allows exploration of the myopectineal orifices, dissection and reduction of hernial sac and its content with posterior placement of mesh without entering the abdominal c avity[14] Studies comparing both techniques have shown similar complication rates in terms of seroma, scrotal edema, cord swelling, testicular atrophy, urinary and bladder injuries, groin nerve injuries, chronic pain, and recurrence[6,15]. To reduce risk of chronic pain associated with suture or tacker fixation, self-adhering, or self-gripping mesh materials (SAMMS)

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