Short Term Outcomes of Laparoscopic Totally Extraperitoneal Repair of Uncomplicated Groin Hernia Using Polyester Anatomical Mesh Without Fixation

Hamdy Sedky Abdalla

doi:10.11648/j.js.20170506.13

Abstract

Background: Totally extraperitoneal (TEP) repair of groin hernia can be performed with or without mesh ﬁxation. Fixation can result in postoperative pain or paresthesia due to nerve entrapment. Compared to polypropylene mesh, polyester anatomical mesh (Parietex®, Covidien, Mansfield, MA, USA) has a special configuration to fit the posterior inguinal anatomy. Also, the polyester-based chemistry and the rapidly absorbable biological coating increase the hydrophilicity of the mesh, which is thought to result in a fast and intimate tissue ingrowth that may obviate the need for fixation. Patients and Methods: Laparoscopic TEP repair using Parietex® anatomical mesh without ﬁxation was performed for 60 patients presenting with 63 uncomplicated groin hernias. Results: All patients were males with a mean age of 44.7±14.75 years. There were 60 (95.3%) primary, 3 (5%) bilateral inguinal and 2 (3.3%) femoral hernias. The mean operative time was 64.8±22.6 minutes. There were no major operative complications or conversions to transabdominal preperitoneal or open repair. In the early postoperative period, 54 patients (90%) had mild or no pain. Nine patients (15%) developed minor postoperative complications. The mean length of hospital stay was 1.1±0.3 days and the mean time of return to normal daily activities and to work was 2.6±0.64 and 7.15±1.13 days respectively. No patient developed chronic groin pain, mesh-related complications or recurrences during the study period. Ninety one percent of patients described their satisfaction with surgery as good or excellent. Conclusion: laparoscopic TEP repair of uncomplicated groin hernia using Parietex® anatomical mesh without fixation is safe and does not increase the risk of hernia recurrence.

Highlights

Inguinal hernia repair is one of the most frequently performed operations in general surgery [1]
The aim of this study was to assess the short term clinical outcomes of using polyester anatomical mesh (Paritex®) in Totally extraperitoneal (TEP) repair of uncomplicated groin hernia without fixation and to compare the obtained results to those published in the literature
In spite of markedly reducing recurrence rates, prosthetic materials are often linked to several complications including chronic groin pain and foreign body sensation resulting in reduced quality of life [14, 15]

Summary

Introduction

Inguinal hernia repair is one of the most frequently performed operations in general surgery [1]. Operative techniques have evolved continuously over the past decades establishing tension-free mesh repair as the standard of care [2] These techniques can be performed via open or laparoscopic surgery [3,4]. Laparoscopic mesh repair of inguinal hernia, compared with conventional hernia repair, provides very promising outcomes It has all the advantages of preperitoneal repair and minimally invasive surgery with comparable results in terms of recurrence [5,6,7,8]. Patients and Methods: Laparoscopic TEP repair using Parietex® anatomical mesh without fixation was performed for 60 patients presenting with 63 uncomplicated groin hernias. Conclusion: laparoscopic TEP repair of uncomplicated groin hernia using Parietex® anatomical mesh without fixation is safe and does not increase the risk of hernia recurrence

Objectives

Methods

Conclusion