Therapeutic effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) in various methods of mesh fixation

Abstract

Objective To investigate the difference of curative effect and complications of the mesh fixation of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) with medical adhesive, auto-suture tacks or absorbable suture. Methods 90 cases of primary inguinal hernia treated by the TAPP in Beijing Chuiyangliu Hospital during September 2017 to December 2018 were reviewed. In our control studies, 90 patients were divided into three groups using medical adhesive, auto-suture tacks or absorbable suture, respectively. And they were followed up for 6 to 12 months. Results There was no recurrence in all groups. There were 0 case of local seroma in the medical adhesive group, 1 case in the auto-suture tacks group, and 1 case in the absorbable suture group; No chronic pain occurred in the medical adhesive group. But one case of auto-suture tacks group was happened, and one case in the absorbable suture group. The operative times in each groups of medical adhesive, auto-suture tacks and absorbable suture were (47.5±7.3) minutes, (36.4±6.5) minutes, and (69.2±6.6) minutes. The time of auto-suture tacks group was significantly shorter than the medical adhesive group and the absorbable suture group (P 0.05). The hospitalization expenses of auto-suture tacks group were (13,325±645) yuan. This expense was apparently higher than the medical adhesive group [(9629±646) yuan, P 0.05). The postoperative pain scores at 1, 3, 5, 7, and 14 days after operation in the auto-suture tacks group and in the absorbable suture group were apparently higher than in the medical adhesive group (P<0.05). The pain scores of the absorbable suture group was generally lower than that of the auto-suture tacks group. Conclusion Various methods of mesh fixation in TAPP are safe and effective, and there is no meshes displacement or even recurrence. In comparison, the fixation by auto-suture tacks is the fastest method; medical adhesive and absorbable suture fixation is relatively inexpensive; the fixation by medical adhesive can reduce postoperative pain and decrease the occurrence of hematoma. Key words: Hernia, inguinal; Herniorrhaphy; Laparoscopes; Mesh fixation