Mesh Fixation Technique Research Articles

A randomized clinical trial comparing early patient-reported pain after open anterior mesh repair versus totally extraperitoneal repair of inguinal hernia.

This was a prospective, multicentre, non-blinded, randomized clinical trial involving two parallel groups of patients. Adult patients with symptomatic unilateral primary inguinal hernia were included in this study. Patients were enrolled and treated in five Finnish hospitals. Eligible patients were randomized by use of a computer-based program to receiving either open anterior repair (modified Lichtenstein) with glue mesh fixation or totally extraperitoneal (TEP) repair. The primary aims were to compare 30-day patient-reported pain scores and return to work after surgery between the two groups. A total of 202 patients were randomized: 98 patients to TEP repair and 104 patients to open repair. All randomized patients received their allocated treatment. A total of 86 patients (88 per cent) in the TEP group and 94 patients (90 per cent) in the Lichtenstein group completed the 30-day follow-up. Patients experienced less early pain (P < 0.001) and used less analgesics after TEP repair, compared to those who had modified Lichtenstein repair. Two patients in the TEP group and five in the Lichtenstein group developed superficial wound infection (P = 0⋅446). Only one reoperation was performed in the Lichtenstein group due to haematoma. TEP inguinal hernia repair is associated with less early postoperative pain compared to the open glue mesh fixation technique. NCT03566433 (http://www.clinicaltrials.gov).

Mesh fixation techniques in primary ventral or incisional hernia repair.

Mesh fixation techniques in primary ventral or incisional hernia repair.

An evaluation of clinical and quality of life outcomes after ventral hernia repair with poly-4-hydroxybutyrate mesh.

Despite continued efforts, recurrence after ventral hernia repair (VHR) remains a common problem. Biosynthetic Phasix™ (Poly-4-Hydroxybutyrate, P4HB) mesh combines the durability of synthetic mesh with the bio-resistance of biologics. P4HB has shown promising early outcomes, but long-term data are lacking. We examine patients following VHR with P4HB with at least 3years of follow-up to assess clinical and patient reported outcomes (PROs). Adult patients (≥ 18years old) undergoing VHR with P4HB mesh between 10/2015 and 01/2018 by a single surgeon were retrospectively identified. Patients with < 36months of follow-up were excluded unless they had a documented recurrence. Clinical outcomes and quality of life using the Hernia-Related Quality of Life Survey (HerQLes) were assessed. Seventy-one patients were included with a median age and body mass index of 61.2 and 31kg/m2, respectively. Mesh was placed in the retromuscular (79%) and onlay (21%) planes with 1/3 of patients having hernias repaired in contaminated fields. There were no mesh infections, enterocutaneous fistulas, or mesh explantations. Nine patients (12.7%) developed recurrence at a median follow-up of 43.1months [38.2-49.1]. Mesh plane, fixation technique, and Ventral Hernia Working Group were not associated with recurrence. Significant improvement in disease-specific PROs was observed and maintained at 3-year follow-up. Longitudinal clinical and quality of life outcomes after clean and contaminated VHR with P4HB are limited. Here, we conclude that P4HB is an effective and versatile mesh option for use in abdominal wall reinforcement.

Comparative evaluation of outcomes in different techniques of mesh fixation in totally extraperitoneal hernioplasty

PURPOSE: Inguinal hernia repair is the most commonly performed surgery worldwide with surgical approaches being open and endoscopic hernioplasty. Mesh fixation in endoscopic hernia repair still remains a topic of debate. Moreover, a paucity of literature is present with regard to the quality of life (QOL) outcomes after mesh fixation in endoscopic hernia repair.MATERIALS AND METHODS: This prospective nonrandomized study was done on patients operated by totally extraperitoneal (TEP) hernioplasty. Primary outcome parameters included any complications, postoperative pain, and hernia-related QOL by Carolina's Comfort Scale among two different types of mesh fixation techniques (Group I - intracorporeal Suture fixation and Group II - tack fixation).RESULTS: TEP repair was done on 74 patients with suture fixation of the mesh by intracorporeal knotting (Group I; n = 30) and tack fixation of mesh (Group II; n = 44). There was no significant difference in the time to return to routine work, sensation of mesh, and pain, but time to return to office work was significantly lower in the patients of Group I (4.29 ± 0.99) compared to Group II (4.75 ± 0.96) and there was a significant difference in movement limitation from postoperative to subsequent time period in all groups except for after 3 months to 6 months in Group II.CONCLUSION: Intracorporeal suture fixation of mesh in TEP can be used as an alternate technique for mesh fixation with comparable perioperative and QOL outcomes.

REFLECTED INGUINAL LIGAMENT: A POTENTIAL ANATOMICAL LANDMARK FOR MESH FIXATION IN INGUINAL HERNIA REPAIR.

Introduction Recurrence of inguinal hernia after surgery secondary to mesh fixation techniques still remains a complication of inguinal hernioplasty. This study focuses on evaluating the reflected inguinal ligament and its potential in surgical application. Method A total of 181 patients undergoing inguinal hernia repair at Travancore Medical College, Kollam, Kerala between 2015 to 2020 were included in the study. The reflected inguinal ligament was identified by tracing fibres passing upwards and medially from the pubic tubercle to the rectus sheath. The incidence of the ligament and its shape were documented. Results Of the 181 patients, the male to female ratio was 7.6:1. The average age of the study population was 55.1 ± 14.3. 37% had right sided inguinal hernia, 19% had left sided inguinal hernia and 44% had bilateral inguinal hernia. Intraoperatively, the reflected inguinal ligament was identified in all patients with 60% having a triangular shape and rest had rectangular shape. Rectangular shape is more common as age increases. Discussion Current literature rarely examines the reflected inguinal ligament in depth. Further ambiguity is caused by various authors using different nomenclature for the ligament. Accepting the limitations such as constrained geographical variation in our study population, the findings of our study in combination with those of existing literature warrants further studies specifically evaluating the reflected inguinal ligament. Conclusion The reflected ligament was identified in all of our patients. This study recommends that further studies evaluate the reflected inguinal ligament as a potential landmark to fix the medial end of the mesh during inguinal hernioplasty.

Impact of Mesh and Fixation on Chronic Inguinal Pain in Lichtenstein Hernia Repair: 5-Year Outcomes from the Finn Mesh Study

ObjectiveTo find out the mesh fixation technique that minimises chronic pain in Lichtenstein hernioplasty.Summary background dataMesh fixation may affect chronic pain and recurrence after inguinal hernia surgery, but long-term results of comparative trials are lacking.MethodsLichtenstein hernioplasty was performed under local anaesthesia on 625 patients in day care units. The patients were randomised to receive either a cyanoacrylate glue (n = 216), self-gripping mesh (n = 202) or non-absorbable 3–0 polypropylene sutures (n = 216) for the fixation of mesh. A standardised telephone interview or postal questionnaire was conducted 5 years after the index operation. The patients with complaints suggesting recurrence or chronic pain (visual analogue scale ≥ 3, 0–10) were examined clinically. The rate of occasional pain, chronic severe pain, recurrence, re-operations, daily use of analgesics, overall patient satisfaction and sensation of a foreign object were recorded.ResultsA total of 82% of patients (n = 514) completed the 5-year audit including 177, 167 and 170 patients in the glue, self-fixation and suture groups, respectively. There were no significant differences in the incidence of pain (7–8%), operated recurrences (2–4%), overall re-operations (4–5%), need for analgesics (1–2%), patient’s satisfaction (93–97%) or in the feeling of a foreign object (11–18%) between the study groups.ConclusionThe choice of the mesh or fixation method had no effect on the overall long-term outcome, pain or recurrence of hernia. Less penetrating fixation (glue or self-gripping mesh) is a safe option for the fixation of mesh in Lichtenstein hernia repair.

Tissue Adhesives for Hernia Mesh Fixation: A Literature Review.

In an effort to optimize the results during inguinal hernia repair, surgeons need to consider the role of different mesh fixation techniques. The use of tissue adhesives is proposed for mesh fixation, which demonstrate similar or improved outcomes in the realm of postoperative pain, hernia recurrence, cost, and formation of a hematoma or seroma. In this review, mesh fixation using fibrin glue and cyanoacrylate glue is compared to standard suture or tack techniques. The results of this investigation warrant consideration by surgeons seeking to improve patient outcomes.

Changing the innate consensus about mesh fixation in trans-abdominal preperitoneal laparoscopic inguinal hernioplasty in adults: Short and long term outcome. Randomized controlled clinical trial.

Inguinal hernioplasty is the standard treatment for inguinal hernia in adults. Mesh fixation was used to keep mesh in place for which various mesh fixation techniques have been used in laparoscopic inguinal hernia repair in adults, but their effectiveness has remained inconclusive. to evaluate non fixation method of mesh laparoscopic inguinal hernioplasty as safe and effective as regard short and long term outcomes. Over the period from July 2013 to July 2018, 798 patients with oblique inguinal hernias undergoing Trans abdominal preperitoneal technique (TAPP) were randomized into 3 groups: Group A; mesh non fixation 266 patients. Group B; tacker mesh fixation 266 patients Group C: Cyanoacrylic tissue glues (Histoacryl) mesh fixation 266 patients. Clinical effects were assessed by the following variables: intraoperative data, postoperative outcome as regard recurrence rate, postoperative pain [on visual analogue score (VAS)], analgesic consumption, operation time, hospital stay, and patient costs. Follow up was 18 months. There was no statistical difference between groups (A) and Group (C) regarding operative time, postoperative complications, and length of hospital stay and risk of chronic groin pain, postoperative pain score. In Group (B): the postoperative pain and complications were higher. There were 5 cases of hernia recurrence in all groups, but no significant differences among the three groups. Tacker Mesh fixation increased the risk of chronic groin pain. Pain score was higher with tacker mesh fixation. Laparoscopic TAPP inguinal hernia repair without tacker mesh fixation was safe and feasible with no significant increase in recurrence rates. Furthermore, mesh fixation with tacker procedure increased the risk of postoperative complications and patient costs. All ethical approval was given by our Faculty of Medicine medical ethical committee.

Evaluation of new technique of mesh fixation in laparoscopic inguinal hernia repair

Background: Hernia is a common problem of the modern world with an incidence ranging from 5 to 7%. Of all groin hernias, around 75% are inguinal hernias. Recently with the advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the work was to evaluate a new technique for mesh fixation by Zein method of suturing and compare it with stapled mesh fixation in laparoscopic inguinal hernia repair transabdominal preperitoneal approach.Methods: The study is a randomized, prospective single group study. The study was conducted after the approval of the ethical committee of the surgical department, Menoufia University. It was conducted in Menoufia University Hospital on 50 patients with inguinal hernia who were operated upon between September 2018 and September 2019 with a minimal follow-up of 6 months.Results: Age of studied patients ranged from 27 to 55 years with mean 42.82±7.90 age/years. Regarding sex of studied patients, more than half (74%) of studied patients were males and (26%) were females. Regarding comparsion between high and low overall cost burden on the patient, it was interestingly found that high cost is associated with presence of complication like hematoma, prolonged stay in the hospital and prolonged use of antibiotics.Conclusions: Both the use of sutures and fixation of mesh by absorbable tacks approaches are similarly effective in terms of operative time, the incidence of recurrence, complications, and chronic pain coinciding with all the available literature.

Transfascial suture versus tack fixation of mesh in totally extraperitoneal repair of inguinal hernia: A prospective comparative study.

Purpose:Among laparoscopic surgeries in inguinal hernias, totally extraperitoneal (TEP) repair has demonstrated favourable results in reduction of post-operative pain and mean operative times with early return to physical activity. We have done a prospective comparative study on two different techniques of mesh fixation, i.e., transfascial suture and tack fixation.Materials and Methods:It was a prospective, non-randomised comparative study done on inguinal hernia patients operated by TEP repair from October 2014 to September 2016. These data were compared in two techniques of mesh fixation (tack and transfascial sutures) in terms of post-operative complications, pain scores by visual analogue scale (VAS) and cost analysis of the procedure.Results:Our study on 69 total patients (44 tack fixation and 25 suture fixation group) revealed that mean VAS scores for post-operative pain were not having any statistically significant difference in the tack group versus suture group (2.42 ± 0.24 vs. 2.2 ± 0.24) at 24 h, but VAS scores in the follow-up period at 1 week, 1 month, 3 months and 6 months were 1.14 ± 0.33 versus 0.67 ± 0.27; 0.78 ± 0.24 versus 0.07 ± 0.06; 0.42 ± 0.17 versus 0.07 ± 0.06 and 0.5 ± 0.11 versus 0.07 ± 0.06, respectively, which showed significant difference at 1 and 3 months, suggesting less pain in the suture group. No significant difference was noted in other post-operative complications.Conclusion:Transfascial suture fixation of mesh in TEP repair of inguinal hernia can be a cost-effective procedure with a comparable safety profile as compared to tack fixation.

Mesh fixation technique for inguinal hernia repair: protocol for an umbrella review with integrated and updated network meta-analysis

IntroductionInguinal hernia mesh repair is the standard care for symptomatic inguinal hernia. Mesh fixation is used to keep mesh in place for which various mesh fixation techniques have been used...

Mesh fixation in open IPOM procedure with tackers or sutures? A randomized clinical trial with preliminary results.

In open intra-peritoneal onlay mesh (IPOM) hernia repair, mesh fixation can be done by tacks, sutures or fibrin glue. There are randomized controlled trials (RCTs) on laparoscopic IPOM procedure, but no RCT so far has examined mesh fixation techniques in open IPOM repair. In a single-center RCT, 48 patients undergoing open IPOM repair of an abdominal wall hernia were included. After randomization, surgery was performed in a standardized fashion. Hernia size, extent of mesh fixation, and duration of surgery were documented. The primary endpoint was postoperative pain intensity. Secondary endpoints were: complications, length of stay, quality of life, return to work, hernia recurrence. Follow-up was 1year in all 48 patients. After using tacks, mean pain intensity was 16.9, which is slightly lower than after suture fixation (19.6, p = 0.20). The duration of surgery was about the same (83 vs. 85min). When using tack fixation, significantly more fixation points were applied as compared to sutures (19 vs. 12; p = 0.02), although mesh size was similar. The complication rate was similar (tacks: 6/28 vs. sutures: 3/20). Cost of suture fixation was about 26 €, which is markedly lower than the 180 € associated with tacks. However, surgeons clearly preferred mesh fixation with tacks, because it is more comfortable especially in small hernias. The present study failed to show an advantage of tacks over suture fixation and even there are more severe adverse events. Using tacks significantly increases the costs of hernia repair.

Transfascial suture fixation technique in laparoscopic repair of inguinal hernia.

IntroductionThis study presents the initial results of a transfascial suture mesh fixation technique. This method was devised to reduce operative costs and foreign body‐associated risks while embracing the benefits of fixation in laparoscopic inguinal hernia repair.Materials and Surgical TechniquePatients undergoing laparoscopic inguinal hernia repair with transfascial suture fixation (TRANSFIX) in our center between March 2017 and March 2018 were retrospectively reviewed. The procedure is orchestrated by a reusable fascial closure device sequentially puncturing the fascia vertically through the inferior port site and guiding a polypropylene thread through the mesh. The thread is retrieved from the extraperitoneal plane with the device, creating an extracorporeal suture loop to embed a surgical knot at the subcutaneous layer of the port site.DiscussionIn its first year after introduction, 16 TRANSFIX were performed. All patients were men (mean age, 62.6 years). Thirteen hernias (81.3%) were first occurrence, and three (18.8%) were recurrent. Twelve (75.0%) were direct hernias, and three (18.8%) were indirect hernias; one patient presented with concurrent direct and indirect hernia. Median operating time was 41.5 minutes for unilateral repair and 73.0 minutes for bilateral. Median blood loss was 5 mL. One patient had a seroma after unilateral indirect hernia repair. After a median follow‐up of 15.5 months (range, 9‐21 months), no patient had chronic pain, wound infection, hematoma, or recurrence. Instrumental cost reduction per operation was between $150 and $300. TRANSFIX appears to be a safe and economical mesh fixation method.

A comparative study of mesh fixation versus nonfixation in laparoscopic totally extraperitoneal inguinal hernia repair

Background Inguinal hernia repair is one of the most common elective general surgical procedures, and laparoscopic inguinal hernia repair has become very popular procedure, accounting for 15–20% of hernia operations worldwide. Aim of the work This study was conducted to compare mesh fixation versus nonfixation in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Patients and methods This study is a prospective randomized comparative study that was carried out in the Gastrointestinal and Laparoscopic Surgery Department of Tanta University Hospitals for a year on 40 patients with inguinal hernia who underwent TEP inguinal hernia repair. They were randomized into two equal groups (20 cases): group A: with mesh fixation and group B: without mesh fixation. Results All patients of both groups were males. Group A had a longer operative time than group B (P=0.018). There was no significant difference in postoperative pain in both groups (P=0.6). One (5%) patient in each group had an accidental peritoneal tear. No cases needed conversion. Drain was inserted in one (5%) patient in each group (P=1). No cases had seroma or hematoma formation or chronic groin pain in both groups. One (5% each) patient in each group had scrotal edema, and postoperative surgical emphysema was present in two (10%) patients in each group. No cases of postoperative wound infection or mesh infection were seen in both groups. There was a recurrence in one patient in group B (after 1 week postoperative). The mean hospital stay is statistically insignificant in between both groups. The mean total cost is much higher in group A than group B (P Conclusion On comparing mesh fixation or nonfixation in laparoscopic TEP repair for inguinal hernia, we recommend the technique without mesh fixation as there were no differences in the complications, hospital stay, or recurrence, but longer operative time and higher cost were seen in mesh fixation technique.

Comparison of totally extraperitoneal groin hernia repair with and without mesh fixation

INTRODUCTION: Since the introduction of the laparoscopic technique for tension-free inguinal hernia repair, various mesh fixation techniques have been adopted. The need for mesh fixation during the surgery is still under debate. We conducted our study to compare the outcomes of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair with (MF) and without (NMF) mesh fixation. PATIENTS AND METHODS: One hundred and fifty-seven patients underwent laparoscopic inguinal hernia repair without mesh fixation during 2010–2014. Of these, 113 (71.9%) agreed to participate in our trial, underwent physical examination, and filled out a questionnaire regarding their satisfaction with the surgery outcome. The data collected from medical records and results of the examination and the questionnaire were processed statistically and compared to the results of a previous study, which included patients who underwent TEP with mesh fixation. RESULTS: Mean follow-up was about 3 years in both groups. Duration of procedure and length of hospital stay were shorter in the NMF group. Patients without mesh fixation had less pain and earlier return to work and physical activity. There was no significant difference in recurrence rate between NMF and MF groups (5.6% and 4.6%, respectively). The majority of recurrences in the MF group were among patients in whom a nonsplit mesh was used. Surgery satisfaction, however, was significantly higher in the MF group. CONCLUSION: TEP without mesh fixation results in better surgical and postoperative outcome comparing with mesh fixation. Overall hernia recurrence rate was similar in patients with and without mesh fixation. Regular follow-up of at least 18 months is recommended to define true recurrence rate.

Laparoscopic approach to ventral incisional hernia: absorbable or non-absorbable tacks? —a meta-analysis

Background: To compare feasibility andeffectiveness of absorbable and non-absorbable mesh fixation techniques inlaparoscopic ventral incisional hernia repair. Methods: A PubMed Embase, Google Scholarsystematic review was carried out. Primary and secondary endpoints wereconsidered. Odds ratio (OR) for each item was pooled and no bias according toQUADAS-2 tool and funnel plot asymmetry test were found. Results: Five randomized controlled trials,including 1,091 patients, were enrolled. There was no difference between thetwo techniques in terms of postoperative morbidity (OR: 1.03, P=0.910), seromas(OR: 0.77, P=0.520), adhesion formations (OR: 0.49, P=0.560) and chronic pain(OR: 0.81, P=0.260). Risk of recurrence was significantly higher in theabsorbable group (OR: 1.67, P&lt;0.001). Conclusions: The adoption ofabsorbable or non-absorbable tack techniques does not influence patients’outcome. However, non-absorbable devices should be selected in high risk ofrecurrence cases.

Mesh fixation technique in totally extraperitoneal inguinal hernia repair – A network meta-analysis

Laparoscopic totally extra-peritoneal inguinal hernia repair is the standard option for inguinal hernia treatment. However, there are various types of mesh fixation and their relative uses are still controversial. This network meta-analysis was conducted to compare and rank the different fixations available for TEP. Medline and Scopus databases were search until February 1, 2017 and using randomized controlled trials comparing outcomes between different mesh fixation techniques were included. The results demonstrated that fifteen RCTs (n = 1783) were eligible for pooling. Five types of mesh fixation were used; metallic tack, no-fixation, absorbable tack, suture, and glue. Network meta-analysis that use metallic tack as the reference, indicated that suture and glue both carried a lower risk of recurrence with pooled risk ratios (RR) of 0.29 (95% CI 0.00, 18.81) and 0.29 (0.07, 1.30), respectively. For overall complications, absorbable tack had lower risk (0.63, 95% CI: 0.02, 16.13). However, none of these estimates reached statistical significance. So, this network meta-analysis suggests that glue and absorbable tack might be best in lowering recurrence risk and complications. However, a large scale RCT is still needed to confirm these results.

Pain and Surgical Outcomes Reporting After Laparoscopic Ventral Hernia Repair in Relation to Mesh Fixation Technique: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

The aim of this meta-analysis was to examine postoperative pain and surgical outcomes (operative time, hospital stay, the incidence of seroma and recurrence) with different mesh fixation methods following laparoscopic ventral hernia repair (LVHR). Randomized clinical trials compared different methods of mesh fixation in LVHR and reported on pain outcome measures analyzed. The results were expressed as odds ratio (OR) for combined dichotomous and mean difference (MD) for continuous data. Five randomized controlled trials (RCTs) with a total of 466 patients comparing tack mesh fixation to suture mesh fixation technique in LVHR were identified, all were published after 2005. A meta-analysis gave statistically similar odds of postoperative chronic pain (OR, 1.24; 95% CI, 0.65-2.38; z = 0.65; P = .51). No difference in pain intensity (PI) scores was found at 4-6 weeks (MD, 0.18;% CI, -0.48 to 0.85; z = 0.54; P = .59) and at 3-6 months postoperatively (MD, 0.10; 95% CI, -0.21 to 0.42; z = 0.64; P = .52). There was no difference in the pooled analysis of seroma/hematoma formation (OR, 0.60; 95% CI, 0.29-1.26; z = 1.35; P = .18), recurrence (OR, 1.11; 95% CI, 0.34-3.62; z = 0.18; P = .86), and hospital stay (MD, -0.06; 95% CI, -0.19 to 0.08; z = 0.83; P = .40). Operative time was significantly lower with tack fixation (MD, -19.25; 95% CI, -27.98 to -10.51; z = 4.32; P < .05). Meta-analysis of RCTs comparing tacks to suture fixation in LVHR showed comparable results with regard to postoperative chronic pain incidence and PI, and hernia recurrence. However, the operative time is shorter with tacks compared to suture fixation technique.

A word of caution: never use tacks for mesh fixation to the diaphragm!

BackgroundThe mesh fixation technique used in repair of hiatal hernias and subxiphoid ventral and incisional hernias must meet strenuous requirements. In the literature, there are reports of life-threatening complications with cardiac tamponade and a high mortality rate on using tacks. The continuing practice of tack deployment for mesh fixation to the diaphragm and esophageal hiatus should be critically reviewed.MethodsIn a systematic search of the available literature in May 2017, 23 cases of severe penetrating cardiac complications were identified. The authors became aware of two other cases in which they acted as medical experts. Furthermore, the instructions for use issued by the manufacturers of the tacks were reviewed with regard to their deployment in the diaphragm.ResultsTwenty-three of 25 cases (92%) with severe cardiac injuries and subsequent cardiac tamponade were triggered by the use of tacks in the diaphragm. In six cases (24%), these related to ventral and incisional hernias with extension to the subxiphoid area, and in 19 cases (76%) to mesh-augmented hiatoplasty. Twelve of 25 (48%) patients died as a result of pericardial and/or heart muscle injury with cardiac tamponade despite heart surgery intervention. In the tack manufacturers’ instructions for use, their deployment in the diaphragm, in particular in the vicinity of the heart, is contraindicated. Likewise, the existing guidelines urgently advise against the use of tacks in the diaphragm, recommending instead alternative fixation techniques.ConclusionsTacks should not be used for mesh fixation in the diaphragm above the costal arch.

A new approach in laparoscopic repair of inguinal and femoral hernias

The aim of this study to analyze results of a new method which eliminates complications associated with the classic mesh fixation areas and does not increase recurrence rates. This prospective study included a total of 70 patients applied with inguinal or femoral hernia repair with the laparoscopic TEP method. The patients were randomly separated into two groups as Group 1 applied with tack fixation and Group 2 applied with plug mesh and subcutaneous vicryl fixation. The groups were followed up and compared. The group applied with the newly-developed repair technique of plug mesh and vicryl fixation were observed to have a shorter length of stay in hospital, a lower requirement for postoperative analgesia, and reduced urinary retention and seroma rates. No difference was determined between the two groups in respect of operating time and return to normal activities. In the 24-month follow-up period, there was no significant difference in respect of hernia recurrence. The results of the study showed that the use of the newly-developed repair technique of plug mesh and vicryl fixation in laparoscopic TEP inguinal hernia repair increased the life quality after surgery. There are also cost advantages. This is a technique that can be selected for suitable patients.