Journal of Surgery

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Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia

Received: Jan. 13, 2018    Accepted: Jan. 26, 2018    Published: Feb. 19, 2018
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Abstract

Aim of the work: Randomized comparative study comparing outcome of mesh fixation versus non-fixation in TEP technique for inguinal hernia repair. Methods: In Tanta University Hospitals, over the period from February 2015 to October 2017, 58 patients with with 67 inguinal hernias (9 bilateral) undergoing TEP technique were randomized into 2 groups: Group A; mesh fixation 31 patients with 35 hernias. Group B; mesh non-fixation 27 patients with 32 hernias. Follow up was 6-17 months. Results: There was no statistical difference between 2 groups regarding operative time, postoperative complications, length of hospital stay and risk of chronic groin pain. Postoperative pain score was higher in Group A (mesh fixation). There was one case of hernia recurrence in group A (hernia and recurrence were both indirect), however, risk of hernia recurrence was not statistically significant. Conclusion: Mesh fixation and non-fixation in TEP are comparable regarding operative time, complications and hospital stay, while pain score was higher with mesh fixation. Mesh fixation does not increase the risk of chronic groin pain, while non-fixation does not increase hernia recurrence rate. Both techniques were proved safe.

DOI 10.11648/j.js.20180601.15
Published in Journal of Surgery ( Volume 6, Issue 1, February 2018 )
Page(s) 23-28
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Inguinal Hernia, TEP, Totally Extraperitoneal, Mesh, Fixation, Tacker, Mesh Migration, Hernia Recurrence

References
[1] Kinga A. Powers and Daniel B. Jones (2013): Totally Extraperitoneal Inguinal Hernia Repair in: Master Techniques in Surgery, Hernia Editor: Daniel B. Jones, Josef E. Fischer, LIPPINCOTT WILLIAMS & WILKINS 16; 173-191.
[2] Schwab R, Schwacher O, Junge K, etal., (2008): Biomechanical analysis of mesh fixation in TAPP and TEPP hernia repair, Surg. Endosc. 22 (3) 731e738.
[3] Wake BL, McCormack K, Fraser C, et al. (2005): Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev. (1):CD004703. DOI: 10.1002/14651858.CD004703. pub2.
[4] Benjamin S. Powell and Guy R. Voeller (2013): Totally Extraperitoneal Inguinal Hernia Repair Using Fibrin Glue in: Master Techniques in Surgery, Hernia Editor: Daniel B. Jones, Josef E. Fischer, LIPPINCOTT WILLIAMS & WILKINS 17; 193-202.
[5] Osama Hasan Abd-Raboh, Taha Ahmed Ismael, Hamdy Abdel-Hady Mohamed (2017): Outcome of Laparoscopic Totally Extraperitoneal Approach with Direct Dissection and Mesh Hernioplasty in the Treatment of Inguinal Hernia Journal of Surgery 5 (3-1): 1-7.
[6] C. M. P. Claus, G. M. Rocha, A. C. L. Campos, et al. (2015): Prospective randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh. Surg Endosc DOI 10.1007/s00464-015-4314-7.
[7] Mahmood Ayyaz, Muhammad Waris Farooka, Asad Ali Toor, et al. (2015): Mesh fixation vs. non-fixation in total extra peritoneal mesh hernioplasty JPMA 65: 270.
[8] Cody A. Koch, Susan M. Greenlee, Dirk R. Larson, et al. (2006): Randomized Prospective Study of Totally Extraperitoneal Inguinal Hernia Repair: Fixation Versus No Fixation of Mesh. JSLS 10:457–460.
[9] M. S. Sajid, N. Ladwa, L. Kalra, et al. (2012): A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair. International Journal of Surgery 10, 224e231.
[10] Ashwani Gupta, Ashish, Vimal Bhandari, et al. (2016): Comparing the Clinical Outcome of Non Fixation of Mesh with Mesh Fixation in Laparoscopic Inguinal Hernioplasty (TEP): A Study and Review of Literature Sch. J. App. Med. Sci., 4 (9D):3442-3448.
[11] Adam Cristaudo, Arun Nayak, Sarah Martin, et al. (2015): A prospective randomised trial comparing mesh types and fixation in totally extraperitoneal inguinal hernia repairs. International Journal of Surgery 17, 79e82.
[12] Tetik C, Arregui ME, Dulucq JL, et al. (1994): Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. Sure Endosc. 8 (11): 1316-1322.
[13] Campanelli G, Bertocchi V, Cavalli M, et al. (2013): Surgical treatment of chronic pain after inguinal hernia repair. Hernia. 17 (3):347-53.
[14] Callesen T, Bech K, Kehlet H (1999): Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528– 1531.
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  • APA Style

    Osama Hasan Abd-Raboh, Mohamed Abdallah Hablus, Ahmed Abdelfatah Elshora, Sherif Abdelfatah Saber. (2018). Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia. Journal of Surgery, 6(1), 23-28. https://doi.org/10.11648/j.js.20180601.15

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    ACS Style

    Osama Hasan Abd-Raboh; Mohamed Abdallah Hablus; Ahmed Abdelfatah Elshora; Sherif Abdelfatah Saber. Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia. J. Surg. 2018, 6(1), 23-28. doi: 10.11648/j.js.20180601.15

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    AMA Style

    Osama Hasan Abd-Raboh, Mohamed Abdallah Hablus, Ahmed Abdelfatah Elshora, Sherif Abdelfatah Saber. Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia. J Surg. 2018;6(1):23-28. doi: 10.11648/j.js.20180601.15

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  • @article{10.11648/j.js.20180601.15,
      author = {Osama Hasan Abd-Raboh and Mohamed Abdallah Hablus and Ahmed Abdelfatah Elshora and Sherif Abdelfatah Saber},
      title = {Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia},
      journal = {Journal of Surgery},
      volume = {6},
      number = {1},
      pages = {23-28},
      doi = {10.11648/j.js.20180601.15},
      url = {https://doi.org/10.11648/j.js.20180601.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20180601.15},
      abstract = {Aim of the work: Randomized comparative study comparing outcome of mesh fixation versus non-fixation in TEP technique for inguinal hernia repair. Methods: In Tanta University Hospitals, over the period from February 2015 to October 2017, 58 patients with with 67 inguinal hernias (9 bilateral) undergoing TEP technique were randomized into 2 groups: Group A; mesh fixation 31 patients with 35 hernias. Group B; mesh non-fixation 27 patients with 32 hernias. Follow up was 6-17 months. Results: There was no statistical difference between 2 groups regarding operative time, postoperative complications, length of hospital stay and risk of chronic groin pain. Postoperative pain score was higher in Group A (mesh fixation). There was one case of hernia recurrence in group A (hernia and recurrence were both indirect), however, risk of hernia recurrence was not statistically significant. Conclusion: Mesh fixation and non-fixation in TEP are comparable regarding operative time, complications and hospital stay, while pain score was higher with mesh fixation. Mesh fixation does not increase the risk of chronic groin pain, while non-fixation does not increase hernia recurrence rate. Both techniques were proved safe.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia
    AU  - Osama Hasan Abd-Raboh
    AU  - Mohamed Abdallah Hablus
    AU  - Ahmed Abdelfatah Elshora
    AU  - Sherif Abdelfatah Saber
    Y1  - 2018/02/19
    PY  - 2018
    N1  - https://doi.org/10.11648/j.js.20180601.15
    DO  - 10.11648/j.js.20180601.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 23
    EP  - 28
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180601.15
    AB  - Aim of the work: Randomized comparative study comparing outcome of mesh fixation versus non-fixation in TEP technique for inguinal hernia repair. Methods: In Tanta University Hospitals, over the period from February 2015 to October 2017, 58 patients with with 67 inguinal hernias (9 bilateral) undergoing TEP technique were randomized into 2 groups: Group A; mesh fixation 31 patients with 35 hernias. Group B; mesh non-fixation 27 patients with 32 hernias. Follow up was 6-17 months. Results: There was no statistical difference between 2 groups regarding operative time, postoperative complications, length of hospital stay and risk of chronic groin pain. Postoperative pain score was higher in Group A (mesh fixation). There was one case of hernia recurrence in group A (hernia and recurrence were both indirect), however, risk of hernia recurrence was not statistically significant. Conclusion: Mesh fixation and non-fixation in TEP are comparable regarding operative time, complications and hospital stay, while pain score was higher with mesh fixation. Mesh fixation does not increase the risk of chronic groin pain, while non-fixation does not increase hernia recurrence rate. Both techniques were proved safe.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • General Surgery Department, Tanta University Hospitals, Tanta, Egypt

  • General Surgery Department, Tanta University Hospitals, Tanta, Egypt

  • General Surgery Department, Tanta University Hospitals, Tanta, Egypt

  • General Surgery Department, Tanta University Hospitals, Tanta, Egypt

  • Section