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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 1, September 2014 pp 198-202
A Study of laparoscopic total extraperitoneal inguinal hernia repair: fixation versus nonfixation of mesh
Anup Wakodkar1, Unmed Chandak2, Arti Mitra3, Shrikant Matkari4
1Medical Officer, 2Assistant Professor, 3Associate Professor, 4Professor and HOD, Department of Surgery, Government Medical College and Hospital, Nagpur, Maharashtra, INDIA.
Background: Fixation of the mesh during laparoscopic totally extra peritoneal (TEP) inguinal hernia repair is thought to be necessary to prevent recurrence. However mesh fixation may increase postoperative pain and lead to an increased risk of complications. We questioned whether elimination of fixation of the mesh during TEP inguinal hernia repair leads to decreased postoperative pain, complications and morbidity without an increased rate of recurrence. Methods: A prospective comparison study was carried out in 90 patients who underwent laparoscopic TEP inguinal hernia repair with fixation (group Fx, n= 45) or without fixation (group NFx, n=45) of the mesh. Results: Patients in whom the mesh was not fixed had significantly less operative time, shorter length of hospital stay, early return to routine activity, less postoperative duration of analgesia, lesser post operative pain scores and were less likely to develop urinary retention. No herniarecurrences were observed in either group (follow up range 6 to 24 months). Conclusions: Elimination of fixation of mesh during laparoscopic TEP inguinal hernia repair significantly reduces duration of postoperative analgesia, hospital stay, return to routine activity and pain scores. Eliminating fixation does not lead to an increased rate of recurrence.