World Journal of Laparoscopic Surgery

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  17 (2024)
Volume  16 (2023)
Volume  15 (2022)
Volume  14 (2021)
Volume  13 (2020)
Volume  12 (2019)
Volume  11 (2018)
Volume  10 (2017)
Volume  9 (2016)
Volume  8 (2015)
Volume  7 (2014)
Volume  6 (2013)
Volume  5 (2012)
Volume  4 (2011)
Volume  3 (2010)
Volume  2 (2009)
Volume  1 (2008)
Related articles

VOLUME 16 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Perioperative Outcome and Cost-utility of Mesh Fixation vs Non-fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernioplasty: A Prospective Randomized Controlled Trial

Selmy S Awad, Fahad H Qahtani, Faisal S Alsulaimani, Ahmad H Khalid, Qasem M Alharthi, Musab A AlThomali, Nadiah G AlAmri, Abdullah A Alshamrani, Ahmed H Alsufyani, Fahad A Alorabi, Abdullah A AlGhuraybi, Abdulrahman A Almalki, Abdulrahman S Alghamdi, Azzah Alzahrani, Malak F Almogathali, Shumukh A Alkhammash, Abdulaziz F Alotaibi, Talalalfatimi M Alhassan, Abdullah M Altalhi, Mahmoud R Abdulshafi, Mohamed SA Sheishaa

Keywords : Cost, Inguinal, Laparoscopic, Outcome, Transabdominal preperitoneal

Citation Information : Awad SS, Qahtani FH, Alsulaimani FS, Khalid AH, Alharthi QM, AlThomali MA, AlAmri NG, Alshamrani AA, Alsufyani AH, Alorabi FA, AlGhuraybi AA, Almalki AA, Alghamdi AS, Alzahrani A, Almogathali MF, Alkhammash SA, Alotaibi AF, Alhassan TM, Altalhi AM, Abdulshafi MR, Sheishaa MS. Perioperative Outcome and Cost-utility of Mesh Fixation vs Non-fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernioplasty: A Prospective Randomized Controlled Trial. World J Lap Surg 2023; 16 (3):169-172.

DOI: 10.5005/jp-journals-10033-1584

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: To analyze laparoscopic transabdominal preperitoneal (TAPP) mesh fixation and non-fixation in the perioperative outcome and cost-utility for inguinal hernia repair. Patients with groin hernias were introduced to laparoscopic TAPP repair to reduce the possibility of recurrence and other complications. Postoperative pain and nerve injury may be exacerbated by mesh fixation. Following preperitoneal inguinal hernia repair, there is controversy as to whether mesh should be fixed to prevent recurrences. Materials and methods: From the month of February 2017 to January 2018, 60 patients with inguinal hernias were studied prospectively. Using the TAPP approach under general anesthesia (GA) by the same team, thirty hernias were selected randomly and repaired with the fixation of mesh, and the other thirty ones were repaired without mesh fixation with no attention to the type of hernia (direct or indirect) or the size of the defect. Routine clinical examinations were performed for 6 months on all patients as a regular follow-up. Results: The operative time ranged from 37 to 92 minutes, (with a mean time of 60.44 minutes) in the mesh fixation group and from 40 to 83 minutes (with a mean time of 54.9 minutes). In the mesh fixation group, 15 cases were Rt indirect inguinal hernias. In the mesh non-fixation group, 18 cases were Rt indirect inguinal hernia. The length of the hospital stays ranges from 1 to 3 days with no significance. No statistical significance was noted as regards operative time, intraoperative injury, hospital stay, mesh migration, nerve entrapment, and postoperative analgesia. The significance was observed in cost-utility which represented the cost of trackers mainly. Conclusion: No recorded significance as regards operative time, intraoperative injury, hospital stay, mesh migration, nerve entrapment, and postoperative analgesia within the analysis of laparoscopic TAPP mesh fixation and non-fixation. Clinical significance: Mesh without fixation is a viable method and less costly that has the same benefits and excludes risks of fixation.

HTML PDF Share
  1. Mishra, RK. Complications of minimal access surgery. Textbook of practical laparoscopic surgery, 1st edition. New Delhi: Jaypee Brothers Medical Publication; 2008. pp. 388–389.
  2. Novik B, Sandblom G, Ansorge C, et al. Association of mesh and fixation options with reoperation risk after laparoscopic groin hernia surgery: A Swedish hernia registry study of 25,190 totally extraperitoneal and transabdominal preperitoneal repairs. J Am Coll Surg 2022;234(3):311–325. DOI: 10.1097/XCS.0000000000000060.
  3. Schultz L, Graber J, Pietrafitta J, et al. Laparoscopic herniorrhaphy: A clinical trial preliminary results. J Laparoendosc Surg 1990;1(1): 41–45. DOI: 10.1089/lps.1990.1.41.
  4. Nahid AK, Rahman S, Veerapatherar K, et al. Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: A comparative study. Turk J Surg 2021;37(1):1–5. DOI: 10.47717/turkjsurg.2021.4962.
  5. Lachin AB, Abdrabbu AA, Darwish AAF, et al. Mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair. QJM: An International Journal of Medicine 2020;113(suppl 1): Hcaa050.027. DOI: https://doi.org/10.1093/qjmed/hcaa050.027.
  6. Abdelhamid MS. Trans abdominal preperitoneal hernia repair with external fixation. Hernia 2011;15(2):185–188. DOI: 10.1007/s10029-010-0766-9.
  7. Altintoprak F, Akin E, Gundogdu K, et al. “Laparoscopic Inguinal Hernia Repair: Technical Details, Pitfalls, and Current Results”. Hernia Surgery and Recent Developments, edited by Arshad Malik, IntechOpen, 2018. DOI: 10.5772/intechopen.76942.
  8. Condon RE, Nyhus LM. Complications of groin hernia. In: Condon RE, Nyhus LM, (Eds). Hernia, 4th edition. Philadelphia: JB Lippincott; 2010. p. 269.
  9. Spitz JD, Arregui ME. Laparoscopic Totally Extraperitoneal Repair for Inguinal Hernias. In: Laparoscopic Surgery of the Abdomen, Springer, New York, NY, pp. 295–302.
  10. Murthy PK, Ravalia D. Assessment and comparison of laparoscopic hernia repair versus open hernia: A non-randomized study. International Surgery Journal 2018;5(3):1021–1025. DOI: https://doi.org/10.18203/2349-2902.isj20180823.
  11. Laparoscopic versus open repair of groin hernia: A randomized comparison. The MRC Laparoscopic Groin Hernia Trial Group. Lancet 1999;354(9174):185–190. PMID: 10421299.
  12. Voitk AJ. The learning curve in laparoscopic inguinal hernia repair for the community general surgeon. Can J Surg 1998;41(6):446–450. PMID: 9854534.
  13. Anadol ZA, Ersoy E, Taneri F, et al. Outcome and cost comparison of laparoscopic transabdominal preperitoneal hernia repair versus Open Lichtenstein Technique. J Laparoendosc Adv Surg Tech A 2004;14(3):159–163. DOI: 10.1089/1092642041255414.
  14. Gandhi D, Marcin S, Xin Z, et al. Chronic abdominal pain secondary to mesh erosion into cecum following incisional hernia repair: A case report and literature review. Ann Gastroenterol 2011;24(4):321–324. PMID: 24713759.
  15. Avtan L, Avci C, Bulut T, et al. Mesh infections after laparoscopic inguinal hernia repair. Surg Laparosc Endosc 1997;7(3):192–195. PMID: 9194276.
  16. Tamme C, Garde N, Klingler A, et al. Extraperitoneal inguinal hernioplasty with titanium-coated lightweight polypropylene mesh: Early results. Surg Endosc 2005;19(8):1125–1129. DOI: 10.1007/s00464-004-8219-0.
  17. Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc 1999;13(8): 804–806. DOI: 10.1007/s004649901104.
  18. Stark E, Oestreich K, Wendl K, et al. Nerve irritation after laparoscopic hernia repair. Surgical endoscopy 1999;13(9):878–881. DOI: 10.1007/s004649901124.
  19. Lo CW, Tsai YC, Yang SS, et al. Comparison of short- to mid-term efficacy of nonfixation and permanent tack fixation in laparoscopic total extraperitoneal hernia repair: A systematic review and meta-analysis. Ci Ji Yi Xue Za Zhi 2019;31(4):244–253. DOI: 10.4103/tcmj.tcmj_47_18.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.