Comparative study between tack fixation versus non-fixation of mesh in laparoscopic trans abdominal pre peritoneal inguinal hernia repair
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1801-1807
Abstract
Inguinal hernia is one of the most prevalent surgical disease in clinical practice. Laparoscopic inguinal hernia repair has been shown to be slightly superior to open approaches and is performed with placement of mesh into the pre peritoneal space. Mesh fixation is thought to increase postoperative pain and risk of nerve injury (femoral branch of genitofemoral nerve and the lateral cutaneous nerve of thigh). Non-fixation of the mesh can reduce pain; however it is theoretically a predisposing risk factor for hernia recurrence due to the risk of mesh displacement. The purpose of this study is to compare mesh fixation with non-fixation in terms of postoperative pain, incidence of nerve injury, incidence of recurrence of hernia during laparoscopic Trans Abdominal Pre-Peritoneal hernia repair Methodology: Patients visiting OPD or admitted in ward will be explained about the study and on willingness will be enrolled up after written informed consent is obtained. Will be divided alternately into the 2 groups. One group will undergo TAPP with fixation of the mesh and the other without. Results: 10 patients with direct inguinal hernia and 15 indirect hernia in mesh fixation group. 14 patients with direct inguinal hernia and 11 patients with indirect inguinal hernia were in non-fixation group. All patients were operated under general anesthesia. Laparoscopic converted open hernioplasty cases were excluded. There were 24 patients in tack fixation group and 11 patients in non-fixation group required rescue analgesia at 8th hour of postoperative period. The difference of both groups were statically significant. The hospital stay in our study was 1 day and discharged on 2nd postoperative day. No recurrence in this study. Conclusion: non-fixation of mesh can significantly reduces the post operative pain in LAP TAPP.
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