A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair

Sajid, M. S.; Ladwa, N.; Kalra, L.; Hutson, Kristian; Sains, Parv; Baig, Mirza

doi:10.1016/j.ijsu.2012.03.001

Cited by 81 publications

(47 citation statements)

References 29 publications

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“…Three different meta-analyses in TEP (follow-up time [1 year in 5/7 studies) did not show any difference between fixation or no fixation with respect to recurrence or acute or chronic pain [37][38][39]. The last meta-analysis also included the only available RCT in TAPP [40].…”

Section: Endoscopic Surgerymentioning

confidence: 99%

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Miserez

Peeters

Aufenacker

et al. 2014

Hernia

330

224

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Purpose: In 2009, the European Hernia Society published the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. The guidelines expired January 1, 2012. To keep them updated, a revision of the guidelines was planned including new level 1 evidence. Methods: The original Oxford Centre for Evidence-Based Medicine ranking was used. All relevant level 1A and level 1B literature from May 2008 to June 2010 was searched (Medline and Cochrane) by the Working Group members. All chapters were attributed to the two responsible authors in the initial guidelines document. One new chapter on fixation techniques was added. The quality was assessed by the Working Group members during a 2-day meeting and the data were analysed, especially with respect to any change in the level and/or text of any of the conclusions or recommendations of the initial guidelines. In the end, all relevant references published until January 1, 2013 were included. The final text was approved by all Working Group members. Results: For the following topics, the conclusions and/or recommendations have been changed: indications for treatment, treatment of inguinal hernia, day surgery, antibiotic prophylaxis, training, postoperative pain control and chronic pain. The addendum contains all current level 1 conclusions, Grade A recommendations and new Grade B recommendations based on new level 1 evidence (with the changes in bold). Conclusions: Despite the fact that the Working Group responsible for it tried to represent most kinds of surgeons treating inguinal hernias, such general guidelines inevitably must be fitted to the daily practice of every individual surgeon treating his/her patients. There is no doubt that the future of guideline implementation will strongly depend on the development of easy to use decision support algorithms tailored to the individual patient and on evaluating the effect of guideline implementation on surgical outcome. At the 35th International Congress of the EHS in Gdansk, Poland (May 12-15, 2013), it was decided that the EHS, IEHS and EAES will collaborate from now on with the final goal to publish new joint guidelines, most likely in 2015

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Section: Endoscopic Surgerymentioning

confidence: 99%

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Miserez

Peeters

Aufenacker

et al. 2014

Hernia

330

224

View full text Add to dashboard Cite

show abstract

“…[20] In another meta-analysis performed by Sajid et al, authors indicated that laparoscopic nonfixation TEP method did not increase recurrence risk, and indicated that operative time, postoperative pain, complications, length of hospital stay, and chronic inguinal pain were similar to that detected in cases of mesh fixation method. [21] Limitations of present study include its retrospective design, small number of patients, and short postoperative follow-up period. Results support the abovementioned findings of researchers and demonstrate that laparoscopic TEP inguinal hernia repair performed without mesh fixation is a reliable technique that can reduce postoperative morbidity when applied by adequately experienced surgeons.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Without Mesh Fixation: Report of Early Outcomes

Sağıroğlu¹

2017

South Clin Ist Euras

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Objective: This report is an analysis of outcomes of laparoscopic total extraperitoneal (TEP) inguinal hernia repair without using mesh fixation. Methods:Hospital records of 60 patients who underwent laparoscopic TEP inguinal hernia repair between 2012 and 2015 in the clinic were retrospectively analyzed for length of operative time, postoperative pain, paresthesia, urinary retention, seroma, hematoma, infection, recurrence, and chronic pain.Results: Three of 60 study patients were female (5%), 57 were male (95%); mean age was 48 years (range: 27-66 years). Five (8%) patients presented with recurrent inguinal hernia, 50 (83%) with unilateral, and 5 (8%) with bilateral inguinal hernia. Conversion to open hernia repair technique was recorded in 4 cases. At 24 th postsurgical hour, all patients described level 1-2 pain at incision site. Only 4 patients had level 2 pain at the end of the first week, and none complained of pain at first, third, and sixth month of follow-up period. Paresthesia was recorded in 6 patients during the entire follow-up period. Seroma, which was prominent in 4 patients during first postoperative week, subsided by first month follow-up. None of the patients had hematoma, urinary retention, infection, recurrence, or chronic pain. Conclusion:Laparoscopic TEP inguinal hernia repair without mesh fixation is a safe technique when performed by experienced surgeons.

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“…Dulucq et al [31] reported, in a large series of 3100 patients, recurrence rate of 0.3 % after TEP repair with no fixation. Two recent published meta-analysis of randomized controlled trials indicated that TEP repair with no mesh fixation does not appear to increase the incidence of hernia recurrence [32,33]. According to the International Endohernia Society Guidelines, recurrence rates are equally low after fixed and non-fixed mesh repairs [34].…”

Section: Discussionmentioning

confidence: 99%

“…The Guidelines of International Endohernia Society reported that the risk of acute and chronic pain after staple mesh fixation is higher as compared to non-fixation [34]. A meta- analysis showed equal or lower chronic pain when mesh fixation is not used [32,33,42]. Principles of how to fix the mesh changed in recent years [43,44].…”

Section: Discussionmentioning

confidence: 99%

Prospective, randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh

et al. 2015

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A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair

Cited by 81 publications

References 29 publications

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Without Mesh Fixation: Report of Early Outcomes

Prospective, randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh

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