Mesh fixation compared to nonfixation in total extraperitoneal inguinal hernia repair: a randomized controlled trial in a rural center in India

Garg, Pankaj; Nair, S.; Shereef, Muhammed; Thakur, Jai Deep; Nain, Nikhilesh; Menon, Geetha R.; Ismail, Mohamed

doi:10.1007/s00464-011-1708-z

Cited by 52 publications

(55 citation statements)

References 24 publications

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“…12 Hernia recurrence is considered as mesh displacement. 10 In the present study none of the study groups had recurrence similar to the study conducted by Taylor C et al in which without fixation of mesh in TEP repair was not associated with an increased risk of hernia recurrence and also in the study done by Koch CA et al and Tam KW et al where there is no recurrence in any of the groups. Recurrence within 1 month is 1 (3%) in without fixation group out of 30 patients and 1 (3%)in with fixation group out of 30 patients.…”

Section: Discussionsupporting

confidence: 89%

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Evaluation of recurrence and postoperative pain in laparoscopic inguinal hernia repair with mesh fixation verses without mesh fixation

2018

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INTRODUCTIONInguinal hernia affects both men and women but is much more common in men who comprise over 90% of operated patients. 1 Considering both operated and nonoperated inguinal hernias, the lifetime prevalence rate is 47% for men up to and including the age of 75.2 From an aetiological point of view there are two types of inguinal hernia, congenital and acquired. An acquired inguinal hernia is generally not believed to be associated with a persistent processus vaginalis but develops in a secondary manner. Several risk factors for the development of this type of hernia have been suggested, among these various connective tissue factors. In order to compare the results of inguinal hernia repair, a standardized classification with respect to localisation and size is needed. Several classifications exist, of which the Nyhus classification is one of the most commonly used. 3Hernias can only be cured by surgery. The aim is to reduce the patient's symptoms and prevent possible negative events such as incarceration without causing ABSTRACT Background: Inguinal hernia affects both men and women but is much more common in men who comprise over 90% of operated patients. The purpose of this study was to determine whether elimination of tacking the mesh during endoscopic inguinal hernia repair results in decreased postoperative pain or complications, or both, without increasing the incidence of hernia recurrence. Methods: Patients age between 18 to 70 yrs, willing for laparoscopic surgery, suitable for elective laparoscopic surgery were included in the study. TEP or TAPP endoscopic inguinal hernia repairs would be performed with the patient under general anesthesia. Data collection have done by using a structured pre-prepared case performa. The patient evaluated both by radiological and laboratory investigations both pre-operatively and post-operatively. Results: There is no major significant difference in pain at 1 month after operation in both the group. Recurrence was higher among patient having mesh fixation and it was not statistically significant. Wound infection was occurring more among without fixation group and it was not statistically significant. Urinary retention was reported more among without fixation group and it was not statistically significant. Conclusions: Thus, it was concluded that there is no significant difference in recurrence rate in the both study group either with fixation or without fixation. There is no significant difference in pain at one month in the both study group either with fixation or without fixation. There is more pain (visual analogue scale more than two) at three months after operation in fixation group as compared to without fixation group. There is also high cost in fixation group as compared to without fixation group.

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Section: Discussionsupporting

confidence: 89%

“…10 This difference was statistically significant (4 versus 2, p value <0.0001). The median vas score at 1 month interval in without fixation group was 1 compared to 3 in mesh fixation group.…”

Section: Discussionmentioning

confidence: 83%

Evaluation of recurrence and postoperative pain in laparoscopic inguinal hernia repair with mesh fixation verses without mesh fixation

2018

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“…At the end of at least 2 years of postoperative follow-up, they could not demonstrate any significant difference between groups as far as postoperative pain, duration of hospital stay, return to normal daily activities, seroma formation, or recurrence. [2] Laparoscopic TEP hernia repair has generally been reported to result in fewer problems than open herniorrhaphy, but nearly one-fifth of patients still described a new type of groin pain. [8] Chronic pain develops in 5-35% of adults who have inguinal hernia repair.…”

Section: Discussionmentioning

confidence: 99%

“…[2] Concerns about recurrence rates of inguinal hernia when repaired without mesh fixation led to investigation and documentation of differences in short-and long-term outcomes in patient groups from many perspectives. [2][3][4][5] In the TEP method, stabilization of the nonfixated mesh placed between anterior wall of the abdomen and peritoneum is based on sandwich effect created between tissues. In order to reinforce this sandwich effect, the lower 2-3 cm part of the prosthetic mesh is placed in the Retzius cavity, where it is held in place after completion of desufflation.…”

Section: Discussionmentioning

confidence: 99%

“…A wide spectrum of methods have been described in the literature, ranging from nonfixation methods of placement to fixation with metal tacks. [2][3][4][5] Much of the debate concerns chronic postoperative pain and recurrence. Lichtenstein method and TEP have been compared in various studies, and while a relatively lower incidence of recurrence and chronic pain has been recorded for TEP, both complications can still occur.…”

Section: Introductionmentioning

confidence: 99%

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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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Materials, Devices and Gadgets for Hernia Surgery

Sanders

Ide

Amr

2018

The Art of Hernia Surgery

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Mesh fixation compared to nonfixation in total extraperitoneal inguinal hernia repair: a randomized controlled trial in a rural center in India

Cited by 52 publications

References 24 publications

Evaluation of recurrence and postoperative pain in laparoscopic inguinal hernia repair with mesh fixation verses without mesh fixation

Evaluation of recurrence and postoperative pain in laparoscopic inguinal hernia repair with mesh fixation verses without mesh fixation

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

Materials, Devices and Gadgets for Hernia Surgery

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