Comparative evaluation of outcomes in different techniques of mesh fixation in totally extraperitoneal hernioplasty

Abstract

PURPOSE: Inguinal hernia repair is the most commonly performed surgery worldwide with surgical approaches being open and endoscopic hernioplasty. Mesh fixation in endoscopic hernia repair still remains a topic of debate. Moreover, a paucity of literature is present with regard to the quality of life (QOL) outcomes after mesh fixation in endoscopic hernia repair. MATERIALS AND METHODS: This prospective nonrandomized study was done on patients operated by totally extraperitoneal (TEP) hernioplasty. Primary outcome parameters included any complications, postoperative pain, and hernia-related QOL by Carolina's Comfort Scale among two different types of mesh fixation techniques (Group I - intracorporeal Suture fixation and Group II - tack fixation). RESULTS: TEP repair was done on 74 patients with suture fixation of the mesh by intracorporeal knotting (Group I; n = 30) and tack fixation of mesh (Group II; n = 44). There was no significant difference in the time to return to routine work, sensation of mesh, and pain, but time to return to office work was significantly lower in the patients of Group I (4.29 ± 0.99) compared to Group II (4.75 ± 0.96) and there was a significant difference in movement limitation from postoperative to subsequent time period in all groups except for after 3 months to 6 months in Group II. CONCLUSION: Intracorporeal suture fixation of mesh in TEP can be used as an alternate technique for mesh fixation with comparable perioperative and QOL outcomes.

Keywords

• endoscopy
• inguinal hernia
• mesh