Do we need mesh fixation at the laparoscopic hernia repair?

Abstract

Objective: With the development of laparoscopic treatment, widespread use of laparoscopy has become inevitable for the treatment of inguinal hernias, which is one of the most common ailments in surgical practice. Fixing or not fixing the mesh during laparoscopic repair remains a debate. In our study, we aimed to compare patients with and without mesh fixation in terms of postoperative pain, recurrence, complications, hospitalization and return to social life. Method: The surgical technique to be performed was randomly determined, 81 patients whose data were kept prospectively and evaluated retrospectively were included in the study. Total extraperitoneal repair (TEP) was performed in all patients. While the mesh was not fixed in 50 patients, it was fixed with 2 tackers in 31 patients. Results: When the two groups of patients were compared, the group without mesh fixation was found to be superior in terms of postoperative pain, length of hospital stay and return to social life. There was no difference between the 2 groups in terms of complications and recurrence. Conclusions: In the light of these findings, it is seen that TEP hernia repair can be performed safely without mesh fixation, although prospective randomized studies are needed.

Keywords

• Laparoscopy
• Hernia repair
• Inguinal hernia