Intracorporeal Suturing of MESH and Peritoneum during TAPP as Substituting for Tackers

Abstract

Background groin hernia repair is considered to be one of the most commonly performed operations by general surgeons however; there is no “gold standard” operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, and type of anesthesia, occupation, and leisure activities. Aim of the Work is to compare the outcome results of the laparoscopic total extraperitoneal TEP hernia repair with mesh or the transabdominal preperitoneal repair (TAPP) with mesh to those of open repair with mesh. Patients and Methods this is a prospective study conducted on those who are diagnosed to have inguinal hernia (direct, indirect). 40 cases with direct, indirect, unilateral or bilateral inguinal hernia and will be divided into two groups: Group A 20 cases fixation a mesh with Tackers . Group B 20 cases fixation a mesh with intracorporeal sutures. The study will be Conducted at Ain Shams University hospitals (El-Demerdash) and other authorized hospitals under supervision of thesis supervisors. Results smoking appears to be a risk factor for hernia development since almost 55% of the study group A and 65% of the study group B were smokers, obesity also appears to be a risk factor since BMI was about 30.20± 7.82 among group A and 32.05 ± 5.98 among group B. This is in contrast to age which seems not to be as strongly related. Conclusion we found the rate of postoperative early and late complications comparable in both groups. But in the LAP group we were able to discharge them from the hospital faster than the OPEN group, they also resumed full activity early.