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

Claus, Christiano Marlo Paggi; Rocha, G. M.; Campos, Antônio Carlos Ligocki; Bonin, Eduardo A.; Dimbarre, Daniellson; Loureiro, Marcelo; Coelho, Júlio Cezar Uili

doi:10.1007/s00464-015-4314-7

Cited by 66 publications

(59 citation statements)

References 42 publications

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“…Claus et al investigated mesh migration in laparoscopic TEP hernia repair and compared results of radiological examinations performed immediately, and 30 days after surgery in groups that underwent hernia repair with or without mesh fixation, and also reported lack of any difference between groups. [19] In their meta-analysis, Tam et al reported that hernia repair using TEP laparoscopic method without mesh fixation could significantly decrease operative time, surgical costs, and length of hospital stay, and they found no difference between mesh fixation and nonfixation methods in terms of hernia recurrence, complications, or postoperative pain. [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.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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

Sağıroğlu¹

2017

South Clin Ist Euras

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“…Most of the studies examined by Tam et al had a median follow‐up period of less than 12 months. Several other trials similarly found that there was no significant difference between having and not having fixation in terms of short‐term to midterm recurrence . Long‐term results are insufficient to draw further conclusions.…”

Section: Discussionmentioning

confidence: 95%

“…Studies on recurrence after laparoscopic repair have attributed it to improper fixation and mesh migration, and as a result, mesh fixation with various devices has become a widespread practice . However, in recent years, encouraging early results have bolstered the concept of non‐fixation, but the long‐term benefits are unclear if mesh migration occurs; moreover, current data are insufficient to support its widespread use …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] However, in recent years, encouraging early results have bolstered the concept of non-fixation, but the long-term benefits are unclear if mesh migration occurs; moreover, current data are insufficient to support its widespread use. 5,6 Despite being widely employed, fixation devices are not free of risks and often raise cost concerns. Reported complications associated with popular tacking staplers and tissue glue, including chronic pain, nerve entrapment, and foreign body inflammatory reactions, have prompted caution and scrutiny.…”

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confidence: 99%

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Transfascial suture fixation technique in laparoscopic repair of inguinal hernia

Chan

2019

Asian J Endoscop Surgery

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Introduction This study presents the initial results of a transfascial suture mesh fixation technique. This method was devised to reduce operative costs and foreign body‐associated risks while embracing the benefits of fixation in laparoscopic inguinal hernia repair. Materials and Surgical Technique Patients undergoing laparoscopic inguinal hernia repair with transfascial suture fixation (TRANSFIX) in our center between March 2017 and March 2018 were retrospectively reviewed. The procedure is orchestrated by a reusable fascial closure device sequentially puncturing the fascia vertically through the inferior port site and guiding a polypropylene thread through the mesh. The thread is retrieved from the extraperitoneal plane with the device, creating an extracorporeal suture loop to embed a surgical knot at the subcutaneous layer of the port site. Discussion In its first year after introduction, 16 TRANSFIX were performed. All patients were men (mean age, 62.6 years). Thirteen hernias (81.3%) were first occurrence, and three (18.8%) were recurrent. Twelve (75.0%) were direct hernias, and three (18.8%) were indirect hernias; one patient presented with concurrent direct and indirect hernia. Median operating time was 41.5 minutes for unilateral repair and 73.0 minutes for bilateral. Median blood loss was 5 mL. One patient had a seroma after unilateral indirect hernia repair. After a median follow‐up of 15.5 months (range, 9‐21 months), no patient had chronic pain, wound infection, hematoma, or recurrence. Instrumental cost reduction per operation was between $150 and $300. TRANSFIX appears to be a safe and economical mesh fixation method.

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“…13 One recurrence has thus far been detected after six months (0.2%). This was confirmed by laparoscopy to be a lateral recurrence associated with infolded mesh in a patient in the mesh fixation group, and re-repaired using a laparoscopic transabdominal approach (a 2 cm indirect defect had been repaired with mesh fixated by eight tacks).…”

Section: Discussionmentioning

confidence: 98%

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

Abstract: Fixation of the mesh for TEP repair is unnecessary. TEP repair with no mesh fixation is safe and is not associated with increased risk of mesh displacement.

Cited by 66 publications

References 42 publications

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

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

Transfascial suture fixation technique in laparoscopic repair of inguinal hernia

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

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