Short Term Outcomes of Laparoscopic Totally Extraperitoneal Repair of Uncomplicated Groin Hernia Using Polyester Anatomical Mesh Without Fixation

Abstract

Abstract:Background: Totally extraperitoneal (TEP) repair of groin hernia can be performed with or without mesh fixation.Fixation can result in postoperative pain or paresthesia due to nerve entrapment. Compared to polypropylene mesh, polyester anatomical mesh (Parietex ® , Covidien, Mansfield, MA, USA) has a special configuration to fit the posterior inguinal anatomy. Also, the polyester-based chemistry and the rapidly absorbable biological coating increase the hydrophilicity of the mesh, which is thought to result in a fast and intimate tissue ingrowth that may obviate the need for fixation. Patients and Methods: Laparoscopic TEP repair using Parietex ® anatomical mesh without fixation was performed for 60 patients presenting with 63 uncomplicated groin hernias. Results: All patients were males with a mean age of 44.7±14.75 years. There were 60 (95.3%) primary, 3 (5%) bilateral inguinal and 2 (3.3%) femoral hernias. The mean operative time was 64.8±22.6 minutes. There were no major operative complications or conversions to transabdominal preperitoneal or open repair. In the early postoperative period, 54 patients (90%) had mild or no pain. Nine patients (15%) developed minor postoperative complications. The mean length of hospital stay was 1.1±0.3 days and the mean time of return to normal daily activities and to work was 2.6±0.64 and 7.15±1.13 days respectively. No patient developed chronic groin pain, mesh-related complications or recurrences during the study period. Ninety one percent of patients described their satisfaction with surgery as good or excellent. Conclusion: laparoscopic TEP repair of uncomplicated groin hernia using Parietex ® anatomical mesh without fixation is safe and does not increase the risk of hernia recurrence.