Is mesh fixation considered a routine step in transabdominal preperitoneal hernia repair? The Zagazig-Benha experience

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Abstract

Introduction
Inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Over the past two decades, laparoscopic inguinal hernia repair has become more and more popular.
Objectives
The aim of the present study was to compare between fixation and nonfixation of the mesh in laparoscopic inguinal hernia repair.
Patients and methods
This prospective study was carried out on 58 consecutive male patients with inguinal hernia. The patients were divided into two groups (A and B). Group A patients were treated by using the mesh fixation transabdominal preperitoneal (TAPP) repair, and group B patients were treated by using the mesh nonfixation TAPP repair. Then, postoperative pain and hernia recurrence were evaluated for the two groups.
Results
Highly significant difference was detected between the two groups as regards postoperative pain. Whereas, only one (3.44%) recurrent case was found in group B patients, which was found to be nonsignificant.
Conclusion
Mesh fixation as a routine appears to be unnecessary in TAPP repair. It is associated with higher operative costs and an increased chronic groin pain without increasing the risk for early hernia recurrence.

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