Fixation Versus Non-Fixation of MESH in Laparosopic Transabdominal Preperitoneal (TAPP) Hernia Repair

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine for Girls- Al-Azhar University, Egypt

2 Department of General Surgery, Maadi Military Hospital, Egypt

Abstract

Background: Inguinal hernia repair is one of the most frequently performed operations worldwide. Laparoscopic
transabdominalpreperitoneal (TAPP) repair is widely used, but the necessity of mesh fixation remains controversial. This
study comparedfixation versus non-fixation of mesh in TAPP repair with respect to postoperative pain, operative time,
hospital stay, andrecurrence.
Methods: A prospective randomized controlled trial was conducted on 40 patients with primary inguinal hernia
undergoinglaparoscopic TAPP repair. Patients were randomized into two groups: Group A (n= 20) with mesh fixation
using tackers, and Group B (n= 20) with mesh placement without fixation.
Outcomes measured included operative time, pain (1 week, 3 and 6 months), complications, recurrence, and recovery
time.
Results: Operative time was significantly longer in the fixation group (p= 0.044). Pain was higher at 1 week in Group
A (p= 0.018)but comparable at 3 months, with no pain reported at 6 months. No recurrences occurred in either group.
Hospital stay wassimilar, but return to normal activity was significantly delayed in Group A (p= 0.019).
Conclusions: Mesh fixation prolongs surgery and increases early postoperative pain without improving long-term
outcomes. Non-fixation appears safe, reducing operative time and enhancing recovery.

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