Evaluation of Outcome of Laparoscopic Transabdominal Pre Peritoneal Repair of Inguinal Hernia with Special Reference to Comparison of Result between Fixation and Non Fixation of Mesh

Professor (Prof.) Dr. Sanjeev Kumar, Dr. Sheetal, Dr. Kuldeep Kumar Nagar

Abstract: Aim: This randomized prospective comparative study was done to evaluate and compare fixation with non-fixation of mesh in Trans abdominal pre peritoneal (TAPP) inguinal hernia repair in terms of postoperative complication, recurrence, pain (VAS) regarding the procedure and necessity regarding fixation of mesh. Methods: 60 patients with inguinal hernia were selected in which 30 patients were allotted to the group A for fixation of mesh and 30 patients to group B for non-fixation of the mesh during their hernia repairs by laparoscopic TAPP. Results: In fixation mean age was 42.36 and in non-fixation 42.44. The operative time for fixation was 95.83 min and for non-fixation 56.83 min (p=.000). Using Visual analog scale, pain among fixation and non-fixation at 12, 24, 72 hrs, 1 and 6 months was statistically significant (p<0.05). Average Hospital stay for fixation was 3.63 days and for non-fixation was 2.93 days (p=.000). Intra operative complication for fixation was 3.33% and for non-fixation was 0%, p=0.313. Postoperative complication for fixation was 10% and non-fixation was 6.6%, p=0.640. Conclusion: Stapling mesh in TAPP offers no advantage over non-fixation of mesh and non-fixation of mesh in TAPP appears to be a safer alternative with less pain, shorter operative time and shorter hospital stay.

Keywords: Trans abdominal pre peritoneal, TAPP, Fixation of Mesh, Complication