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Surgical Endoscopy

Published in:

01-03-2016

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

Authors: C. M. P. Claus, G. M. Rocha, A. C. L. Campos, E. A. Bonin, D. Dimbarre, M. P. Loureiro, J. C. U. Coelho

Published in: Surgical Endoscopy | Issue 3/2016

Abstract

Introduction

Repair of inguinal hernia is one of the most common elective operations performed in general surgery practice. Mesh hernia repair became the gold standard because of its low recurrence rate in comparison with non-tension-free repair. Laparoscopic approach seems to have potential advantages over open techniques, including faster recovery and reduced acute and chronic pain rate. Laparoscopic mesh fixation is usually performed using staples, which is associated with higher cost and risk for chronic pain. Recently, the role of mesh fixation has been questioned by several surgeons.

Aim

To evaluate mesh displacement in patients undergoing laparoscopic inguinal hernia repair comparing mesh fixation with no fixation.

Methods

From January 2012 to May 2014, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups: control group—10 patients underwent totally extraperitoneal (TEP) repair with mesh fixation; NO FIX group—50 patients underwent TEP repair with no mesh fixation. Mesh was marked with three 3-mm surgical clips at its medial inferior, medial superior and lateral inferior corners. Mesh displacement was measured by comparing an initial X-ray, performed in the immediate postoperative period, with a second X-ray obtained 30 days later.

Results

The mean displacement of all three clips in control group was 0.1–0.35 cm (range 0–1.2 cm), while in NO FIX group was 0.1–0.3 cm (range 0–1.3 cm). The overall displacement of control and NO FIX group did not show any difference (p = 0.50).

Conclusion

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.

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Title: Prospective, randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh
Authors: C. M. P. Claus
G. M. Rocha
A. C. L. Campos
E. A. Bonin
D. Dimbarre
M. P. Loureiro
J. C. U. Coelho
Publication date: 01-03-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4314-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Aim

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Aim

Methods

Results

Conclusion

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