Transabdominal pre-peritoneal inguinal hernia repair with external fixation

Area of Science:

• Minimally invasive surgery
• Surgical techniques
• Hernia repair

Background:

• Debate exists on whether mesh fixation is necessary in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.
• The impact of mesh stapling on recurrence rates and neuralgia is not fully understood.
• An alternative approach involves external mesh fixation to reduce port size, cost, and patient discomfort.

Purpose of the Study:

• To identify a cost-effective method for laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.
• To evaluate an external mesh fixation technique for TAPP inguinal hernia repair.

Main Methods:

• A prospective trial involving 42 patients with unilateral inguinal hernias was conducted.
• Laparoscopic TAPP inguinal hernia repair was performed using external fixation of the mesh with prolene threads.
• The study was carried out at Al Hayat Hospital, Jeddah, Saudi Arabia, from September 2008 to April 2009.

Main Results:

• Operative times ranged from 35 to 85 minutes.
• Follow-up of 9-16 months showed no recurrence and no post-operative pain.
• The technique resulted in reduced port size requirements and lower overall costs.

Conclusions:

• Internal mesh fixation is not essential for laparoscopic TAPP inguinal hernia repair.
• External mesh fixation offers a viable alternative, reducing port size and significantly lowering costs.
• This method provides the benefits of TAPP repair at a reduced financial burden.