Related Experiment Video
Updated: Jul 16, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Transabdominal preperitoneal videolaparoscopic hernioplasty without mesh fixation
Vitor Neves1, Gabriela Lyons2, Fernando Athayde Madureira1
1Universidade Federal do Estado do Rio de Janeiro, Departament of Surgery - Rio de Janeiro (RJ), Brazil.
Background:
Laparoscopic inguinal hernia repair using the transabdominal preperitoneal (TAPP) technique requires a stapler for mesh fixation, making the method expensive.
Aims:
To demonstrate the feasibility of videolaparoscopic inguinal hernioplasty (TAPP) without mesh fixation in patients who are not stage 3 according to the European Hernia Society classification.
Methods:
Forty patients underwent videolaparoscopic inguinal hernioplasty (TAPP) with a polypropylene mesh and without fixation from October 2017 to October 2018. After the procedure, outpatient follow-up appointments were scheduled until the 6th postoperative month. In June 2020, the patients were contacted by phone and a follow-up questionnaire was administered.
Results:
A total of 52 hernias were operated on, as 25% of patients had bilateral hernias. No patient presented with recurrence or chronic pain. Late in the course of the procedure, 72.5% of patients were contacted, with a mean follow-up of 27.2 months. The incidence of surgical site infection was 12.5%.
Conclusions:
The inguinal hernia repair by hernioplasty (TAPP) without mesh fixation in grade I and II patients (European Hernia Society) is feasible.
Central Message:
Inguinal hernia repair is the most commonly performed surgical procedure worldwide, with over 20 million operations carried out annually. Laparoscopic procedures are associated with reduced postoperative pain and a shorter recovery time, including a faster return to work. The transabdominal preperitoneal (TAPP) approach is one of the most widely used techniques for laparoscopic inguinal hernia repair and traditionally involves mesh fixation with disposable tackers.
Perspectives:
Laparoscopic inguinal hernia repair using the TAPP technique without mesh fixation in patients with European Hernia Society grade I and II defects is feasible. The technique showed no recurrences or chronic pain, high quality of life improvement, and a low rate of surgical site infections, supporting its feasibility and safety in selected patients. These findings suggest that, in carefully selected cases, TAPP inguinal hernioplasty without mesh fixation may be considered a safe and cost-effective alternative, particularly in resource-limited settings.
