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New Indian Journal of Surgery

Volume  11, Issue 3, July – September 2020, Pages 347-352
 

Original Article

Laparoscopic Inguinal Hernia Repair Tapp Without Mesh Fixation

Ronak Shah1, Vipul Gurjar2, Honeypal3

1Resident, 2Professor, 3Associate Professor, Department of Surgery , Smt B K Shah Medical Institute and Research Center, Vadodara, Gujarat 391760, India.

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.11320.14

Abstract

Introduction: Laparoscopic repair of hernia can be
done by 2 ways with mesh fixation and without mesh
fixation. Laparoscopic hernia repair can be by two
approaches:
1. Total Extra Peritoneal (TEP) Repair
2. Trans Abdominal Pre Peritoneal (TAPP) Repair.
Postoperative complications like pain are one
of the most common complications that occur after
performing a TAPP.


Material And Methods: 31 patients who underwent
laparoscopic inguinal hernia repair without mesh
fxation for uncomplicated inguinal hernia at Dhiraj
hospital were included in my study. All patients
were assessed by thorough clinical examination
and consent was taken.After proper dissection of
the tissue and cord, mesh of size 15*12 cm size was
placed without fxation. The peritoneum closed with
vicryl 2,0 RB in continuous manner. All patients were assessed during the first postoperative day, day of discharge, and at follow up visits at 1st week, 1 month, 3 months and 6 months
post operatively.


Results: A total of 31 elective TAPP were performed
in my study. Out of 30 patients, 7 patients develoed pain in post
operative period, so 23.33%.Out of which 5 developed pain over the operativesite (16.67) and 2 developed pain in the testicular pain
(6.67).


Conclusion: In our study the most common
complication seen was postoperative groin pain and
testicular pain. It was seen in total 7 patients (22.57%)
whereas in Wang et. al. it was seen in 2.6% of patients
without mesh fxation and 23.68% of patients with
mesh fxation. So this suggests pain is due to mainly
extensive tissue dissection and cord dissection.
In our study in a span of follow up period of 6
months the recurrence seen was 0% but in Mayer et.
al. study it was seen in 1.1% of patients without mesh
fixation and 0.9% of patients with mesh fixation.
So our study proves that recurrence rate does not
depend upon the fixation of the mesh.


Keywords: Inguinal hernia; Laparoscopic hernia
repair; TAPP; Mesh fixation.
 


Corresponding Author : Vipul Gurjar.