Mesh fixation in laparoscopic reconstruction of inguinal hernias
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Keywords

inguinal hernia, TAPP, hematoma, recurrence, pain

Abstract

Introduction: Laparoscopic inguinal hernia repair is a widely used surgical technique, although not exempt from potential complications. The aim of our study was to compare our postoperative results according to the fixation method of the prosthetic material.
Methods: This is a retrospective study. We looked up 167 patients who underwent laparoscopic inguinal hernioplasty between 01 Jan 2015 and 31 Dec 2016 at the Surgical Department of Vsetin Hospital. The patients were invited for a follow-up visit after 4−6 weeks and a questionnaire was sent them after 9−33 months. We evaluated any development of postoperative hematoma, recurrent hernia and pain after one month and during the first year from the surgery in dependence on the fixation method (stapler Pro Thick, acrylic glue Glubran, 3D light mesh).
Results: In total, 120 patients were enrolled in the study, 22 in the Glubran group, 59 in the stapler group and 39 in the 3D group. A hematoma developed in 10% in the stapler group, while there was none in the other groups; the difference was statistically significant (p=0.0382). Recurrent hernia was found in 5% in the Glubran group, 3% in the stapler group, and 0% in the 3D group; no statistically relevant difference was found. No difference was demonstrated for postoperative pain, either.
Conclusion: Long-term postoperative results after TAPP were not found to differ in recurrence rates and pain based on the used fixation material in our set of patients. The stapler was associated with a higher risk of postoperative hematoma, but it was a preferred method in all cases of large hernias.

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