Totally extraperitoneal inguinal hernia repair without mesh fixation: Experiences with 250 cases at Can Tho General Hospital

Abstract Introduction: It remains controversial whether mesh should be fixed during totally extraperitoneal inguinal hernia repair. This prospective study was done to determine the outcomes of patients undergoing totally extraperitoneal (TEP) inguinal hernia repair without mesh fixation. Patients and Methods: This was a prospective study on 250 patients with 289 inguinal hernias who underwent TEP repair without mesh fixation between January 2020 and December 2020 with an average of forty-two months postoperative follow - up at the Department of General Surgery, Can Tho General Hospital, Viet Nam. Results: The mean age was 52.95 ± 17.75 years. There were 282 primary, 211 unilateral and 39 bilateral hernias. The average operating time was 47.6 and 71.7 minutes for unilateral and bilateral hernias, respectively. With one case of conversion to TAPP repair, the success rate for TEP was 99.6%. The rate of intraoperative complication was 1.2% (3 cases), all of them were bleeding. Seroma was the most common postoperative complication seen in 9 patients (3.6%). One case of postoperative bleeding was from branches of the epigastric artery requiring re-operation. The length of postoperative hospital stay was 2.82 + 1.82 days. There were only 4 cases (1.6%) of mild chronic pain and no other postoperative complications or recurrence after an average of 42 months postoperative follow– up. Conclusions: TEP repair without mesh fixation is an excellent technique for laparoscopicinguinal herniarepair with low rates of intraoperative and postoperative complications after an average of 42 months post-operative follow-up. Keywords: Inguinal hernia repair, Totally extraperitoneal repair – TEP, mesh fixation