Innovative approach to laparoscopic hernioplasty (TAPP) without mesh fixation

The purpose of this study was to compare hernioplasty techniques with and without mesh prosthesis fixation. The study included 187 patients with primary inguinal hernias who were treated at the Municipal Non-Profit Enterprise “Kyiv City Clinical Hospital No. 1” from 2020 to 2024, divided into 2 groups: Group 1 (control group) – 92 patients, and Group 2 (experimental group) – 95 patients. The duration of surgery for lateral hernias was statistically significantly longer (p < 0.01) than for medial and femoral hernias. In both groups, a significant (p < 0.01) reduction in pain was noted within 1 month after surgery. The level of pain in the control group was greater (p < 0.01) compared to the group that underwent hernioplasty without fixation of the mesh endoprosthesis. In surgical intervention without mesh fixation, the incidence of complications was substantially reduced: seroma formation decreased from 10.9 ± 0.3% in the control group to 2.1 ± 0.1% in the main group (p = 0.031); oedema was observed in 28 patients (30.4 ± 0.5%) from the control group, and in 12 patients (12.6 ± 0.3%) from the main group (p = 0.005). Based on the analysed data obtained in this study, hernioplasty without fixation of the mesh endoprosthesis has considerable advantages, according to all criteria, compared to surgical intervention using a herniostapler. Hernioplasty without mesh fixation is a safe and effective technique that reduces pain, complications, and the cost of surgery, while maintaining the success of hernia repair. Proper patient selection, sufficient mesh overlap, and careful peritoneal closure are key to the success of the surgical intervention