To Evaluate The Outcome in Laparoscopic Total Extra-Peritoneal Repair of Inguinal Hernia With Staple Fixation of Mesh Vs Non-Fixation: A Prospective Observational Study

Abstract Introduction: Total Extra-Peritoneal (TEP) approach is a minimally invasive procedure used for Inguinal Hernia repair. In this method mesh is placed in extra-peritoneal space and fixation of mesh done by suture materials or using devices such as tacks staple or tissue glue or no fixation of mesh. Objective: To evaluate the outcome of the tacks staple fixation of mesh vs non-fixation in laparoscopic TEP repair of inguinal hernia in terms of intra-operative, post-operative and socioeconomic outcomes. Material and Method: In this prospective study, total 66 patients underwent Laparoscopic Total Extra-Peritoneal repair and were observed into two study groups: Group I (n=33)- with fixation of mesh by absorbable tacks and Group II (n=33)- no fixation of mesh. Post operatively there was a specific follow-up (at 1 week, 1 month, 3 months and 6 months) for surveillance of patients for wound complications, surgical site infections and recurrence. Results: In this study the mean age was found to be 49.54±10.27 and the majority of patients were in their 4th and 5th decade of life and were male. Hospital stay for the fixation of mesh group was found to be 2.24±0.44 days while that in non-fixation group it was 2.33±0.59 days and the association was found to be statistically insignificant (p<0.05). The chronic groin pain was seen in 1 (3.0%) in the fixation group while no chronic groin pain was seen in non-fixation group (p<0.314). There was no surgical site infection; seroma formation and recurrence in both the group. Conclusion: Totally extra peritoneal repair is a safe procedure. Avoidance of fixation of mesh during extra peritoneal repair of inguinal hernias is as safe as mesh fixation with certain advantages. It does not lead to increased recurrence though it does not decrease the incidence of chronic groin pain.