Impact of Mesh Fixation on Chronic Pain in Total Extraperitoneal Inguinal Hernia Repair (TEP)

2016 ◽  
Vol 263 (6) ◽  
pp. 1199-1206 ◽  
Author(s):  
Nihad Gutlic ◽  
Peder Rogmark ◽  
Pär Nordin ◽  
Ulf Petersson ◽  
Agneta Montgomery
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Total Extraperitoneal

scholarly journals Mesh fixation techniques for inguinal hernia repair: an overview of systematic reviews of randomised controlled trials

Hernia ◽  
2021 ◽  
Author(s):  
A. Alabi ◽  
N. Haladu ◽  
N. W. Scott ◽  
M. Imamura ◽  
I. Ahmed ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Systematic Reviews ◽  
Randomised Controlled Trials ◽  
Mesh Fixation ◽  
Controlled Trials ◽  
Fixation Techniques ◽  
Randomised Controlled

Abstract Purpose Inguinal hernia repair using surgical mesh is a very common surgical operation. Currently, there is no consensus on the best technique for mesh fixation. We conducted an overview of existing systematic reviews (SRs) of randomised controlled trials to compare the risk of chronic pain and recurrence following open and laparoscopic inguinal hernia repairs using various mesh fixation techniques. Methods We searched major electronic databases in April 2020 and assessed the methodological quality of identified reviews using the AMSTAR-2 tool. Results We identified 20 SRs of variable quality assessing suture, self-gripping, glue, and mechanical fixation. Across reviews, the risk of chronic pain after open mesh repair was lower with glue fixation than with suture and comparable between self-gripping and suture. Incidence of chronic pain was lower with glue fixation than with mechanical fixation in laparoscopic repairs. There were no significant differences in recurrence rates between fixation techniques in open and laparoscopic mesh repairs, although fewer recurrences were reported with suture. Many reviews reported wide confidence intervals around summary estimates. Despite no clear evidence of differences among techniques, two network meta-analyses (one assessing open repairs and one laparoscopic repairs) ranked glue fixation as the best treatment for reducing pain and suture for reducing the risk of recurrence. Conclusion Glue fixation may be effective in reducing the incidence of chronic pain without increasing the risk of recurrence. Future research should consider both the effectiveness and cost-effectiveness of fixation techniques alongside the type of mesh and the size and location of the hernia defect.

scholarly journals Mesh Fixation versus Non Fixation in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A B Lachin ◽  
A A Abdrabbu ◽  
A A F Darwish ◽  
M M K Ali
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Operation Time ◽  
Fixation Group ◽  
Transabdominal Preperitoneal ◽  
Transabdominal Preperitoneal Inguinal Hernia

Abstract Background inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Several studies have shown that laparoscopic repair offers the advantage of minimally invasive surgery to the patient. The mesh can be placed without fixation or can be fixed into place with tuckers. Aim of the Work this study aimed to compare mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia, as regards the operation time, hospitalization, postoperative complication, recurrence and chronic pain. Patients and Methods sixty adult males with inguinal hernia were repaired with laparoscopic transabdominal preperitoneal inguinal hernia repair, divided into; mesh fixation group (n = 35) versus non-fixation group (n = 25), and certain parameters were assessed during the operative, postoperative and follow-up periods. Results mean operation time and mean hospital stay time were significantly higher in mesh fixation group than non-fixation group. VAS scores 2days, 3months, and 6months postoperative were less for non-fixation group. Non-significant difference was found between both groups regarding intraoperative injury, hernia recurrence, wound seroma, mesh infection, chronic pain, return to physical activity. Conclusion TAPP inguinal hernioplasty without mesh fixation does not increase recurrence rate, but reduces operative duration, hospital stay duration and decreases the incidence of postoperative pain.

Less chronic pain following mesh fixation using a fibrin sealant in TEP inguinal hernia repair

Hernia ◽  
2006 ◽  
Vol 10 (3) ◽  
pp. 272-277 ◽  
Author(s):  
R. Schwab ◽  
A. Willms ◽  
A. Kröger ◽  
H. P. Becker
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Fibrin Sealant ◽  
Mesh Fixation

scholarly journals Endoscopic Techniques in the Treatment of Inguinal Hernias

2020 ◽  
Vol 13 (2) ◽  
pp. 138-145
Author(s):  
Wadim Trukhalev ◽  
Alexander Vlasov ◽  
Аleksandra Kalinina ◽  
Elena Krivenkova
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Tension Free ◽  
Inguinal Hernias ◽  
Total Extraperitoneal ◽  
Endoscopic Methods

The review is devoted to the treatment methods of inguinal hernia. Inguinal hernia repair is one of the most common operations in the world and is performed on more than 20 million patients per year. Recurrence rates of inguinal hernias after different types of surgical interventions range from 10 to 15%. The use of synthetic materials reduced the rates of hernia recurrence on average to 1-5%. Currently there are traditional tissue-based techniques, open tension-free mesh hernia repair, and laparoscopic mesh hernioplasty. Nowadays tension-free repair with synthetic mesh is a technique of choice for inguinal hernia repair. The emphasis has been placed on endoscopic methods of inguinal hernia prosthetic repair. According to the literature, laparoscopic repair is associated with low rates of wound infection and fewer haematomas, which leads to early resumption of everyday activities compared with Lichtenstein hernia repair. The paper discusses two standardized endoscopic methods for inguinal hernia treatment, namely laparoscopic transabdominal preperitoneal patch (TAPP) and total extraperitoneal (TEP) repair. Analysis of the literature has shown that criteria of necessity and method of mesh fixation during TAPP procedure were not completely identified. However, a number of researches have demonstrated that TAPP technique without mesh fixation proved to be a safe procedure which can be used in most patients with unilateral and bilateral inguinal hernia showing no increase in postoperative complications and low recurrence rates.

Evaluation of Chronic Groin Pain Rates After TEP Hernioplasty – A Single-Center Study

2019 ◽  
Vol 12 (2) ◽  
pp. 153-156
Author(s):  
Dobromir D. Dimitrov
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
University Hospital ◽  
Chronic Groin Pain ◽  
Minimal Risk ◽  
Preoperative Pain ◽  
Total Extraperitoneal

Summary Total extraperitoneal hernioplasty (TEP) has become increasingly used by surgeons. The TEP procedure is technically more challenging due to space constraints and has a higher learning curve. Chronic groin pain after inguinal hernia repair has become the dominant outcome investigated rather than recurrence. We aimed to evaluate the rate of chronic groin pain after TEP inguinal hernia repair performed at the Department of Surgical Oncology in G. Stranski University Hospital – Pleven. The procedures performed totaled 36. There was one conversion, and the patient was excluded from the study because the procedure performed was not laparoscopic. Distribution according to inguinal hernia type was: 41.7% - indirect hernia (15), 36.1% - direct hernia (13), 13.9% combined (5), and 8.3% femoral (3). Twenty-eight of the patients (80%) had preoperative pain. Two of the patients with chronic groin pain had had their meshes fixed with tacks (14.3% from the tack group with p=0.7). Our study showed that the TEP procedure is a safe, feasible operation with minimal risk for complications. Using tacks for mesh fixation is associated with higher rates of chronic groin pain, but it does not affect the recurrence rate, which correlates with the literature review data.

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