Comparing Fixation versus Non-fixation of Mesh in Laparoscopic Totally Extraperitoneal Repair of Inguinal Hernia: A Prospective Study

Introduction: Inguinal hernia repair is one of the most common surgical procedures done worldwide. Conventional repair involves the usage of a mesh to cover the hernia defect to prevent recurrence. The mesh is fixed securely without tension in open hernia repair. Laparoscopic surgery for inguinal hernia repair is done by two methods, which only vary in approach to the preperitoneal space. They include laparoscopic transabdominal preperitoneal inguinal hernia repair and totally extraperitoneal (TEP) inguinal hernia repair. Purpose: The purpose of this study is to compare the outcomes and complications between fixation using suture and non-fixation of mesh in laparoscopic TEP inguinal hernia repair. Materials and Methods: The study period was 1 year, and all patients were followed up for a period of 1 year following surgery. All the surgeries were performed by a single surgeon, and all the ultrasounds were performed by the same radiologist. Results: The study population was randomized into two groups, 46 patients met with the inclusion criteria and were included in the study. Of the 46 patients, 22 patients were randomized to the group in whom, the mesh was fixed. 24 patients were randomized to the group in which the mesh was not fixed. Out of 46 patients, 36 had unilateral hernia and 10 had bilateral hernia giving a total sample size of 56. Out of 36 patients who had unilateral hernia, 11 had hernia on left side. 25 had hernia on the right side. Conclusion: We conclude that the placement of mesh without fixation results in less post-operative pain, consumes less time for placement of mesh and is cost-effective in comparison to mesh fixation technique. And there is no significant difference in the mesh migration in our study.