Although mesh fixation has been associated to an increased incidence of nerve injury and involves increased operative costs, many surgeons feel that fixation is necessary to reduce the risk of hernia recurrence. The aim of this study is to evaluate the outcomes of laparoscopic herniorrhaphies performed with and without mesh fixation at our institution.
A randomized prospective study was conducted. Four groups of patients were constituted: (1) TEP with mesh fixation (2) TEP without fixation, (3) TAPP with mesh fixation, (4) TAPP without fixation. 120 patients were randomized to each group. The principal outcomes assessed were postoperative chronic groin pain assessed by visual analogue pain scale (VAS), hernia recurrence, other morbidity rates and hospital costs. Patients were reviewed in outpatient unit at 1 week and at 1, 6, 12 and 24 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
400
Standard totally extraperitoneal preperitoneal (TEP) inguinal hernia repair
Standard totally extraperitoneal preperitoneal (TEP) inguinal hernia repair
Standard transabdominal preperitoneal (TAPP) inguinal hernia repair without mesh fixation
Standard transabdominal preperitoneal (TAPP) inguinal hernia repair
Medical Park Gaziantep Hospital
Gaziantep, Turkey (Türkiye)
Change from preoperative pain levels at 2 years assessed by the visual analogue pain scale (VAS)
neuralgia, inguinal
Time frame: preoperative and postoperative 2nd year
Change from preoperative pain levels at 1 year assessed by the VAS
neuralgia, inguinal
Time frame: preoperative and postoperative 1st year
Change from preoperative pain levels at 6 months assessed by the VAS
neuralgia, inguinal
Time frame: preoperative and postoperative 6th month
Change from preoperative pain levels at 3 months assessed by the VAS
neuralgia, inguinal
Time frame: preoperative and postoperative 3th month
Change from preoperative pain levels at 1 month assessed by the VAS
neuralgia, inguinal
Time frame: preoperative and postoperative 1 month
Change from preoperative pain levels at 1 week assessed by the VAS
neuralgia, inguinal
Time frame: preoperative and postoperative 1th week
Total hospital costs
consisted all costs of hospital stays and outpatient treatments
Time frame: up to 24 months
conversion rate
conversion to open surgery
Time frame: through the first day
recurrence rate
clinical and radiological diagnosed
Time frame: up to 24 months
rate of minor and major complications
it was assessed as; no complication, minor complications, major complications and complications needed reoperation
Time frame: 2 year
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