Tacker Fixation versus Suturing of Mesh in Laparoscopic Inguinal Hernia Repair.

Autor: Mohamed Amer, Hazem Abdelsalam, Abdelmoaty, Karim Fahmy, Raslan, Ibrahim Khaled, Ahmed Mostafa, Ahmed Mostafa
Předmět:
Zdroj: QJM: An International Journal of Medicine; 2024 Supplement, Vol. 117, pi103-i103, 1/3p
Abstrakt: Background: Laparoscopic hernia repair is more difficult technically than open surgery and there is evidence of learning curve in its performance and many complications which reported from laparoscopic procedure is due to learning curve lead to operative complications. Objective: To compare the outcome results of the fixation of mesh by intracorporeal sutures and by tackers in TAPP hernia repair. Patients and Methods: In our study, 30 patients were included divided on two groups, 15 for each. Group A; fixation mesh with tackers, Group B; fixation mesh with intracorporeal sutures. Both groups were compared in terms of operative technique, operative time, mesh device fixation cost, intra & post operative complications, early post operative pain within two weeks and in first month, hospital stay, restriction of physical activity and incidence of recurrence and chronic pain. Results: We found that using Intracorporeal sutures for fixation mesh is available, cheaper and more handle than using the Tackers which are expensive and less available so it makes a laparoscopic hernia more practical and decrease need for open surgery so we avoid the complication of open surgery. Both techniques are considered safe and effective with similar rates of recurrence and chronic pain although further wider scale studies are recommended. Conclusion: TAPP hernia is considered safe as all perioperative complications are well tolerated by patients and mostly there was no need for a second operative intervention. Mesh fixation technique did not affect long-term persistent pain. A large number of patients reported persistent pain regardless of mesh fixation technique, which emphasizes the need for preoperative information. Preoperative pain was a risk factor for persistent pain. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilateral or bilateral, primary or recurrent status, strangulation and type of anesthesia, occupation, and leisure activities. Both techniques are effective in the management of inguinal hernia and were associated with same recurrence rate. However, due to small sample size and short follow up duration, longer-term studies are also recommended. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index