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Inguinal Hernia Repair: Experience with Total Extra Peritoneal (tep) Technique Using a Self-fixation Mesh

Ricardo Nassar, MD1, Felipe Giron, MD1, Juan D Linares, MD1, Erika Torres, MD1, Cynthia Fuentes, MD1, Natan Zundel2, Juan D Hernandez, MD1. 1Hospital Universitario Fundacion Santa Fe de Bogota, 2Florida International University School of Medicine

Introduction: Inguinal hernia repair is a very frequent operation around the world, usually practiced in a short stay or day surgery modality. Hernias may cause severe complications, being the most common the incarceration, with the risk of bowel necrosis. Multiple approaches have been described, both open and minimally invasive. Laparoscopic totally extraperitoneal repair technique (TEP) is becoming more frequent due to its low rate of post surgical complications. Different types of mesh and fixation methods are used. Pain can be a problem and is mostly related to the fixation devices employed, and measures must be taken to prevent it.

Objective: To describe post operative outcomes for patients undergoing laparoscopic TEP hernia repair with self-fixation mesh at a fourth level University Hospital in Bogotá, Colombia.

Methods: Case series report of a group of 74 consecutive patients with inguinal hernias who underwent an inguinal hernia repair with TEP technique and self-fixation mesh from January 2012 to January 2016. Inclusion criteria were: minimum follow-up of 3 months; patients over 16 years of age, complete clinical records available, and that all patients answered a phone questionnaire. Patients were examined to rule out reproduction and they were asked to score pain on the analog scale at six months and one, two and three years either during visit or by phone.

Results: A total of 74 patients underwent TEP operations using a self-fixating mesh. Of them, 14 have been followed-up for more that three years, 23 for more that 2, 30 for more than one and 7 for more than six months. Postoperative controls have shown satisfactory results in terms of pain resolution and control, and no reproduction of hernias has been documented. Additionally, there are no complications associated to the procedure and none have required a reoperation.

Conclusion: The use of a self-fixation mesh for inguinal hernia repair with TEP technique is safe and effective, with good results in terms of pain control and reproduction rates after a mid-term follow-up. Avoiding the use of fixation devices (tacks or tackers) may contribute to a reduction in postoperative pain.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80814

Program Number: P028

Presentation Session: Poster (Non CME)

Presentation Type: Poster

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