Peeravudh Chantana, MD, Ratchanon Bongsuwan, Setthasiri Pantanakul, MD, Panot Yimcharoen, MD. Bhumibol Adulyadej hospital
Background: Inguinal hernia is a commonly encountered surgical condition. Laparoscopic techniques have become more popular in the recent years. Laparoscopic approach provides considerable advantage in shortening post-operative recovery time. Fixation of mesh is a challenge point in laparoscopic hernia repair. This study will compare outcome between mesh fixation by fixation device and self-fixating mesh, done by laparoscopic TEP.
Objective: To compare post-operative outcome using parameters of pain, length of hospital stay, operative time, time of recovery to effective life activities, short term recurrence and complications, in patients underwent LAP TEP with the use of mesh with fixation device and self-fixating mesh
Materials and Methods: Data was collected from 2015 to 2018 and reviewed. Patients undergoing LAP TEP with use of fixation device (ProTack™) and self-fixating mesh (ProGrip™). The procedures were performed by expert in laparoscopic surgery. One-hundred-and-thirty-one (131) patients with complete medical records met the inclusion criteria.
Results: In total, 131 Lap TEP surgery was performed, fixation devices were used in 112 cases (85%) while in 19 cases (15%) self-fixating mesh was independently placed. Male patients were the most common visitor with the condition (97%). The mean age was 66.45 (22-91) years old. Most of the participants had bilateral disease (56%) and indirect inguinal hernia was the most commonly found. Operative time, estimate blood loss, length of hospital stay, time of recovery to effective life activities within a week were not different between two groups. Three-month post-operative pain with mild severity were found in 3 cases with placement of fixation device . Mean score of the first day post-operative pain was 1.6 in self-fixation mesh and 2.3 in fixation device. Six-month recurrence was found in 3 cases in fixation device group. Complications were found in 10 cases with placement of fixation device, comprised of 3 cases of seroma, 6 cases of hematoma and 1 case of wound infection.
Conclusion: This study revealed the outcome of fixation technique. Self-fixating mesh was found superior in pain outcome both first day and at 3 month. Complications and recurrences were found only in fixation device group. Long term and larger study may be needed to confirm the effectiveness of self-fixating mesh.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95162
Program Number: P588
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster