Comparison of single absorbable tacker vs. conventional method in fixating the mesh in bilateral inguinal hernia undergoing laparoscopic transabdominal preperitoneal (TAPP) A randomized control trial study

Pouya Mir Mohammad Sadeghi, Amir Naseri, Hamid Melali, Ali Ashjaei

Abstract


Background: The current study aims to investigate the superior mesh fixation method, single absorbable tacker versus conventional method, in patients undergoing bilateral inguinal hernia repair through the laparoscopic total abdominal preperitoneal (TAPP) approach.

Materials and Methods: The current randomized clinical trial has been conducted on 81 patients undergoing bilateral hernia repair through TAPP. The patients were randomly assigned into one of the mesh fixation groups including single absorbable
tacker (Group S) (n = 41) and conventional method (Group C) (n = 40). All  atients were assessed during the hospital stay and 1 month postoperatively to assess the surgery?associated complications and days for return to daily activity. Eura?Hs questionnaire was applied to assess the quality of life (QOL) after hernia surgery during 12?month follow?up.

Results: The duration of bilateral inguinal hernia operation (P = 0.067), postoperative urinary catheterization (P = 0.813), and hospital stay duration (P = 0.779) did not differ between the groups; whereas Group C significantly required a longer time for returning to daily activity (P < 0.001). Only a patient in Group C
represented hematoma (P = 0.494). Seroma incidence was not statistically  ifferent between the two groups (P = 0.712). Postoperative pain was statistically less in Group S (P < 0.001 for all the assessments). Postoperative QOL within a year after hernia repair revealed an insignificant difference between the groups in general (P > 0.05); however, a pain subscale was significantly less in Group S (P = 0.002).

Conclusion: Based on the findings of this study, a single absorbable tacker was generally superior to the conventional method considering its less pre- and postoperative complications. However, the two methods did not differ regarding 1?year follow?up QOL.


Keywords


Hernia, inguinal, laparoscopy, postoperative complications, quality of life, surgical mesh

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