Background: Inguinal hernias are a significant cause of patient morbidity. It is the most common type of hernia,
accounting for 75% of all the abdominal wall hernias. Several methods of inguinal hernia repair have been described and
have been evolved over time. The Laparoscopic approach for inguinal hernia repair was first reported by Ger, who
performed a high ligation of the sac without mesh placement. Total extraperitoneal repair was developed because of
concern for possible complications associated with intra-abdominal access, which was required for the transabdominal
preperitoneal approach. Laparoscopic total extra peritoneal repair (TEP) of inguinal hernia is associated with less
postoperative pain and morbidity than open hernia repair. The TEP method allows access to the preperitoneal space and
avoids the need for a peritoneal incision. The study is aimed to evaluate the role of laparoscopic total extra peritoneal
hernia repair without mesh fixation in early ambulation, recurrence rate and post-operative chronic groin pain. Methods:
This is prospective study, was conducted on 30 patients suffering from inguinal hernia attending General Surgery
Department at Benha University Hospital. Results: The mean age of the studied patients was 31 years, with a standard
deviation of 6 years. Regarding gender, there was a male predominance; most of the studied patient was males (93.3%).
Regarding complaint, about half of the studied patients (53.3%) complained of left inguinal hernia and the other half
(46.7%) complained of right inguinal hernia. Less than one-quarter of the patients had DM or hypertension; 20.0% for
each. Only 16.7% had a history of a previous operation. Less than one-quarter had a history of cough or constipation;
20.0% and 23.3%, respectively. Prostatic problem was reported by only 6.7% of the studied patients. The mean surgical
time was 60 minutes, with a standard deviation of 14 minutes. No conversion to open surgery was reported in the studied
patients. Regarding early outcome, less than one-quarter of the patients reported hematoma, groin pain, or seroma; 20.0%,
16.7%, and 6,7%, respectively. No urine retention was reported. Regarding wound state, most of the patients (93.3%)
reported clean wound, and only 6.7% reported infected wound. Regarding late outcome, recurrence occurred in only two
patients (6.7%). Only 16.7% reported chronic groin pain. Conclusion: TEP inguinal hernia repair performed without mesh
fixation is safe, effective procedure with low morbidity and feasible with minimal recurrence rates. Not fixing the mesh
avoids possible complications. |
