Mesh Fixation Versus Non-Fixation in Laparoscopic Trans-Abdominal Preperitoneal Repair of Inguinal Hernia: A Randomized Controlled Study

Background: Several methods are used for mesh fixation in laparoscopic hernia repair including staples, tackers, sutures, and polycyanoacrylate derivatives.
Objective: This study aimed to compare the outcomes of fixation versus non fixation of the mesh in laparoscopic trans-abdominal preperitoneal repair (TAPP).
Patients and methods: The current study include 64 male patients who were eligible for TAPP repair. They were divided into two groups: Group A (n =32) underwent TAPP with mesh fixation, while group B (n=32) underwent TAPP without mesh fixation. Follow up was done for Operative time and times to ambulation, return to daily activity, long-term follow up for recurrence and postoperative pain.
Results: The mean age was 42.7 ± 4.5 and 44.2 ± 3.9 years in groups A and B respectively. There was significantly less mean operative time in group B than in group A.  There was no statistically significant difference regarding early post-operative pain in both groups. The reported time for return to basic, home and work activities were almost the same with no reported significant difference. For long-term follow up there was statistically significant less chronic pain and FB sensation in group B. There was no reported recurrence, or testicular atrophy in both groups.
Conclusion: According to the current results, TAPP repair can be done without significant impact on the outcomes.