gms | German Medical Science

Einleitung: Laparoscopic inguinal hernia repair (TAPP) is usually associated with mesh fixation, resulting in higher rates of postoperative chronic pain Aim of this single-centre study was to demonstrate the safety and efficacy of mesh placement in TAPP-procedure without mesh fixation in inguinal hernia with diameter below 4cm. The incidence of chronic pain, post-operative complications, patient satisfaction and hernia recurrence at follow-up after 12 months was evaluated.

Material und Methoden: Data were collected retrospectively from patient files and were analyzed for 300 male and female patients with 220 primary inguinal hernias. All patients included were treated by laparoscopic TAPP procedure using Ultrapro™ (Ethicon, Johnson&Johnson) meshes. All operations were performed by one expert surgeon. Perioperative data were collected, and a follow-up after 12 months was performed prospectively. Complications, pain scored on a 0–10 numeric rating scale (VAS), patient satisfaction and hernia recurrence were assessed.

Ergebnisse: No single recurrence occurred. The only complications were minor post-operative: hematoma/seroma (3 cases) and swelling above the genital organs (1 case for each). Satisfaction level was very high, as well as level for chronic postoperative pain with only 1.2 % reporting severe pain (NRS score 7–10) and 3.6 % reported mild pain.

Schlussfolgerung: This study demonstrates that in experienced hands, inguinal hernia repair surgery performed by laparoscopic transabdominal preperitoneal hernioplasty without mesh fixation for hernia diameter below 4 cm is rapid, efficient and safe with low pain, no foreign body feeling due to tacs and so far no hernia recurrence .