Fixation in Laparoscopic Inguinal Hernia Repair

There is a broad spectrum of fixation options for laparoscopic inguinal hernia repair. Categories of fixation include no fixation, adhesive fixation, and penetrating mechanical fixation. Given the confinements of the preperitoneal space, all forms of fixation are adequate with the exception of no fixation, which should be used in select scenarios where the patient has a small indirect defect. Understanding the biomechanics of each fixation type, however, enhances the surgeon’s ability to select appropriate fixation based on a patient’s hernia characteristics.