Comparative Study between Mesh Fixation vs. Non-Fixation in Totally Extraperitoneal Hernioplasty for Inguinal Hernia

Aim of the work: Randomized comparative study comparing outcome of mesh fixation versus non-fixation in TEP technique for inguinal hernia repair. Methods: In Tanta University Hospitals, over the period from February 2015 to October 2017, 58 patients with with 67 inguinal hernias (9 bilateral) undergoing TEP technique were randomized into 2 groups: Group A; mesh fixation 31 patients with 35 hernias. Group B; mesh non-fixation 27 patients with 32 hernias. Follow up was 6-17 months. Results: There was no statistical difference between 2 groups regarding operative time, postoperative complications, length of hospital stay and risk of chronic groin pain. Postoperative pain score was higher in Group A (mesh fixation). There was one case of hernia recurrence in group A (hernia and recurrence were both indirect), however, risk of hernia recurrence was not statistically significant. Conclusion: Mesh fixation and non-fixation in TEP are comparable regarding operative time, complications and hospital stay, while pain score was higher with mesh fixation. Mesh fixation does not increase the risk of chronic groin pain, while non-fixation does not increase hernia recurrence rate. Both techniques were proved safe.