Laparoscopic totally extraperitoneal (TEP) hernia repair is a well-accepted
technique for inguinal hernia repair. Different types of mesh
and fixation methods have been described. Recently, a novel, self-fixating mesh
has been introduced and used successfully in open inguinal hernia repairs. We
report the first initial experience using this mesh for TEP repairs.
Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s,
promising less pain and short recovery period, but carrying the risk mesh
bulging and migration. Objective: We
have presented our technique in which central zone of mesh is fixed only after
closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct
inguinal hernias, 4 both direct and indirect inguinal hernias on the same
side). These cases are undergoing tension-free mesh repair after closure of
hernial defect, and the mesh is fixed only at its central zone using Gulbran 2,
between April 2011 and March 2013. The follow-up period ranged from 6 to 30
months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day.
The age of this group of patients ranged from 23 to 63 years (mean, 47 years).
The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The
intraoperative complications were in form of mild bleeding in 7 patients (25.9%)
during hernial sac dissection. Postoperative complications were mild inguinal
pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%)
was recorded. No recurrence or bulging at hernia site was noticed during the
period of follow-up. Conclusion: Laparoscopic
inguinal hernia repair with central mesh fixation after closure of hernial
defect is effective, easy and free of complications.