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Laparoscopic TAPP repair of inguinal hernia : Different methods of mesh fixation /

Mohamed Salah Farag

Laparoscopic TAPP repair of inguinal hernia : Different methods of mesh fixation / الطرق المختلفة لتثبيت الشبكة : إصلاح الفتق الإربى باستخدام المنظار الجراحى من خلال تجويف البطن وقبل الغشاء البريتونى Mohamed Salah Farag ; Supervsed Salma Fouad Dowara , George Abdelfady Nashed , Tarek Osama Hegazy - Cairo : Mohamed Salah Farag , 2021 - 187 P. : charts , facsimiles ; 25cm

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General surgery

Background: During laparoscopic repair of inguinal hernia using TAPP technique there are different methods for mesh fixation such as using tacker clips, fibrin glue and self-adhesive mesh. Objective: This study conducted to find out the best method of fixation of mesh in TAPP repair of inguinal hernia and the complication of each. And Evaluation the intra-operative and post-operative complications comparing between these methods. Study design: Prospective, randomized controlled study. Setting: Maadi Military Hospital and Kasr AL Aini teaching hospital. Subjects: We included 90 adult male and female patients with inguinal hernia divided into 3 equal groups all patients had (TAPP), transabdominal preperitoneal hernioplasty. Group A: (30 patients) fixed by tacker clips (secure strap). Group B: (30 patients) fixed with fibrin glue. Group C: (30 patients) with self-fixing mesh. Methods: All patients were subjected to full history taking, full clinical examination, routine investigations for all patients, including: Complete blood picture, Coagulation profile, Liver and kidney function tests, fasting blood sugar, ECG, Chest x-ray, Co-morbidities like COPD, cardiac diseases, chest diseases and diabetes mellitus are controlled preoperatively. Materials used: Mesh: polyprolene 15X10, Self-fixing mesh, Tacks: securestrap absorbable, and Fibrin glue. Primary postoperative outcomes include; Rate of recurrence after 18 months follow up. Secondary post-operative outcome parameters include; pain control, Intraoperative Mesh complications and postoperative complications (seromas, hematoma and, hydrocele). Results: In the studied population, Comparative study between the 3 groups revealed; an increase in operative time, in group-II (68.67±10.59 min); compared to other groups; but not reaching statistical significance (p > 0.05), and non-significant difference as regards days of hospital stay and return to normal activity (p > 0.05)



Inguinal hernia Mesh fixation TAPP