Laparoscopic inguinal hernia repair without fixation

Aim. Comparison of the immediate and long-term results of laparoscopic inguinal hernia repair with and without mesh implant fixation.

Methods. The study included 145 patients over 18 years of both genders with inguinal hernias, including those with relapse after auto-hernioplasty. Patients underwent transabdominal preperitoneal hernioplasty with the application of mesh implant. Patients were randomly divided into two groups matched by age, sex and the type of hernias. In group 1 (n=71) patients underwent laparoscopic hernia repair without fixation, which in case of a direct inguinal hernia was supplemented with transverse fascia endoloop plication; and in group 2 (n=74) - laparoscopic hernioplasty using hernia stapler and/or endocorporal suture.

Results. The duration of surgical intervention in compared groups did not differ significantly (p=0.92), there was no recurrence of hernia in either group. The patients of group 1 had less pain syndrome in the early postoperative period, which was expressed in a significantly lower need for narcotic analgesics in terms of the equivalent amount of morphine (p=0.03) and shorter duration of hospital stay (p=0.5). Advantages of laparoscopic hernioplasty without fixation are the following: (1) intensity of pain syndrome in patients operated by this method is less than in patients operated by the traditional method, during both the first 24 hours after the surgery (p=0.45) and on day 5 (p=0.69); (2) there is no need to purchase foreign-made devices (hernia staplers) and self-locking endoprostheses.

Conclusion. The long-term and immediate results of laparoscopic inguinal hernia repair without mesh implant fixation are not inferior to the traditional methods of implant application; besides, the studied method has a raw of advantages.