Muhammad Farooq Afzal, Muhammad Waris Farooka, Wasim Hayat Khan, Allah Nawaz, Usman Butt, Awais Amjad Malik, Mubasher Shaukat, Syed Muhammad Bilal, Mahmood Ayyaz.
Experience of laparoscopic total extraperitoneal inguinal hernia repair without fixation of the mesh.
Pak J Med Health Sci Jan ;4(4):442-5.

Background: The main aim of the study is to examine the recurrence rate and postoperative pain in laparoscopic total extraperitoneal repair (TEP) of inguinal hernias performed with and without fixation of the mesh. Methods: This is a retrospective review of a prospectively maintained database and is conducted at a teaching hospital of Lahore. From the period December 1,2007 to August 31, 2009, 23 patients (27 hernias) who had undergone TEP were included in the study. The main outcome variable was the short term recurrence rate. Results: Of the 23 patients, the mesh was fixed (Fx) for 8 and not fixed (NFx) for 15 . The commonest intraop complication(17 cases) was peritoneal tear leading to loss of space. The follow-up period ranged from 6 to 18 months (mean, 9 months). Two patients in the Fixation group and three patients in the Fx group developed recurrence.Majority of recurrence were noted in the first three months.There were two conversions.one to TAPP and other to open Conclusions: This small study found TEP without mesh fixation to be safe and feasible with no significant increase in recurrence rate activities but has a difficult learning curve.

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