Outcomes of usage of polypropylene mesh in TAPP hernia repair

Amit Kumar; Adeel Ahmed Malik; Gurbir singh; Agnishikha Bhat

doi:10.18203/2320-6012.ijrms20231335

Authors

Amit Kumar Department of General Surgery, Government Medical College, Jammu, Jammu and Kashmir, India
Adeel Ahmed Malik Department of General Surgery, Government Medical College, Jammu, Jammu and Kashmir, India
Gurbir singh Govt medical college, jammu
Agnishikha Bhat Department of General Surgery, Government Medical College, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231335

Keywords:

Inguinal hernia, Post-operative pain, Polypropylene mesh, TAPP, TEP

Abstract

Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair.

Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh.

Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery.

Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.

Metrics

Metrics Loading ...

References

Abrahamson J. Hernias. In: Schwartz SI, edr. Maingot’s Abdominal Operation. 10th edn. PH International; 1989:506.

Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons Jr R, Dunlop D, Gibbs J, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004;350(18):1819-27.

Hair A, Paterson C, Wright D, Baxter JN, O’Dwyer PJ. What effect does the duration of an inguinal hernia have on patient symptoms? J Am Coll Surg. 2001;193(2):125-9.

Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835-9.

Burcharth J, Pommegurd HC, Rossenberg J. The inheritance of groin hernia, a systematic review. Hernia. 2013;17:183-9.

Lau H, Fang C, Yuen WK, Patil NG. Risk factors for inguinal hernia in adult males: a case-control study. Surgery. 2007;141(2):262-6.

Mahon D, Decadt B, Rhodes M. Prospective randomized trial of laparoscopic (Transabdominal Preperitoneal) versus open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc. 2003;17:1386-90.

Novik B, Hagedorn S, Mörk UB, Dahlin K, Skullman S, Dalenbäck J. Fibrin glue for securing the mesh in laparoscopic totally extraperitoneal inguinal hernia repair: a study with a 40-month prospective follow-up period. Surg Endosc Other Intervent Tech. 2006;20:462-7.

Mitura C, Romanchuk N, Wroblewski T. Early results of inguinal hernia repair method Desarda in 17 operated patients. A preliminary report. Arch Minimal. 2006;1:18-22.

Mitura K, Romanczuk M. Comparison between two methods of inguinal hernia surgery- Lichtenstein and Desarda. Pol Merkur Lekarski. 2008;24(143):392-5.

Situma SM, Kaggwa S, Masiira NM, Mutumba SK. Comparison of Desarda versus modified Bassini inguinal Hernia repair: a randomized controlled trial. East Cent Afr J Surg. 2009;14(2):70-6.

Desarda MP. Inguinal herniorrhaphy with an undetached strip of external oblique aponeurosis: a new approach used in 400 patients. Eur J Surg. 2001;167(6):443-8.

Desarda MP, Ghosh A. Comparative study of open mesh repair and Desarda’s no-mesh repair in a district hospital in India. East Cent Afr J Surg. 2006;11(2):28-34.

Xuan NT, Son NH. Laparoscopic transabdominal preperitoneal technique for inguinal hernia repair in adults. Cureus. 2020;12(6):e8692.

Shah T, Rajbhandari AP, Rijal B, Koirala R, Shakya A. Laparoscopic groin hernia repair: a systematic institutional study. Acta Scient Gastroint Disord. 2020;3(8):2-8.

Rodríguez PR, Delgado FR, Gonzalez OL, Surgeon G, Cabrera FO, Cabrera JR, et al. Randomized controlled trial comparing open prosthesis repair and Desarda’s no mesh repair for inguinal hernia (A study of 836 patients). Cochrane Database Syst Rev. 2010;12:114-22.

Kalra T, Soni RK, Sinha A. comparing early outcomes using non absorbable polypropylene mesh and partially absorbable composite mesh through laparoscopic transabdominal preperitoneal repair of inguinal hernia. J Clin Diagn Res. 2017;11(8):13-6.

Ghani A, Khalil J, Khan MI, Khan H. Laparoscopic transabdominal preperitoneal versus lichtenstein tension free repair for inguinal hernia. Pak J Surg. 2012;28(1):6-11.

Rather ZM, Islam MN, Lone ZG. Laparoscopic trans-abdominal pre-peritoneal mesh hernioplasty for inguinal hernias: a tertiary care institute experience. Int J Adv Res. 2018;6:1324-8.

Eisa A, Gaber A, Harb TT. Laparoscopic transabdominal preperitoneal inguinal hernia repair. Egypt J Surg. 2014;33:86-9.

Shakya VC, Sood S, Bhattarai BK, Agrawal CS, Adhikary S. Laparoscopic inguinal hernia repair: a prospective evaluation at Eastern Nepal. Pan Afr Med J. 2014;17.

Salma U, Ahmed I, Ishtiaq S. A comparison of post operative pain and hospital stay between Lichtenstein's repair and laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia: A randomized controlled trial. Pak J Med Sci. 2015;31(5):1062-6.

Sharma D, Yadav K, Hazrah P, Borgharia S, Lal R, Thomas S. Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015;22:110-7.

Cawich SO, Mohanty SK, Bonadie KO, Simpson LK, Johnson PB, Shah S, et al. Laparoscopic inguinal hernia repair in a developing nation: short‑term outcomes in 103 consecutive procedures. J Surg Tech Case Rep. 2013;5(1):13-7.

Tzovaras G, Symeonidis D, Koukoulis G, Baloyiannis I, Georgopoulou S, Pratsas C, et al. Long-term results after laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair under spinal anesthesia. Hernia. 2012;16:641-5.

Chalkoo M, Mir MA, Makhdoomi H. Laparoscopic transabdominal preperitoneal mesh hernioplasty: a medical college experience. Surg Sci. 2016;07:107-13.

Weiser HF, Klinge B. Endoscopic hernia repair, experiences and characteristic features. Visz Chir. 2000;35:316-20.