Fixation of Conventional Polypropylene Mesh Versus Non-fixation of 3D Mesh in Laparoscopic Transabdominal Preperitoneal (TAPP) Inguinal Hernia Repair: a Randomized Controlled Trial

Inguinal hernia repair is one of the most commonly performed operations in general surgery, with several surgical techniques to do it. The laparoscopic transabdominal preperitoneal (TAPP) approach has gained wide popularity in recent years. Introduction of 3D mesh is one of the recent advances in inguinal hernia treatment. The aim of this study is to evaluate the efficacy of 3D mesh compared to conventional polypropylene mesh in laparoscopic TAPP repair of inguinal hernia. A prospective study was carried out on 60 patients, 30 patients in each group. They underwent laparoscopic TAPP repair of inguinal hernia with 3D mesh or polypropylene mesh over a period of one year. The data analysed included demographic data, mesh spreading time, operative time, post-operative pain, post-operative complications, hospital stay, and chronic groin pain. Follow-up period was 1 year. The mesh spreading time was shorter in 3D mesh 7.32 SD 2.98 vs 12.68 SD 3.59 min, in polypropylene mesh (p = 0.001). The postoperative pain score was higher in polypropylene mesh 4.93 SD 0.87 vs 3.97 SD 0.81 (p = 0.001). The incidence of postoperative complications was not significantly different between the two groups apart from the frequency of chronic pain after 6 months, which was significantly higher in polypropylene mesh group 5 (16.7%) vs 1 (3.3%) (p = 0.02). The non-fixation of 3D mesh in laparoscopic TAPP inguinal hernia repair is a feasible, safe option for surgical treatment of inguinal hernia with shorter mesh spreading time and reduced post-operative pain and chronic pain, without increasing complications nor recurrence rates.