Kishore, P (2021) A Comparison study on Laparoscopic Inguinal Hernia Repair with Mesh Fixation Versus Without Mesh Fixation in Tertiary Care Centre. Masters thesis, Stanley Medical College, Chennai.
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Abstract
Two major problems in using laparoscopic inguinal hernia (IH) repair are recurrences and chronic groin pain (CGP). The procedure uses fixing of the mesh with the tackers which is considered to increase the rate of CGP because of nerve injuries. Thus, mesh without fixation is being proposed but concerns remain regarding increased recurrences. We sought to look at our outcomes after we started using non-fixation of mesh method in totally extraperitoneal repair (TEP). Retrospective review of prospectively maintained database of 100 repairs were done (fixation 50 and non-fixation 50) endeavor to complete a minimum of 6 months of clinical follow-up. The primary objectives were to assess the recurrence rates and CGP and the secondary objectives were to assess operative times, immediate post-op pain, duration of hospital stay, wound seroma and cost. The mean operative times for the fixation and non-fixation groups were 65.74 ± 8.6 and 80.18 ± 6.39 min, respectively (p< 0.001). The mean pain score was 3.02 ± 0.38 and 5.02 ± 0.31; (p < 0.001) in the two groups, respectively. At a mean follow-up of 6 months the incidence of CGP was 1 (2%) and 2 (4%) (p = 1.000) and recurrences were 03 (6%) and 2 (4%) in the two groups, respectively (p = 0.646). Non-fixation of mesh in TEP though it does not decrease the incidence of chronic groin pain, it does not lead to increased recurrence. Added benefits would be decreased operative times, reduced post-operative pain and decreased costs.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221811061 |
| Uncontrolled Keywords: | Laparoscopic Inguinal Hernia Repair, Mesh Fixation, Without Mesh Fixation, Tertiary Care Centre. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 03 May 2021 09:37 |
| Last Modified: | 09 Jan 2022 15:14 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15686 |
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