Abu Kamal Nahid, Sanjida Rahman, Keerthanaa Veerapatherar, Roland Fernandes

Clinic of General and Colorectal Surgery, William Harvey Hospital, Ashford, United Kingdom


Objective: Inguinal hernia repair is one of the most common general surgical procedure, and laparoscopic approach gained popularity over the open approach. This study aimed to compare the clinical effects of TEP inguinal hernioplasty with or without mesh fixation. The primary outcome was acute post-operative pain.

Material and Methods: A retrospective comparative study on a prospectively collected data was conducted in a large DGH in England between Janu- ary 2017 and December 2019 on 47 patients. The patients were divided into two groups. In group A, mesh fixation was performed with absorbable tackers and in group B no fixation was performed. Patients were followed up to 18 months postoperatively. Data was collected on post-operative pain, cost, recurrences and time taken to return to normal activities. Patients with lower midline scar and complicated inguinal hernias were excluded.

Results: Out of the 47 patients 53% (n= 25) were in group A and 47% (n= 22) in group B. All the patients in both groups were male. The mean postopera- tive pain score at 72h in group A was 7.12 (SD 1.13) and 4.91 (SD 1.23) in group B (p< 0.001). Group B patients have taken shorter time to return to normal activities in comparison to group A (p< 0.001), while recurrence (2%) rate is higher in group B (p> 0.05).

Conclusion: Pain and time taken to return to normal work postoperatively were significantly less in the non-fixation group. The study recommends non-fixation over fixation as it is feasible, cost-effective, causes less post-operative pain and no differences in terms of recurrences.

Keywords: İnguinal hernia, laparoscopic, mesh, fixation, non-fixation, chronic pain

Cite this article as: Nahid AK, Rahman S, Veerapatherar K, Fernandes R. Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: a comparative study. Turk J Surg 2021; 37 (1): 1-5.


Ethics Committee Approval

All procedures performed in this study were in accordance with the ethical standards of trust, and the study was discussed by the East Kent Hospitals University NHS Foundation Trust, UK.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - R.F., A.K.N.; Design - A.K.N.; Supervision - R.F., A.K.N.; Materials - A.K.N., R.F.; Data Collection and/or Processing - All of authors; Literature Review - A.K.N.; Writing Manuscript - A.K.N.; Critical Reviews - R.F.

Conflict of Interest

The authors declare that they have no conflict of interest.

Financial Disclosure

The authors declared that this study has received no financial support.