Sanjay Kala1, Ramendra Kumar Jauhari2, Anurag Singh3, Abhishek V. Kulkarni4
BACKGROUND
The debate between fixation and non-fixation of mesh in laparoscopic hernia
surgery has been going since the advent of this technique. While earlier studies
insisted on mesh fixation, emerging studies are now supporting elimination of
mesh fixation. Therefore, a prospective comparative study was performed in
tertiary health care centre in northern India to compare the incidence of
recurrence, post-operative pain and chronic groin pain between mesh fixation and
non-fixation. In this study, we wanted to compare the intra-operative
complications, post-operative pain and recovery, duration of hospital stay,
incidence of chronic groin pain and pain during follow up visits and incidence of
recurrence in laparoscopic inguinal hernia repair between fixation and non-fixation
of mesh.
METHODS
A prospective comparative study was conducted among 50 patients admitted in
surgery unit in a tertiary health care centre in northern India from January 2019
to October 2020 and were divided into two groups (group A - fixation, group B -
non-fixation). Different factors such as post-operative pain, analgesia required
post-operatively, duration of hospital stay, chronic groin pain and recurrence were
compared between the two groups. Patients were followed up at 1, 3, 6 and 12
months.
RESULTS
The mean pain score at the end of 1 month and 3 months was higher in patients
in the mesh fixation group. The days required by patients to resume their routine
activities was lesser in patients in the non-fixation group. The recurrence rate was
found to be similar in both the groups.
CONCLUSIONS
Mesh fixation offers no clear advantage over non-fixation and non-fixation can be
considered as the preferred alternative as this procedure has less chance of postoperative
pain, early ambulation and no increased risk of recurrence.
