J Minim Invasive Surg.  2015 Mar;18(1):14-18. 10.7602/jmis.2015.18.1.14.

Mesh Encircling Total Extraperitoneal (TEP) Repair of Inguinal Hernia without a Fixation Material or Preformed Mesh: Overlay Closure of Slit Without Additional Mesh

• Park DJ
• Im YC
• Yang SS
• Kim GY

• KMID: 1895241
• DOI: http://doi.org/10.7602/jmis.2015.18.1.14

Abstract

PURPOSE
Mesh non-fixation in TEP is associated with lower cost and shorter operative time, and it is safe and recommended when performed by an experienced surgeon. In performance of TEP surgery using a non-fixation mesh, particularly by a non-experienced surgeon, prevention of mesh migration is an important issue for mesh application. The aim of this study was to report on a fixation method using a non-preformed mesh encircling a cord structure without the use of tacks, staples, or fibrin sealants in TEP surgery.
METHODS
A total of 41 patients who had undergone mesh-encircling TEP without fixation from December 2008 (first case of surgery) to June 2012 were analyzed.
RESULTS
The mean follow-up period was 23.2 months (12~35 months). Three patients complained of scrotal discomfort, and one patient complained of scrotal edema, but they were resolved with conservative management. There was no recurrence during the follow up period.
CONCLUSION
The method of mesh-encircling TEP without fixation material and no additional mesh in which the slit of the mesh is wrapped around the cord structure using an overlay suture is a simple and safe technique without compromising recurrence or chronic pain.

Keyword

TEP; Inguinal hernia; Fixation; Mesh

MeSH Terms

Chronic Pain
Edema
Fibrin Tissue Adhesive
Follow-Up Studies
Hernia, Inguinal*
Humans
Operative Time
Recurrence
Sutures
Fibrin Tissue Adhesive