Ai. Smith et al., Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair - A prospective randomized trial, SURG ENDOSC, 13(8), 1999, pp. 804-806
Citations number
8
Categorie Soggetti
Surgery
Journal title
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
Background: Controversy exists regarding whether it is necessary to secure
the mesh prosthesis during laparoscopic transabdominal preperitoneal (TAPP)
inguinal hernia repair. It is unknown whether stapling the mesh affects re
currence rate, incidence of neuralgia, or port-site hernia.
Methods: We conducted a prospective randomized trial comparing stapled with
nonstapled laparoscopic TAPP inguinal hernia repairs in a series of 502 co
nsecutive patients undergoing elective inguinal hernia repair at two instit
utions between January 1995 and March 1997.
Results: In all, 263 nonstapled and 273 stapled repairs were performed in 5
02 patients. Patients were evaluated at a median follow-up of 16 months (ra
nge, 1-32 months) by independent surgeons. There was no statistical differe
nce in the incidence of recurrence (0 to 263 nonstapled, 3 to 273 stapled;
chi-square p = 0.09). The overall recurrence rate was 0.6%. There was no si
gnificant difference in operative time, port-site hernia, chronic pain or n
euralgia between the two groups.
Conclusion: It is not necessary to secure the mesh during laparoscopic TAPP
inguinal hernia repair, allowing a reduction in the size of the ports.