Two-point Fixation for Biological Mesh in Laparoscopic Inguinal Hernia Repair.

Abstract

<h4>Objective</h4>To evaluate the clinical outcomes and safety of two-point fixation for biological mesh in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.<h4>Study design</h4>Case series.<h4>Place and duration of study</h4>The first Affiliated Hospital of Fujian Medical University Hospital, Fuzhou, China, from January to December 2019.<h4>Methodology</h4>A total of 38 patients with a primary inguinal hernia who underwent laparoscopic TEP repair with a small intestine submucosal matrix biological mesh were included. A novel two-point fixation method was performed at the level of 2 cm above the upper margin of the hernia ring. The mesh was fixed at 3 cm medial and lateral to the inferior epigastric artery. The recurrence rate, surgical site infection rate, postoperative chronic pain, hematoma/seroma, and chronic pain were evaluated.<h4>Results</h4>There was no conversion to open procedure. The surgical time was 60.0 (range 35-72) min, and the time of mesh fixation was 4.00 (range 2.5-6.0) minutes. All patients were discharged on the first postoperative day and had similar pain scores (VAS score = 1). Hematoma/seroma was detected in only three (7.9%) patients. No infection or recurrence was observed.<h4>Conclusion</h4>The two-point fixation for biological mesh is reliable and easy to perform. Further study with a larger sample size may be needed to validate it.<h4>Key words</h4>Inguinal hernia, Laparoscopy, Biological mesh, Surgical mesh, Herniorrhaphy, Two-point fixation.