Comparison Of The Efficacy Of Non-stapling Mesh And Stapling Mesh In Laparoscopic Transabdominal Preperitoneal Hernia Repair

ObjectiveComparing the efficacy of non-stapling mesh and stapling mesh for hernia repair by using Laparoscopic transabdominal preperitoneal hernia repair technique.MethodsA retrospective analysis of 58 cases of laparoscopic inguinal hernia repair(TAPP)between January 2010 and October 2021 in The Third Affiliated Hospital of Southern Medical University and Shenzhen Hospital of Southern Medical University.The cases were divided into non-stapling group(3Dmax mesh)and stapling group(3Dmax mesh+medical glue)by the differences of mesh handle including 22 in the stapling group and 36 in the non-stapling group.The data including age,gender,the type of hernia,operative time,intraoperative blood loss,postoperative hospital stay,total hospital stay,surgery cost,total hospitalization costs,days of painkiller use,complication(Early postoperative pain estimate by VAS score and chronic postoperative pain,incisional hernia,seroma,urinary retention incision infection,patch infection,testicular atrophy,necrosis of testis and recurrence.ResultsThere were no significant differences between the two groups of patients in age,gender,type of hernia(P>0.05).There were no significant difference in operation time,operation cost and total hospitalization expenses(P>0.05).There were significant differences between the two groups of patients in intraoperative blood loss(P<0.05).The non-fixed group lost more blood than the fixed group.There were significant differences between the two groups of patients in postoperative hospitalization days,total hospitalization days(P<0.05),the non-fixed group was shorter than the fixed group.There was no significant difference between the two groups in the occurrence of early postoperative pain was evaluated by VAS score in the fixed group(n=7)and the non-fixed group(n=12).There was no significant difference between the two groups in days of painkiller use(P>0.05).There was 1 case urinary retention in the non-fixed group and no urinary retention occurred in the fixed group and there was no significant difference in urinary retention(P>0.05).There was 1 case seroma in the fixed group and 2 cases seroma in the non-fixed group,and there was no significant difference between the two groups in seroma(P>0.05).There was 1 case in the fixed group and 2 cases in the non-fixed group in recurrence rate 3 months after surgery,with no statistical significance between the two groups(P>0.05).No patients in the two groups had postoperatively infection of perforated hernia,patch infection of testicular hematoma,testicular atrophy or necrosis,dysesthesia in the operative area and chronic pain after inguinal hernia.ConclusionWhen laparoscopic transabdominal preperitoneal hernia repair is used for the treatment of direct hernia,the use of medical glue to fix the mesh can reduce intraoperative bleeding,but it is not superior to the non-fixation of the mesh in terms of short-term postoperative complications,and it can lead to the patient’s hospital stay extend.