Outcomes of mesh fixation versus non fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair: a randomized clinical study

Objective: The present study aimed to compare the results of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair with and without mesh fixation regarding postoperative pain, recurrence, operative time, and complications. Methods: This randomized controlled clinical trial included 100 patients who underwent TAPP inguinal hernia with mesh fixation (group A) or a fixation-free procedure (group B) for early onset inguinal hernia at the General Surgery Department, Kafrelsheikh University Hospital, from January 2021 to June 2022. Results: The parameters for pain assessment (NRS) in the first week (mean 7 (5 - 8)), the first month (mean 3 (1 - 5)), and after three months (mean 0 - (70% of patients), (mean 1 - (30% of patients) were significantly higher in the fixation group (p<0.001). The fixation group had significantly more operative time than non fixation, with a mean (69.34 +/- 13.55, 60.92 +/- 10.18) respectively. Recurrence rate and postoperative complications did not show any significant difference between the studied groups. Conclusion: Mesh non-fixation for laparoscopic TAPP hernia repair is safe, practical, and effective with minimal postoperative pain and no increased risk of recurrence.