Patients Satisfaction Post Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair with External Fixation Versus Post Internal Fixation
Journal of Surgery
Volume 4, Issue 2, April 2016, Pages: 20-23
Received: Feb. 25, 2016; Accepted: Mar. 5, 2016; Published: Mar. 23, 2016
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Mohamed Salah Abdelhamid, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Ayman Hamdi Abouleid, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Mohamed Hasan Abdelmola, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Ahmed Mohamed Rashad, Surgery Department, Bani-Suef Faculty of Medicine, Bani-Suef University, Bani-Suef, Egypt
Mahmoud Ahmed Negida, Surgery Department, Kasr Elaini Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Zaky Gharib, Surgery Department, October 6th Faculty of Medicine, October 6th University, Giza, Egypt
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Laparoscopic transabdominal preperitoneal inguinal hernia repair wth external fixation is a new technique in which there is a marked reduction in the cost without affecting the outcome The issue of mesh fixation in laparoscopic repair of inguinal hernia repairs remains unsolved. The need for fixing the mesh arises from the fear of increasing recurrence rates. However, specific complications have emerged as a result of mesh fixation. The aim was to find out which is more satisfactory to the patients external fixation or internal fixation. In 80 patients the mesh were fixed from the interior using staples while in the other 80 patients it is fixed to the exterior using prolene threads (Abdelhamid Technique). We conducted A prospective study for laparoscopic TAPP inguinal hernia repair on 160 patients between September 2008 until May 2014 and we follow the patients till May 2015. In 80 we fixed the mesh to the exterior and in another 80 from the interior. There were 90 patients with direct inguinal hernia 45 done through external fixation (gp1) another 45 through internal fixation of the mesh (gp2), 70 patients with indirect inguinal hernia 35 external fixation (gp3) 35 internal fixation (gp4). We follow the patients for recurrence, impulse on cough, inguinal pain and sense of discomfort. The operative time ranged from 35 – 70minutes for external fixation, 30 -60 minutes for internal fixation. During this period we did not encounter any recurrence, but in group 1 there is one patient complained of impulse on cough and in group 2 there were three had the same complain. Regarding pain non of the external fixation patients complained of groin pain while in group 2 there were two and in group 4 there were two patients complained of groin pain. We concluded that in addition to much reduction in the cost as we did not use stapler nor tucker, external fixation is safe easy to learn, external fixation is associated with no groin pain compared to internal fixation and much less incidence of impulse of cough making this technique more acceptable to the patients.
Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair, Mesh Fixation, Cost, Stapling
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Mohamed Salah Abdelhamid, Ayman Hamdi Abouleid, Mohamed Hasan Abdelmola, Ahmed Mohamed Rashad, Mahmoud Ahmed Negida, Ahmed Zaky Gharib, Patients Satisfaction Post Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair with External Fixation Versus Post Internal Fixation, Journal of Surgery. Vol. 4, No. 2, 2016, pp. 20-23. doi: 10.11648/j.js.20160402.13
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