ABSTRACT

Objectives: To assess the postoperative pain and complications in patients who underwent laparoscopic preperitoneal inguinal hernia repair with mesh fixation using sutures as compared to tackers.

Methodology: A quasi-experimental study was conducted at the Department of Surgery, Jinnah Postgraduate Medical Center, Karachi between June 2019 to October 2019. A total number of 60 patients aged 20-60 years underwent laparoscopic transabdominal preperitoneal inguinal hernia repair. Patients were grouped into two. Group 1 included patients in whom mesh fixation was done using sutures while Group 2 had mesh fixation using tackers. Post-operative pain score was calculated using the visual analog scale after 24 hours of procedure. Early postoperative complications were also noted.

Results: Mean age of patients included in this study was 42.62±10.29 years. There were 37 (61.67%) male and 23 (38.33%) female patients. Mean body mass index (BMI) of patients was 24.52±3.99 Kg/m2. There were 39 (65.00%) patients with ASA I and only 21 (35.00%) patients with ASA II. The mean post-operative pain score group 1 (sutures) was 3.67±0.92 versus 4.90±1.21 in patients of group 2 (trackers) with significant p-value of <0.0001. 7 (23.3%) patients in group 1 and 9 (30%) in Group 2 developed complications including urinary retention, seroma, and infection.

Conclusions: We found that mesh fixation using sutures is correlated with lower postoperative pain scores and complications as compared to mesh fixation using tackers.

Keywords: Inguinal hernia, hernioplasty, laparoscopic transabdominal preperitoneal inguinal hernia repair, visual analog scale