الفهرس 
Laparoscopie anatomy of inguinal herniaOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Inguinal hernia repair is one of the most commonly performed surgeries in the world. Laparoscopic herniorraphy, with advantages related to postoperative pain, earlier return to work and normal activities, and an improved quality of life in the postoperative period has emerged as an effective alternative to open repairs. With comparable recurrence rates and complications in experienced hands. But cost concerns remain the main problem in extending its benefits to the general population. Stapling devices have been used to secure the mesh; nerve damage secondary to the staples was the most common complication. Unstapling of the mesh in laparoscopic hernia repair has emerged as an alternative. It avoids the complications associated with stapling and decrease the cost, because a significant bulk of the cost in laparoscopic repairs is consumed in the price of the stapler. In our prospective randomized control trial, 60 patients with inguinal hernia were included. The patients were divided into two groups: group A included 30 patients with inguinal hernia were operated upon by TAPP Laparoscopic inguinal hernia repair with prolene mesh (10x15 cm) fixed by hernia endoclip. group B included the other 30 patients with inguinal hernia were operated upon by TAPP Laparoscopic inguinal hernia repair with prolene mesh (10x15 cm) without fixation. The allocation of the patients in either group was made randomly. All patients at or above the age of 18 years old and all patients have inguinal hernia either direct, indirect or both. We exclude patient with recurrent inguinal hernia, complicated inguinal hernia (infected, obstructed, strangulated…etc.,), converted cases to open surgery, and obesity. Our results showed that there is No statistical significance was found between the two studied groups in the demographic data (p>0.05), No statistical significance was found when comparing the two groups gender distribution (p=0.239), Also when comparing the age distribution of the two groups no statistical significance was found (p=0.353), the mean age of the fixation group being 43.48, mean age in the non-fixation group was 35.97. No statistical significance was found when comparing the type of the hernia and its site between the two groups (p=1 for type of hernia and p=0.969 for this side of the hernia), There was no statistically significant difference between the two groups in terms of recurrence when followed up at 6 month and at 12 month (p=0.309 in both follow ups), however there was a DROP out case from the non-fixation group (3.33%), and 3 DROP outs from the fixation group (10%), these four patient we could not reach them to assess their post-operative follow up, taking the DROP outs into account when comparing the results of fixation and non-fixation no statistical significance was found. We conclusion that Laparoscopic TAPP inguinal hernia repair without mesh fixation is Cost effective allowing for elimination of the cost of tacker and stapler devices with no increase in recurrence rate, paving the road for popularization of laparoscopy in treating inguinal hernia with the added benefits of lesser pain, reduced discomfort, short hospital stay and early resumption of normal daily activities.