Ahmed Abd Al Aziz, MD1, Nader Sh. Zaki, MD2,Karim G. Moustafa, MD3, M. Fathy Elshaal
Abdrabou N Mashhour, Haitham S.E. Omar, Ramy S. Abdelkader.
Hany MS Mikhail, Mohamed M Raslan, Mohamed Y Elbarmelgi, Ramy S. Abdelkader
Adel Morad Abdallah (M.D.)
Ahmed S.M. Omar, MD
H. Said1, Ahmed Khalil1, Ahmed Fathy Hilal2
Ragai S. Hanna1, George Abdelfady Nashed2, Gamal A Makhlouf 3, Nahed A Makhlouf 4, Manal El Sayed Abdelmooty 5
Ragai S. Hanna1 , George Abdelfady Nashed2,Ashraf, A Helmy 3, Gamal A Makhlouf4, Emad Z.K. Said5, Abdelraouf MS Abdelraouf 6
Ramy Mikhael Nageeb1, *, MD, and Shaban M. Abdel Mageed2, *, MD
Shawki M.K Sharouda1*; Ramy Mikhael Nageeb2*; MD and Shaban M. Abdel Mageed1*, MD
Sherif Abdel Halim MD, MRCS, Hanna Habib MD, Hossam Elsadek MD
Ahmed Morad, MD; Wael A Jumuah, MD; Hanna Habib, MD
Yasser El Ghamrini, MD. Karim Sabry Abdel Samee, MD, MRCS(Ed), Wael Abdel Aziem Gumuah, MD.
Anas Mashal MD; Abdallah Magdy MD,FRCS
Anas Mashal MD, *Abdallah Abdelwahed MD;**Hady Saleh Abou-Ashour, MD,MRCS
Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair without Mesh Fixation
Background: Mesh fixation had been reported as a possible cause for persistent groin pain manifested by a
significant number of patients following laparoscopic transabdominal preperitoneal (TAPP) inguinal
hernia repair. It is also associated with increased operative cost. Nonfixation could be done especially for
patients with small defects, thus reducing the cost, postoperative and chronic pain. Patients and methods:
This study was conducted between May 2014 and January 2016. The study included 40 patients with
inguinal hernia operated with laparoscopic TAPP technique without mesh fixation. Patients with huge
inguinoscrotal hernia with large defect were treated with mesh fixation and were excluded from the study.
They were followed up for at least 1 year post-operative for early and late complications. Results: No
intra-operative complications have been registered. Two patients (5%) with direct hernias developed
seroma, and one patient (2.5%) had subcutaneous emphysema. No chronic pain or hernia recurrence was
observed within the follow up period. Conclusion: For selected patients, the nonfixation of mesh in TAPP
seems a safe alternative that is associated with fewer costs, shorter operative time and decreased incidence
of chronic pain without increased risk of recurrence.
Key words: laparoscopic hernia repair, transabdominal preperitoneal, without mesh fixation.