Laparoscopic Hernia Repair Using A Three- Dimensional Mesh: A Follow-up Study

Background Laparoscopic inguinal hernia tension-free repair surgery has become an important way of herniorrhaphy. With the development of surgical techniques and mesh materials, to make the best decisions of surgical approaches and mesh types, as to shorten the operation time and improve surgical results, has raised surgeons’ concern. This study was designed to figure out different influences in terms of operation time, complication, and postoperative recovery within the comparison of using different inguinal hernia repair mesh types and different surgical methods.Methods We collected information of a total of 107 patients, who accepted laparoscopic inguinal hernia tension-free repair surgeries, between September 1,2013 to December 30, 2014 in our hospital. Objective information of the patients and surgeries are recorded, as well as the follow-up information which includes infection, hematoma, postoperative pain, recovery time and so on. We made comparison between two subgroups using Bard 3D mesh and SURGIMESH/ASPIDE 3D meshes respectively and comparison of different surgical methods (TAPP and TEP) were conducted as well.Results In this research, we did LIHR on 107 patients, repairing 148 hernias in total.88 hernias were repaired with Bard 3D mesh and 34 hernias were repaired with SURGIMESH/ASPIDE 3D mesh. Results of postoperative hospital stay, postoperative complications, and recovery time showed no statistical differences between two subgroups. Operative time was shorter with Bard3D mesh than that with SURGIMESH/ASPIDE 3D meshes (p=0.033). A total of 86 surgeries were conducted with TAPP approach and 21 cases were done with TEP approach. Operation time of unilateral hernia repair with TAPP was significantly shorter than that with TEP (p=0.005), while TEP approaches achieved shorter postoperative hospital stay (p=0.004). However, both subgroups showed similar results of postoperative complications, and recovery time.Conclusion Laparoscopic inguinal hernia tension-free repair (LIHR) surgeries are safe and effective surgical procedures of inguinal hernia repair with low recurrence rates. TAPP and TEP are two main approaches currently, strengthening abdominal wall outside the peritoneum. LIHR surgeries have series of advantages of low recurrence, few complications, low scores of postoperative pain and short recovery time. And three-dimensional meshes, with reasonable design to be manipulated, perform reliable results on hernia repair.