Tack fixation versus nonfixation of mesh in laparoscopic transabdominal preperitoneal hernia repair

Context: Laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia is traditionally performed by fixing the mesh to the abdominal wall by spiral tacks. However, mesh fixation might not be necessary as there is little space for the mesh to migrate; besides, tack fixation predisposes to postoperative pain. Aim: The present study aimed to compare mesh fixation versus nonfixation regarding postoperative pain and recurrence rates. Settings and design: This study was a prospective, controlled, randomized study. Patients and methods: In total, 60 patients with inguinal hernias were divided into two equal groups, were compared regarding mesh fixation versus nonfixation by TAPP technique, and followed-up for up to 12 months for postoperative complications, pain, and recurrence. Statistical analysis: Continuous variables are expressed as means and SDs. Categorical variables are expressed as frequencies and percentages. Results: There was significant reduction in postoperative pain and chronic pain in patients without mesh fixation in comparison with patients with mesh fixation and early return to work. There was no significant difference between the two groups regarding postoperative complications and recurrence rates. Conclusion: Mesh nonfixation reduces the incidence of postoperative pain and chronic pain in patients undergoing TAPP repair without increase in postoperative complications or recurrence rates.