WHAT IS THE BEST MESH FIXATION TECHNIQUE IN LAPAROSCOPIC INGUINAL HERNIA SURGERY?

Abstract

Introduction: Laparoscopic operations have increased annually, as well as the prevalence of abdominal wall hernias. With this, the techniques of performing the operations, as well as certain procedures, have been studied. One of the debated questions is about the type of fixation of the mesh. Objective: To evaluate mesh fixation techniques in ventral laparoscopic surgery for inguinal hernia. Method: This is a systematic review. Three databases were consulted: Cochrane Database of Systematic Reviews (CDSR), EMBASE and PUBMED. During the searches, descriptors with controlled vocabulary and text words were used. Results: Regarding the study design, 1 review included only ACE, 2 ACE and ECNA and 1 combined the inclusion of ACE and observational studies. Regarding the type of fixation, 2 studies compared the effects of stud fixation vs. fibrin glue and 2 others comparison of staple vs. fibrin glue. Of all the meta-analysis outcomes evaluated, only the reduction of chronic groin pain by fibrin glue fixation was statistically superior to the mechanical fixation method in 3 of 4 studies. Conclusion: The findings show that the difference between mesh fixation techniques in laparoscopic ventral inguinal hernia surgery is that glue fixation decreases the incidence of postoperative chronic pain.