Abstract:

Objective To explore the efficacy, safety, complication and shrinkage of mesh and non-mesh surgical patch in the application of transabdominal preperitoneal prosthetic（TAPP）.
Methods Data of 60 cases with primary inguinal hernia treated with the laparoscopic TAPP herniorrhaphy in our department during Jan 2009 to Jul 2009 were reviewed. The patients were randomized in to two groups to receive mesh and the non-mesh surgical patches in the operation, respectively, and the patients were followed up for 9~14 months. Analysis of the data, including operation duration, postoperative length of stay, cost of hospitalization, postoperative complication, chronic pain, foreign body sensation, recurrence rate and shrinkage.
Results It showed that in all of the 60 cases the TAPP was finished, there was no significant difference in operation duration, postoperative length of stay, cost of hospitalization and the occurrence of hematoma between the 2 groups. The chronic pain sensation occurred in 1 case(3.3%) of non-mesh group, which was lower than the surgical mesh group(3 cases, 10%), the foreign body sensation occurred in 2 cases(6.7%) of the non-mesh group, which was lower than the surgical mesh group(5 cases, 16.7%). The measurement of the meshes’ diameter was used to calculate the shrinkage by the ultrasound(post operation 1, 3, 6, 9 months). From the second month after the operation，less shrinkage of non-mesh group than the surgical mesh group was seen(P<0.05).
Conclusion The non-mesh patch was more effective and safe than the mesh in TAPP, the non-mesh patch could reduce the occurrence of chronic pain and foreign body sensation, caused less shrinkage.

Key words: laparoscopy, non-mesh surgical patch, hernia, inguinal