title: Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial.
abstract: BACKGROUND
  Controversy exists regarding whether it is necessary to secure the mesh prosthesis during laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. It is unknown whether stapling the mesh affects recurrence rate, incidence of neuralgia, or port-site hernia.
  
  
  METHODS
  We conducted a prospective randomized trial comparing stapled with nonstapled laparoscopic TAPP inguinal hernia repairs in a series of 502 consecutive patients undergoing elective inguinal hernia repair at two institutions between January 1995 and March 1997.
  
  
  RESULTS
  In all, 263 nonstapled and 273 stapled repairs were performed in 502 patients. Patients were evaluated at a median follow-up of 16 months (range, 1-32 months) by independent surgeons. There was no statistical difference in the incidence of recurrence (0 to 263 nonstapled, 3 to 273 stapled; chi-square p = 0.09). The overall recurrence rate was 0.6%. There was no significant difference in operative time, port-site hernia, chronic pain or neuralgia between the two groups.
  
  
  CONCLUSIONS
  It is not necessary to secure the mesh during laparoscopic TAPP inguinal hernia repair, allowing a reduction in the size of the ports.
authors.affiliation: Hull Royal Infirmary, Anlaby Rd Hull, HU3 2JZ, Brough W, Rate A, Deans GT, and Stepping Hill Hospital, Stockport, Australia.
authors.forename: A I
authors.initials: AI
authors.lastname: Smith
authors.forename: C M
authors.initials: CM
authors.lastname: Royston
authors.forename: P C
authors.initials: PC
authors.lastname: Sedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D017792:Surgical Stapling