title: Tacks-free transabdominal preperitoneal (TAPP) inguinal hernioplasty, using an anatomic 3-dimensional lightweight mesh with peritoneal suturing: pain and recurrence outcomes-initial experience.
abstract: BACKGROUND
  The emphasis for research in inguinal hernia repair has shifted from hernia recurrence to groin pain, which is considered the most important factor for poor quality of life.
  
  
  OBJECTIVE
  : To evaluate hernia recurrences and pain at trocar site and at inguinal hernia site, in patients who underwent tacks-free transabdominal preperitoneal inguinal hernia repair, using a lightweight nonfixed 3-dimensional mesh with peritoneal suturing.
  
  
  METHODS
  Between 2009 and 2011, 32 patients (2 female) with mean age 51 years underwent hernia repair. The mean follow-up period was 12.4 months.
  
  
  RESULTS
  The mean operative time was 84 minutes. There was minimal blood loss. No bowel or urinary bladder injury had occurred. Mean hospital stay was 1 day. One patient developed seroma 4 months postoperatively. There were no conversions to open repair, no hernia recurrence, and no deaths. The mean value of pain at trocar site and inguinal hernia site 12 hours postoperatively was 1.469 and 0.875, respectively. The pain was more intense bearing a peak at 12 hours postoperatively at the trocar site, compared with the inguinal site.
  
  
  CONCLUSIONS
  It is demonstrated with this technique that there are no recurrences and the chronic pain is negligible. These findings call for confirmatory randomized trials in larger series with longer follow-up.
authors.affiliation: 2nd Department of Surgery, Tzanion General Hospital, Piraeus, Greece. gagiomam@med.uoa.gr
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Ayiomamitis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Zaravinos
authors.forename: Panayiotis C
authors.initials: PC
authors.lastname: Stathakis
authors.forename: Efstratios
authors.initials: E
authors.lastname: Kouroumpas
authors.forename: Phivos
authors.initials: P
authors.lastname: Georgiades
authors.forename: George
authors.initials: G
authors.lastname: Polymeneas
authors.forename: John
authors.initials: J
authors.lastname: Griniatsos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult