title: Preperitoneal surgery using a self-adhesive mesh for inguinal hernia repair.
abstract: OBJECTIVE
  Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh.
  
  
  METHODS
  This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from April 4, 2010, through July 22, 2014. Data assessed were age, sex, body mass index (BMI), hernia repair indications, hernia type, pain, paresthesia, occurrence (bilateral or unilateral), recurrence, and patient satisfaction. Descriptive and regression analyses were performed.
  
  
  RESULTS
  Six hundred forty patients underwent laparoscopic preperitoneal hernia surgery with self-adhesive mesh. The average age was 56 years, nearly all were men (95.8%), and the mean BMI was 26.2 kg/m(2). Cases involved primary hernia more frequently than recurrent hernia (94% vs 6%; P < .05). After surgery, 92% of the patients reported no more than minimal pain, <1% reported paresthesia, and 0.2% had early recurrence. There were 7 conversions to an open procedure. The patients had no adverse reactions to anesthesia and no bladder injury. Postoperative acute pain or recurrence was not explained by demographics, BMI, or preoperative pain. There were significant associations of hernia side, recurrence, occurrence, and sex with composite end points. Nearly all patients (98%) were satisfied with the outcome.
  
  
  CONCLUSIONS
  The use of self-adhesive, Velcro-type mesh in laparoscopic TEP inguinal hernia repair is associated with reduced pain; low rates of early recurrence, infection, and hematoma; and improved patient satisfaction.
authors.affiliation: John C. Lincoln North Mountain Hospital, Phoenix, Arizona.
authors.forename: Alicia
authors.initials: A
authors.lastname: Mangram
authors.affiliation: Valley Surgical Clinics, Ltd, Phoenix, Arizona.
authors.forename: Olakunle F
authors.initials: OF
authors.lastname: Oguntodu
authors.affiliation: Valley Surgical Clinics, Ltd, Phoenix, Arizona.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodriguez
authors.affiliation: Valley Surgical Clinics, Ltd, Phoenix, Arizona.
authors.forename: Roozbeh
authors.initials: R
authors.lastname: Rassadi
authors.affiliation: John C. Lincoln North Mountain Hospital, Phoenix, Arizona.
authors.forename: Michael
authors.initials: M
authors.lastname: Haley
authors.affiliation: Valley Surgical Clinics, Ltd, Phoenix, Arizona.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Shively
authors.affiliation: John C. Lincoln North Mountain Hospital, Phoenix, Arizona.
authors.forename: James K
authors.initials: JK
authors.lastname: Dzandu
mesh_terms: D000269:Adhesives; D004867:Equipment Design; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013526:Surgical Mesh
chemical_list: D000269:Adhesives
keywords: Laparoscopic hernia surgery; Original research; Self-adhesive mesh; Totally extraperitoneal