Perioperative complications of laparoscopic mesh repair for inguinal hernia: A prospective observational study from a tertiary centre in Kashmir

BACKGROUND: Laparoscopic mesh repair for inguinal hernia offers faster recovery and less post-operative pain than open repair, though concerns persist regarding perioperative and mesh-related complications. This prospective observational study evaluated the incidence and pattern of complications following laparoscopic inguinal hernia repair in a high-volume tertiary care centre in Kashmir. PATIENTS AND METHODS: Adults ≥18 years with primary, uncomplicated inguinal hernia undergoing elective laparoscopic mesh repair (transabdominal preperitoneal [TAPP], totally extraperitoneal [TEP] or extended TEP [e-TEP]) were included, while obstructed, strangulated, irreducible, recurrent and paediatric hernias were excluded. Demographic, clinical, operative and outcome data were analysed. RESULTS: Fifty-six male patients (mean age 56.25 ± 13.56 years) were studied. Hypertension (32.1%) and hypothyroidism (19.6%) were common comorbidities; smoking (46.4%) was the predominant risk factor. Most hernias were unilateral (75%), right-sided (42.8%) and indirect (71.4%). TAPP was performed in 57.1%, e-TEP in 30.3% and TEP in 12.6% of cases. Mean operative time was 65.7 ± 3.9 min for unilateral and 88 ± 7.4 min for bilateral repairs. No intraoperative complications occurred. Early post-operative complications included pain (7.1%) and urinary retention (1.8%), mainly after TAPP. Intermediate complications comprised port-site infection (1.8%) and seroma (5.4%), more frequent after e-TEP. Mesh infection occurred in 2 patients (3.6%), requiring explantation in one. Mean hospital stay was 1.6 ± 0.62 days (96.4% discharged within 2 days). No mortality or recurrence occurred at 6 months. CONCLUSION: Laparoscopic mesh repair using TAPP, TEP or e-TEP is safe, with minimal pain, short hospitalisation and low complication rates. Optimisation of comorbidities and mesh selection may further enhance outcomes.