ABSTRACT
Laparoscopic hernioplasty requires the use of a prosthetic biomaterial. Consequently, a method of fixation will be necessary for all but the smallest of incisional and some of the inguinal hernia prostheses. The earliest attempts to repair inguinal hernias laparoscopically were performed with the suture fixation of the mesh to the structures of the inguinal floor. This was a very tedious task, which greatly hindered the adoption of this new technology. Manufacturers of instruments responded with the development of different devices that delivered metal fixation to secure the biomaterial to the inguinal floor. The use of these devices is, of course, an integral part of all laparoscopic hernia repairs. There have been a number of these products that have not been successful or even brought to large-scale production. These and the newer instruments are discussed below.
