A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair

Prakash, Pradeep Bangalore; Bansal, Virinder Kumar; Misra, Mahesh Chandra; Babu, Divya; Sagar, Rajesh; Krishna, Asuri; Kumar, Subodh; Rewari, Vimi; Subramaniam, Rajeshwari

doi:10.4103/0972-9941.170018

Cited by 14 publications

(27 citation statements)

References 23 publications

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“…[24][25][26][27][28][29][30][31] Agarwal et al in 2009, Prakash et al in 2016, and Kalra et al in 2017 presented the mean score on the Visual Analogue Scale (VAS) AE the standard deviation (SD); however, they did respond to the request for the additional data required for meta-analysis. [32][33][34] Eight 16)…”

Section: Chronic Pain-any Pain and Severe Painmentioning

confidence: 99%

“…Ultrapro (28) and TiMesh (35) Vypro II (30) and TiMesh (35) Prolene soft (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) Ultrapro ( 28) Ultrapro ( 28) Ultrapro ( 28 of these 11 studies reported severe pain results, albeit with varying definitions (Table 1A). 18,24,[26][27][28][29][32][33][34] The risk of any pain showed no significant difference when using a LWM (123/1362 patients) compared with a HWM (127/1277 patients) (RR 0.79, 95% CI: 0.52-1.20) (Fig. 2).…”

Section: Chronic Pain-any Pain and Severe Painmentioning

confidence: 99%

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Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-endoscopic Inguinal Hernia Repair

Bakker

Aufenacker

Boschman³

et al. 2020

Annals of Surgery

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Objective: This meta-analysis and trial sequential analysis aims to provide an update on the available randomized controlled trials (RCTs) and recommendations on using lightweight mesh (LWM) or heavyweight mesh (HWM) in laparo-endoscopic inguinal hernia repair. Background: LWM might reduce chronic pain through improved mesh flexibility and less fibrosis formation. However, in laparo-endoscopic repair chronic pain is already rare and LWM raise concerns of higher recurrence rates. Methods: A literature search was conducted in May 2019 in MEDLINE, Embase, and the Cochrane library for RCTs that compared lightweight (≤50 g/m2) and heavyweight (>70 g/m2) mesh in patients undergoing laparo-endoscopic surgery for uncomplicated inguinal hernias. Outcomes were recurrences, chronic pain, and foreign-body sensation. The level of evidence was assessed using GRADE. Risk ratios (RR) and 95% confidence intervals (CI) were calculated by random effect meta-analyses. Trial-sequential-analyses were subsequently performed. Results: Twelve RCTs, encompassing 2909 patients (LWM 1490 vs HWM 1419), were included. The follow-up range was 3 to 60 months. Using LWM increased the recurrence risk (LWM 32/1571, HWM 13/1508; RR 2.21; CI 1.14–4.31), especially in nonfixated mesh direct repairs (LWM 13/180, HWM 1/171; RR 7.27; CI 1.33–39.73) and/or large hernia defects. No difference was determined regarding any pain (LWM 123/1362, HWM 127/1277; RR 0.79; CI 0.52–1.20), severe pain (LWM 3/1226, HWM 9/1079; RR 0.38; CI 0.11–1.35), and foreign-body sensation (LWM 100/1074, HWM 103/913; RR 0.94; CI 0.73–1.20). Conclusion: HWM should be used in laparo-endoscopic repairs of direct or large inguinal hernias to reduce recurrence rates. LWM provide no benefit in indirect hernias.

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Section: Chronic Pain-any Pain and Severe Painmentioning

confidence: 99%

Section: Chronic Pain-any Pain and Severe Painmentioning

confidence: 99%

Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-endoscopic Inguinal Hernia Repair

Bakker

Aufenacker

Boschman³

et al. 2020

Annals of Surgery

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“…The pore size was reported in 13 studies (9-11, 14, 18, 20, 22, 23, 28, 50-53) (Figure 2B). Two studies described that the lightweight mesh had large pore size without specifying the size in mm (10,22), while the remaining ten studies either reported the pore diameter in mm or in µm, which was converted to mm (one study informed the size by email ( 23)) (9,11,14,18,20,23,(50)(51)(52)(53). Two studies had unspecified pore sizes (9,53) and two studies used a range (14,28).…”

Section: Lightweight Meshmentioning

confidence: 99%

“…Two studies described that the lightweight mesh had large pore size without specifying the size in mm (10,22), while the remaining ten studies either reported the pore diameter in mm or in µm, which was converted to mm (one study informed the size by email ( 23)) (9,11,14,18,20,23,(50)(51)(52)(53). Two studies had unspecified pore sizes (9,53) and two studies used a range (14,28). Nevertheless, the median of all lightweight meshes was 1.6 mm with an IQR of 1.0-2.3 mm and a range of 1.0-4.0 mm.…”

Section: Lightweight Meshmentioning

confidence: 99%

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Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Deveci¹,

Öberg²,

Rosenberg³

2023

J. Abdom. Wall Surg.

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Introduction: Groin hernia literature often uses the terms light- and heavyweight and small or large pores to describe meshes. There is no universal definition of these terms, and the aim of this scoping review was to assess how mesh weight and pore sizes are defined in the groin hernia literature.Methods: In this systematic scoping review, we searched PubMed, Embase, and Cochrane CENTRAL. We included randomised controlled trials with adults undergoing groin hernia repair with the Lichtenstein or laparoscopic techniques using a flat permanent polypropylene or polyester mesh. Studies had to use the terms lightweight, mediumweight, or heavyweight to be included, and the outcome was to report how researchers defined these terms as well as pore sizes.Results: We included 48 studies with unique populations. The weight of lightweight meshes ranged from 28 to 60 g/m2 with a median of 39 g/m2, and the pore size ranged from 1.0 to 4.0 mm with a median of 1.6 mm. The weight of heavyweight meshes ranged from 72 to 116 g/m2 with a median of 88 g/m2, and the pore size ranged from 0.08 to 1.8 mm with a median of 1.0 mm. Only one mediumweight mesh was used weighing 55 g/m2 with a pore size of 0.75 mm.Conclusion: There seems to be a consensus that meshes weighing less than 60 g/m2 are defined as lightweight and meshes weighing more than 70 g/m2 are defined as heavyweight. The weight terms were used independently of pore sizes, which slightly overlapped between lightweight and heavyweight meshes.

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Randomized trial comparing self gripping semi re-absorbable mesh (PROGRIP) with polypropylene mesh in open inguinal hernioplasty: the 6 years result

Fan

Yip

Foo

et al. 2016

Hernia

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A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair

Cited by 14 publications

References 23 publications

Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-endoscopic Inguinal Hernia Repair

Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-endoscopic Inguinal Hernia Repair

Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Randomized trial comparing self gripping semi re-absorbable mesh (PROGRIP) with polypropylene mesh in open inguinal hernioplasty: the 6 years result

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