Anatomical changes after inguinal hernia treatment: a reason for chronic pain and recurrent hernia?

Abstract

The treatment of inguinal hernia by the suture technique is followed by significant anatomical changes such as reduction of the surface area and a subsequent increase of tension in the inguinal region. This could be one of the main reasons for chronic pain and hernia recurrence.

Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial

“…Several studies have investigated postoperative pain after hernia repair [16][17][18]. Fei et al [19] reported the feasibility of primary inguinal repair with open tension-free and sutureless technique using a new polypropylene ''patch and plug system'' (Prolene 3D patch).…”

Sutureless hernioplasty with light-weight mesh and fibrin glue versus Lichtenstein procedure: a comparison of outcomes focusing on chronic postoperative pain

“…Chronic inXammation and foreign body reaction are other important factors causing POP in hernia surgery [21]. Despite being a biocompatible material, polypropylene is not absorbable.…”

Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia

“…The reported follow‐up was sufficient for detection of recurrence in all analysed trials ( Table 1 ), all employed intention‐to‐treat methodology and the analysis of this important outcome measure may be considered robust in the absence of statistical evidence of bias or heterogeneity. Patient‐related risk factors including changes in anatomy after index hernia repair18, or surgeon‐related factors including the greater likelihood of technical error17, increase the likelihood of recurrence independently of the operative technique employed for the repair of recurrent inguinal hernia.…”