Randomized clinical trial comparing self-gripping mesh with a standard polypropylene mesh for open inguinal hernia repair

Verhagen, Tim; Zwaans, W A R; Loos, Maarten; Charbon, J. A.; Scheltinga, Marc R.; Roumen, R. M. H.

doi:10.1002/bjs.10178

Cited by 28 publications

(35 citation statements)

References 21 publications

(34 reference statements)

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“…The operative duration is significantly shorter in this study and similar conclusion drawn by Zhang et al and Fang et al 9,10 Significant reduction of early postoperative pain which helped the patient for early return to day to day activities in this study is also comparable to the earlier studies. 7,11,12 Another study Fan et al, there is no recurrence with comparison to present study in P group. 13 …”

Section: Discussionsupporting

confidence: 46%

An institutional comparative study of self-gripping progrip mesh with prolene mesh in repair of inguinal hernia: a single center study

2018

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Background: The type of inguinal hernia repair used depends on many factors predominantly surgeon's training, interpretation of the literature and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed in this hospital with two different mesh types. Methods: Analysis was undertaken on 60 consecutive patients who underwent inguinal hernia repair during last one year. Short-term outcomes were compared between those repaired with conventional polypropylene mesh and those with Covidien Progrip mesh. Results: All patients were male, and the mean age was 60 years. The median operative time was 60 minutes for unilateral hernias and 90 minutes for bilateral hernias. The use of Covidien Progrip mesh reduced the operative time to 40 minutes for unilateral hernias and 60 minutes for bilateral hernias. After unilateral hernia repair, 10% of the patients repaired with Progrip mesh were discharged home within 1 day of operation. Almost 99% of Progrip repair cases were discharged within 48 hrs. Twenty-four hours postoperatively, 74% of the patients were either totally pain free or had minimal discomfort. At 4weeks, 99%of the patients were either pain free or had minimal discomfort. Patients who underwent unilateral inguinal hernia repair with progrip mesh had the most rapid return to normal activities. All these parameters are slight longer in polypropylene mesh repair cases. Conclusions: Open anterior mesh repair is safe and results in minimal postoperative pain and early return to normal activities. Progrip mesh resulted in a shorter operative time and more rapid return to normal activities and decrease in long term postoperative pain compared with polypropylene mesh.

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Section: Discussionsupporting

confidence: 46%

An institutional comparative study of self-gripping progrip mesh with prolene mesh in repair of inguinal hernia: a single center study

2018

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“…Of 2682 articles identified by the literature search, 51 were selected for full‐text assessment and 29 articles met the inclusion criteria. After removing duplicate articles, 25 were included in the meta‐analysis, representing 23 studies ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

“…One study had a multiarm trial design comparing cyanoacrylate glue fixation and ProGrip™ self‐gripping mesh with suture fixation of the mesh. Five studies reported on fibrin glue fixation, eight on cyanoacrylate glue fixation and 11 on the use of ProGrip™ self‐gripping mesh. Of the 23 articles included in the meta‐analysis, 15 provided the incidence of chronic pain at 12 months, according to the definition provided in the methods.…”

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

et al. 2019

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Background Chronic postoperative pain occurs in up to 21·7 per cent of patients undergoing open inguinal hernia repair. Several mesh fixation techniques using glue or self‐gripping meshes have been developed to reduce postoperative pain. The aim of this meta‐analysis was to evaluate RCTs comparing adhesional/self‐gripping and sutured single‐layer open mesh fixations in the repair of inguinal herniation, with postoperative pain as endpoint. Methods PubMed, Embase and Cochrane CENTRAL databases were searched systematically for RCTs according to the PRISMA guidelines; the study was registered at PROSPERO (CRD42017056373). Different fixation methods were analysed. The primary outcome, chronic pain, was defined as a postoperative visual analogue scale (VAS) score of at least 3 at 12 months. Secondary outcomes were mean VAS score at 1 week and at 1 month after surgery. Results Twenty‐three studies including 5190 patients were included in the meta‐analysis. Adhesional (self‐adhering or glued) or self‐gripping fixation methods were associated with a significantly lower VAS score at 1 week (mean difference –0·49, 95 per cent c.i. ‐0·81 to –0·17; P = 0·003) and at 1 month (mean difference –0·31, –0·58 to –0·04; P = 0·02) after surgery than suture fixation, but the incidence of chronic pain after 12 months was similar in the two groups (odds ratio 0·70, 95 per cent c.i. 0·30 to 1·66). Differences in recurrences and complications between groups did not reach statistical significance. Conclusion There was no difference in the incidence of chronic pain 12 months after different mesh repair fixation techniques despite significant reductions in short‐term postoperative pain favouring a non‐sutured technique. There were no differences in recurrence rates or in rates of other complications at 1 year.

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“…Given the aforementioned recommendation that there is still a need to fixate mesh prostheses in some instances, namely a large direct hernia (M3 and above) (8), it is likely that it will take some time and considerable evidence for no-fixation to be widely adopted in practice. With the possibility that self-gripping mesh technology may play a role in advancing this movement (28). …”

Section: Discussionmentioning

confidence: 99%

Outcome of the “Manchester Groin Repair” (Laparoscopic Totally Extraperitoneal Approach With Fibrin Sealant Mesh Fixation) in 434 Consecutive Inguinal Hernia Repairs

et al. 2018

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Introduction: This study looks at the outcome of 352 patients that underwent the “Manchester groin repair” in the period from 2007 to 2016. The effect of laterality on chronic groin pain and the reduction of pain scores post-surgery are evaluated as well as the rate of hernia recurrence for the inguinal hernia repairs.Methods: The “Manchester groin repair” is a modification of a laparoscopic totally extra-peritoneal approach with fibrin sealant mesh fixation. Data were collected prospectively. In addition to demographic data and the European Hernia Society classification grading of each hernia, pain scores were assessed prior to surgery and at 4–6 weeks post-operatively using a ten-point visual analog pain scale. Data were collected on a bespoke database and differences between time-points analyzed by non-parametric Wilcoxon signed rank tests with Kruskal-Wallis rank sum test for three-group comparisons. Significance was at the P < 0.05 level. The study was undertaken as an institutional audit.Results: Three hundred and fifty two patients underwent TEP repair as per the “Manchester Groin Repair” modification during the period of interest with a median follow-up period of 109.5 (IQR 57.0–318.5) weeks. Of these 274 (77.8%) were for the repair of true hernias and 78 (22.2%) were for inguinal disruptions.All inguinal hernia repairs patients were evaluated (254 m, 20 f); median [interquartile range] age 50 (39–65) years. There were 75 right inguinal hernias (27.4%), 39 Left inguinal hernias (14.2%), and 160 bilateral inguinal hernias (58.4%), giving a total of 434 hernia repairs. During follow-up there were 6 recurrences (1.4%).Of the 274 patients evaluated, 145 (52.9%) had both pre and post-operative pain scores available. Median pre-operative pain score was 5 [IQR 4–7]. Median post-operative pain score was 1 [IQR 1–2]. This difference was significant (P < 0.001). Pre-operative pain scores were higher for those with a bilateral hernia (median 6 vs. 5 and 4, respectively; P = 0.005), but there was no difference in post-operative scores (P = 0.347). One patient (0.3%) presented with chronic groin pain (pain after 3 months).Conclusion: This study demonstrates that the “Manchester groin repair” provides an excellent repair with a low rate of recurrence and low incidence of chronic pain. Longer-term evaluation and larger patient series will add to the understanding of the role of this procedure in groin hernia repair.

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Randomized clinical trial comparing self-gripping mesh with a standard polypropylene mesh for open inguinal hernia repair

Abstract: NTR1212 (http://www.trialregister.nl).

Cited by 28 publications

References 21 publications

An institutional comparative study of self-gripping progrip mesh with prolene mesh in repair of inguinal hernia: a single center study

An institutional comparative study of self-gripping progrip mesh with prolene mesh in repair of inguinal hernia: a single center study

Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

Outcome of the “Manchester Groin Repair” (Laparoscopic Totally Extraperitoneal Approach With Fibrin Sealant Mesh Fixation) in 434 Consecutive Inguinal Hernia Repairs

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