Standard polypropylene mesh vs lightweight mesh for Lichtenstein repair of primary inguinal hernia: A randomized controlled trial

Demetrashvili, Zaza; Khutsishvili, Kakhi; Pipia, Irakli; Kenchadze, Giorgi; Ekaladze, Eka

doi:10.1016/j.ijsu.2014.10.025

Cited by 21 publications

(14 citation statements)

References 29 publications

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“…However, in contrast to previous trials, we have used an expertise-based design, possibly counteracting bias introduced by individual surgeons preferring a certain type of mesh while allocated to operate with the other type. However, our findings that local groin symptoms were more prevalent with the heavyweight mesh are consistent with the aforementioned research [ 9 – 11 ]. We also demonstrated that most patients had a better quality of life after inguinal hernia surgery, which too is in accordance with previous research [ 12 ].…”

Section: Discussionsupporting

confidence: 93%

“…A systematic review of nine trials comparing lightweight mesh with heavyweight mesh showed that there is a reduction in chronic pain with the lightweight mesh [ 9 ], while two recent trials have not been able to show any differences according to mesh type [ 10 , 11 ]. In the current study, we could not discern any advantage with the lightweight mesh regarding chronic pain, despite an adequately powered trial.…”

Section: Discussionmentioning

confidence: 99%

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Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh

Rutegård

Gümüscü

Stylianidis

et al. 2018

Hernia

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PurposeThere is a paucity of high-quality evidence concerning mesh choice in open inguinal hernia repair. Using an expertise-based randomized clinical trial design, we aimed to evaluate the postoperative impact of two different mesh types on pain and discomfort, quality of life and sex life.MethodsIn two regional hospitals, male patients with primary inguinal hernia were randomized to one of two groups of surgeons that performed the Lichtenstein operation. One group of surgeons used a heavyweight polypropylene mesh (90 g/m2, Bard™ Flatmesh, Davol) while the second group employed a lightweight mesh (28 g/m2, ULTRAPRO™, Ethicon). Follow-up data were collected by questionnaires and outpatient visits in the range of 1–3 years after surgery.ResultsSome 412 patients were randomized and 363 patients were analysed. There was no difference in pain between groups after surgery but a statistically significant difference concerning awareness of a groin lump and groin discomfort, favouring the lightweight group 1 year after surgery. No differences in quality of life between groups could be detected but both groups had a substantially better quality of life postoperatively, as compared to before surgery. In the analysis of impact on sex life, no differences between mesh groups were found.ConclusionThe Lichtenstein operation performed for primary inguinal hernia improves quality of life for most of the male patients, independently of the type of mesh used. The lightweight mesh group experienced less awareness of a groin lump and groin discomfort 1 year postoperatively.ClinicalTrials.gov Identifier: NCT00451893.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh

Rutegård

Gümüscü

Stylianidis

et al. 2018

Hernia

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“…On a long-term projection, this fact may contribute to a more physiological abdominal wall compliance after LW polypropylene mesh implantation [7]. Furthermore, our decision to use a LW class allograft is supported by some larger clinical trials that demonstrated that the usage of the LW meshes was associated with less feeling of a foreign body by the patient compared to using a HW mesh, what can be considered as prevalence of LW mesh hernioplasty [8].…”

Section: Experimental Partmentioning

confidence: 99%

Textile Polypropylene Allografts and their Postoperative Tissue Reaction in the Surgery of Inguinal Hernia

Bratu¹,

Boicean²,

Tănăsescu³

et al. 2017

Mat.Plast.

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The usage of prosthetic devices in the surgery of parietal defect is, nowadays, essential for a good abdominal wall recovery and prevention of the hernia recurrence. A good and suitable textile allograft should poses one or more, ideally all, of the following characteristics: pliable, strong, non-allergenic and with perfect tissue integration behavior. The aim of this paper is to evaluate the immediate and long term tissue reaction of different textile allografts used in open surgery of inguinal hernia repair.

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“…Mesh fixation has become controversial, and non‐fixation methods like fibrin glue have shown lower pain while not affecting recurrence rates 11‐13 . On the other hand, in open surgery, the use of light‐weight meshes may lead to decreased postoperative pain and discomfort 14‐16 . Therefore, although it was shown in existing controlled studies that laparoscopic repair has an advantage over open repair on account of less postoperative pain, it may differ in the contemporary clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Significance of umbilical trocar size and intra‐abdominal pressure on postoperative pain after transabdominal preperitoneal repair for inguinal hernia

Kinoshita

Ohyama²,

Kawaguchi³

et al. 2020

Asian J Endoscop Surgery

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Introduction: Laparoscopic inguinal hernia repair is reported to be associated with lower postoperative pain than open repair. However, in the actual clinical setting, some patients experience relatively severe pain. This study aimed to elucidate surgical factors that affect pain after transabdominal preperitoneal (TAPP) repair. Methods: We evaluated 199 patients who underwent elective TAPP for inguinal hernia from 2014 to 2019 in Heisei Memorial Hospital. The umbilical trocar size was changed from 12 to 5 mm from October 2017. The pneumoperitoneum intra-abdominal pressure was changed from 10 to 8 mmHg from 2019. Postoperative pain scores and analgesics were compared between patients who were grouped according to trocar size and intra-abdominal pressure, as well as 80 patients who received open repair. Results: Patients with a 12 mm trocar had significantly higher pain than open repair patients (P < .0001). Patients with a 5 mm umbilical trocar and 8 mm Hg intra-abdominal pressure had significantly lower pain than a 12 mm trocar (P = .025) and did not significantly differ with pain after open repair. Analgesic use significantly decreased in patients using a 5 mm trocar than 12 mm (P = .002). Conclusion: Umbilical trocar size and pneumoperitoneum intra-abdominal pressure were significantly associated with post-TAPP pain. Using a 5 mm umbilical trocar and 8 mm Hg intra-abdominal pressure achieved pain levels as comparatively low as open repair.

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Standard polypropylene mesh vs lightweight mesh for Lichtenstein repair of primary inguinal hernia: A randomized controlled trial

Cited by 21 publications

References 29 publications

Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh

Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh

Textile Polypropylene Allografts and their Postoperative Tissue Reaction in the Surgery of Inguinal Hernia

Significance of umbilical trocar size and intra‐abdominal pressure on postoperative pain after transabdominal preperitoneal repair for inguinal hernia

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