TEP With Long-Term Resorbable Mesh in Patients With Indirect Inguinal Hernia

Abstract

Background and Objectives:The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh. This is the first human study to use long-term degradable mesh with the TEP approach.Methods:This study was prospective, including 35 primary IHs surgically treated with TEP repair using TIGR Mesh (Novus Scientific Pte, Ltd, Singapore). At the 1-year follow-up recurrence was assessed by clinical examination and the incidence of pain or discomfort was assessed before and after surgery by Visual Analog Scale (VAS) and Inguinal Pain Questionnaire (IPQ).Results:After 12 months, no patients had chronic pain. Only 1 (2.8%) patient reported pain using the VAS (score = 2), and 4 patients reported pain that could easily be ignored. All 4 patients reported less pain 1 year after the operation using both IPQ and VAS, compared with the preoperative assessment. One patient (2.8%) developed a recurrence 20 months after the primary operation.Conclusion:TEP repair using a synthetic long-term resorbable mesh was found to be safe and promising regarding pain and discomfort at 1-year follow-up in patients with IH. Longer follow-up is necessary to establish the risk of recurrence.

Results at 3-year follow-up of totally extraperitoneal (TEP) hernia surgery with long-term resorbable mesh

“…Other Intra-operative data is shown in Table 1. More extensive information about early complications and 1-year follow-up data has been reported already [17].…”

“…The description of the hernia was done according to the Classification of the European Hernia Society (EHS) and the Swedish Hernia Register (SBR). An extended description of the operation technique has been previously published [17].…”

“…Since various studies indicate that the Totally Extra Peritoneal (TEP) technique has less risk of CPP than the Lichtenstein hernia repair [15,16], our research group has recently tested the same long-term resorbable mesh in patients with LIH using the TEP technique. The trial showed promising results on chronic post-operative pain and low recurrences at 1-year follow-up [17]. The aim of the present pilot study is to perform a 3-year follow-up of the same cohort of patients in order to establish the longterm risk of recurrences and CPP in patients operated with TEP using a slowly degradable mesh.…”