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Published in: Hernia 4/2006

01-08-2006 | Original Article

Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair

Authors: L. R. Khan, S. Kumar, S. J. Nixon

Published in: Hernia | Issue 4/2006

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Abstract

Prosthetic mesh reinforcement is now routine in the management of inguinal hernia but can cause considerable pain and stiffness around the groin. The aim of this study was to compare the outcome after laparoscopic TEP inguinal repair using new lightweight or traditional heavyweight mesh performed in a single unit. Between November 2004 and March 2005, 113 patients underwent laparoscopic TEP inguinal repair using either lightweight (28 g/m2) or heavyweight (85 g/m2) mesh. Follow-up data was obtained using case note review and telephone-based questionnaire in April 2005. Follow-up information was obtained for 93 (83%) out of 113 patients. There was no difference between the two groups in the incidence of pain/discomfort at mean 3-month follow-up (45 vs 41%, Mann–Whitney U, P=0.641). However, there was a significant inverse correlation between the length of time since operation and severity of pain/discomfort in the lightweight group (P=0.001, Pearson test), suggesting a faster speed of recovery with lightweight mesh. Laparoscopic TEP inguinal hernia repair with lightweight mesh yields promising early results. Whilst there was no significant difference in pain or recurrence in the short term, post-operative pain scores improved earlier in patients with lightweight mesh compared to heavyweight mesh. This merits further study, with larger cohorts and longer follow-up, to determine the benefits of lightweight mesh.
Literature
1.
go back to reference Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker A, MacIntyre IM, O’Dwyer PJ (2000) Groin hernia repair in Scotland. BJS 87:1722–1726CrossRef Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker A, MacIntyre IM, O’Dwyer PJ (2000) Groin hernia repair in Scotland. BJS 87:1722–1726CrossRef
3.
go back to reference MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 354:185–190CrossRef MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 354:185–190CrossRef
4.
go back to reference EU Hernia Trialist Collaboration (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 6:2–10CrossRef EU Hernia Trialist Collaboration (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 6:2–10CrossRef
5.
go back to reference Hamer-Hodges DW, Scott NB (1985) Replacement of an abdominal wall defect using expanded PTFE sheet (Core-Tex). J R Coll Surg Edinb 30:65–67PubMed Hamer-Hodges DW, Scott NB (1985) Replacement of an abdominal wall defect using expanded PTFE sheet (Core-Tex). J R Coll Surg Edinb 30:65–67PubMed
6.
go back to reference DeBord JR (1998) The historical development of prosthetics in hernia surgery. Surg Clin North Am 78:973–1006PubMedCrossRef DeBord JR (1998) The historical development of prosthetics in hernia surgery. Surg Clin North Am 78:973–1006PubMedCrossRef
8.
go back to reference Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63–39PubMedCrossRef Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63–39PubMedCrossRef
9.
go back to reference Junge K, Rosch R, Krones CJ, Klinge U, Mertens PR, Lynen P, Schumpelick V, Klosterhalfen B (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia Feb 10 [Epub ahead of print]. PMID:15703859 Junge K, Rosch R, Krones CJ, Klinge U, Mertens PR, Lynen P, Schumpelick V, Klosterhalfen B (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia Feb 10 [Epub ahead of print]. PMID:15703859
10.
go back to reference Holzheimer RG (2004) First results of Lichtenstein hernia repair with Ultrapro-mesh as cost saving procedure–quality control combined with a modified quality of life questionnaire (SF-36) in a series of ambulatory operated patients. Eur J Med Res 9:323–327PubMed Holzheimer RG (2004) First results of Lichtenstein hernia repair with Ultrapro-mesh as cost saving procedure–quality control combined with a modified quality of life questionnaire (SF-36) in a series of ambulatory operated patients. Eur J Med Res 9:323–327PubMed
11.
go back to reference Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. BJS 91:44–48CrossRef Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. BJS 91:44–48CrossRef
12.
go back to reference O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. BJS 92:166–170CrossRef O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. BJS 92:166–170CrossRef
13.
go back to reference Champault G, Barrat C (2005) Inguinal hernia repair with beta glucan-coated mesh: results at two-year follow up. Hernia 9:125–130PubMedCrossRef Champault G, Barrat C (2005) Inguinal hernia repair with beta glucan-coated mesh: results at two-year follow up. Hernia 9:125–130PubMedCrossRef
14.
go back to reference Ferzli GS, Massad A, Albert P (1992) Extraperitoneal endoscopic inguinal hernia repair. J Laparoendosc Surg 2:281–286PubMed Ferzli GS, Massad A, Albert P (1992) Extraperitoneal endoscopic inguinal hernia repair. J Laparoendosc Surg 2:281–286PubMed
15.
go back to reference Ware JE Jr, Sherbourne CD (1992) The MOS 36-item-short-form health survey (SF36). 1. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef Ware JE Jr, Sherbourne CD (1992) The MOS 36-item-short-form health survey (SF36). 1. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef
16.
go back to reference Bringman S, Wollert S, Osterberg J, Heikkinen T (2005) Early results of a randomized multicenter trial comparing prolene and VyproII mesh in bilateral endoscopic extraperitoneal hernioplast (TEP). Surg Endosc 19:536–540PubMedCrossRef Bringman S, Wollert S, Osterberg J, Heikkinen T (2005) Early results of a randomized multicenter trial comparing prolene and VyproII mesh in bilateral endoscopic extraperitoneal hernioplast (TEP). Surg Endosc 19:536–540PubMedCrossRef
17.
go back to reference Beattie GC, Kumar S, Nixon SJ (2000) Laparoscopic total extraperitoneal hernia repair: mesh fixation is unnecessary. J Laparoendosc Adv Surg Tech A 10:71–73PubMedCrossRef Beattie GC, Kumar S, Nixon SJ (2000) Laparoscopic total extraperitoneal hernia repair: mesh fixation is unnecessary. J Laparoendosc Adv Surg Tech A 10:71–73PubMedCrossRef
18.
go back to reference National Institute for Clinical Excellence (2001) Guidance on the use of Laparoscopic surgery for inguinal hernia. Technological Appraisal Guidance No. 18 National Institute for Clinical Excellence (2001) Guidance on the use of Laparoscopic surgery for inguinal hernia. Technological Appraisal Guidance No. 18
19.
go back to reference Liem MS, van Steensel CJ, Boelhouwer RU, Weidema WF, Clevers GJ, Meijer WS, Vente JP, de Vries LS, van Vroonhoven TJ (1996) The learning curve for totally extraperitoneal laparoscopic inguinal hernia repair. Am J Surg 171:281–285PubMedCrossRef Liem MS, van Steensel CJ, Boelhouwer RU, Weidema WF, Clevers GJ, Meijer WS, Vente JP, de Vries LS, van Vroonhoven TJ (1996) The learning curve for totally extraperitoneal laparoscopic inguinal hernia repair. Am J Surg 171:281–285PubMedCrossRef
20.
go back to reference National Institute for Clinical Excellence (2004) Guidance on the use of Laparoscopic surgery for inguinal hernia. Technological Appraisal Guidance No 83 National Institute for Clinical Excellence (2004) Guidance on the use of Laparoscopic surgery for inguinal hernia. Technological Appraisal Guidance No 83
21.
go back to reference Kumar S, Wilson RG, Nixon SJ, Macintyre IMC (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. BJS 89:1476–1479CrossRef Kumar S, Wilson RG, Nixon SJ, Macintyre IMC (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. BJS 89:1476–1479CrossRef
22.
go back to reference Courtney CA, Duffy K, Serpell MG, O’Dwyer PJ (2002) Outcome of patients with severe chronic pain following repair of groin hernia. BJS 89:1310–1314CrossRef Courtney CA, Duffy K, Serpell MG, O’Dwyer PJ (2002) Outcome of patients with severe chronic pain following repair of groin hernia. BJS 89:1310–1314CrossRef
23.
go back to reference Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7PubMedCrossRef Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7PubMedCrossRef
Metadata
Title
Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair
Authors
L. R. Khan
S. Kumar
S. J. Nixon
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Hernia / Issue 4/2006
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-006-0093-3

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