Skip to main content
Top
Published in: Surgical Endoscopy 11/2010

01-11-2010

Prospective, randomized, controlled trial comparing lightweight versus heavyweight mesh in chronic pain incidence after TEP repair of bilateral inguinal hernia

Authors: L. B. Chui, W. T. Ng, Y. S. Sze, K. S. Yuen, Y. T. Wong, C. K. Kong

Published in: Surgical Endoscopy | Issue 11/2010

Login to get access

Abstract

Background

This prospective, clinical, randomized, controlled study was performed to define the incidence of chronic pain after total extraperitoneal (TEP) repair with a light-weighted mesh compared with heavyweight mesh in patients with bilateral inguinal hernias.

Methods

Consecutive patients with bilateral inguinal hernias were recruited for TEP inguinal hernia repair under general anesthesia. Heavyweight mesh was randomly assigned to one side of the groin and lightweight mesh to the other. Patients were followed up regularly for up to 1 year by an independent surgeon who was unaware of the mesh assignment. The postoperative pain score by means of a visual analogue scale (VAS) and other data were recorded.

Results

Fifty bilateral TEP hernia repairs were performed between September 2007 and February 2009. Six patients (12%) complained of chronic pain 3 months after the operation. A higher average pain score was observed for the side of hernia repaired by heavyweight mesh compared with lightweight mesh, but the difference was not statistically significant. More patients complained about foreign body sensation on the side repaired with heavyweight mesh (24%) compared with the side with lightweight mesh (8%; P < 0.05). There was no recurrence or need for reintervention for either type of mesh.

Conclusions

Lightweight polypropylene mesh may be preferable to heavyweight mesh for TEP inguinal hernia repair because it provides less postoperative foreign body sensation; however, there was no significant difference in the incidence of chronic pain.
Literature
1.
go back to reference The EU Hernia Trialists Collaboration (2001) Meta-analysis of randomized controlled trials. Ann Surg 235:322–332 The EU Hernia Trialists Collaboration (2001) Meta-analysis of randomized controlled trials. Ann Surg 235:322–332
2.
go back to reference Wright D, Paterson C, Scott N, Hair A, O’Dwyer PJ (2001) Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg 235:333–337CrossRef Wright D, Paterson C, Scott N, Hair A, O’Dwyer PJ (2001) Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg 235:333–337CrossRef
3.
go back to reference Kuhry E, van Veen RN, Langeveld HR, Steyerbery EW, Jeekel J, Bonjer HJ (2007) Open or endoscopic total extraperitoneal inguinal hernia repair? A systemic review. Surg Endosc 21:161–166CrossRefPubMed Kuhry E, van Veen RN, Langeveld HR, Steyerbery EW, Jeekel J, Bonjer HJ (2007) Open or endoscopic total extraperitoneal inguinal hernia repair? A systemic review. Surg Endosc 21:161–166CrossRefPubMed
4.
go back to reference Poobalan AS, Bruce J, Cairns W, Smith S, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19:48–54CrossRefPubMed Poobalan AS, Bruce J, Cairns W, Smith S, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19:48–54CrossRefPubMed
5.
go back to reference Memon MA, Cooper NJ, Memon B, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1478–1492CrossRef Memon MA, Cooper NJ, Memon B, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1478–1492CrossRef
6.
go back to reference Nienhuijs S, Staal E, Strobbe L, Roseman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systemic review. Am J Surg 194:394–400CrossRefPubMed Nienhuijs S, Staal E, Strobbe L, Roseman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systemic review. Am J Surg 194:394–400CrossRefPubMed
7.
go back to reference Weyhe D, Belyaev O, Muller C, Meurer K, Bauer KH, Papapostolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of light meshes: a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244CrossRefPubMed Weyhe D, Belyaev O, Muller C, Meurer K, Bauer KH, Papapostolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of light meshes: a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244CrossRefPubMed
8.
go back to reference Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63CrossRefPubMed Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63CrossRefPubMed
9.
go back to reference Ng WT, Chui LB (2008) Routine contralateral exploration is advisable during extraperitoneal hernioplasty for left inguinal hernia. Surg Endosc 22(3):806–807CrossRefPubMed Ng WT, Chui LB (2008) Routine contralateral exploration is advisable during extraperitoneal hernioplasty for left inguinal hernia. Surg Endosc 22(3):806–807CrossRefPubMed
10.
go back to reference Ng WT (2008) A cost-effective mesh design for extraperitoneal inguinal hernia repair using lightweight mesh. Hernia 12:447–448CrossRefPubMed Ng WT (2008) A cost-effective mesh design for extraperitoneal inguinal hernia repair using lightweight mesh. Hernia 12:447–448CrossRefPubMed
11.
go back to reference Merskey H, Bogduk N (eds) (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definition of pain terms. Task Force on Taxonomy of the I+ASP, 2nd edn. IASP Press, Seattle, WA, pp 209–214 Merskey H, Bogduk N (eds) (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definition of pain terms. Task Force on Taxonomy of the I+ASP, 2nd edn. IASP Press, Seattle, WA, pp 209–214
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. Br J Surg 92:166–170CrossRefPubMed 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. Br J Surg 92:166–170CrossRefPubMed
13.
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. Br J Surg 91:44–48CrossRefPubMed Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48CrossRefPubMed
14.
go back to reference Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367:1625–1628CrossRef Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367:1625–1628CrossRef
15.
go back to reference Felix E, Scott S, Crafton B, Geis P, Duncan T, Swell R, McKernan B (1998) Causes of recurrence after laparoscopic hernioplasty. Surg Endosc 12:226–231CrossRefPubMed Felix E, Scott S, Crafton B, Geis P, Duncan T, Swell R, McKernan B (1998) Causes of recurrence after laparoscopic hernioplasty. Surg Endosc 12:226–231CrossRefPubMed
16.
go back to reference Agrwal BB, Agarwal KA, Mahajan KC (2009) Prospective double-blind randomized controlled study comparing heavy-and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early result. Surg Endosc 23:242–247CrossRef Agrwal BB, Agarwal KA, Mahajan KC (2009) Prospective double-blind randomized controlled study comparing heavy-and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early result. Surg Endosc 23:242–247CrossRef
Metadata
Title
Prospective, randomized, controlled trial comparing lightweight versus heavyweight mesh in chronic pain incidence after TEP repair of bilateral inguinal hernia
Authors
L. B. Chui
W. T. Ng
Y. S. Sze
K. S. Yuen
Y. T. Wong
C. K. Kong
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 11/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1036-8

Other articles of this Issue 11/2010

Surgical Endoscopy 11/2010 Go to the issue