Is Tachosil mesh better than polypropylene mesh for inguinal hernia repair?

Excerpt

Inguinal hernia is very common and Lichtenstein’s repair is accepted by many as the gold standard for its surgical treatment. I read with great interest the study published in the journal’s February, 2013 issue, entitled “A new approach for transversalis fascia reinforcement in Lichtenstein’s inguinal hernia repair” [1]. The authors used the biological mesh, Tachosil, instead of polypropylene mesh in Lichtenstein repair for 52 patients. Fixation of this mesh is able to be achieved without suturing. In 3 years of follow-up they encountered no case of recurrence and only two patients who suffered minor complications; namely, urinary retention and chronic groin pain. A control group of 45 patients underwent conventional Lichtenstein repair with standard polypropylene mesh. The authors reported less postoperative pain and analgesic use and fewer postoperative complications in the Tachosil mesh group. Tachosil mesh, being sutureless and absorbable, seems to be superior to polypropylene mesh in terms of postoperative and chronic pain. Notwithstanding, as Tachosil mesh is absorbed in the body in 12 weeks [2], the possibility of formation of a weak area for hernia recurrence after the mesh absorption should not be underestimated. Therefore, I believe that a longer follow-up period is needed to establish the true recurrence rates. The risk of infectious transmission from this biological material is another disadvantage. Finally, the authors did not compare the cost of polypropylene vs. Tachosil mesh. …