Prospective Comparative Study of Laparoscopic Totally Extra-Peritoneal Repair for Inguinal Hernia with Light Weight Polypropylene Mesh V/S 3D Anatomically Shaped Large Pore Polypropylene Mesh

Minimally invasive surgery has taken over the hernia surgeries in popularity in many countries. Laparoscopic totally extra-peritoneal (TEP) hernia with meshplasty is one of the techniques. A lot of new meshes for laparoscopic hernia surgery have been developed over years. Polypropylene mesh that has been traditionally used has been compared head to head with 3D anatomically shaped large pore polypropylene mesh (3D mesh) and is an emerging alternative that needs no or minimal fixation. We performed a randomised controlled trial enrolling 50 patients with inguinal hernia, randomising 25 patients to receive laparoscopic totally extra-peritoneal repair (TEP) of inguinal hernia using 3D mesh (3DM) and 25 patients to receive laparoscopic TEP repair of inguinal hernia using light weight polypropylene mesh (LWPM). The end points of the study were mesh placement time, postoperative pain, seroma formation, hospital stay, chronic groin pain, sensory impairment and recurrence. We followed up the patients for 3 months. We found that 3DM had less mesh fixation time 12.72 min (p = 0.0001) and less postoperative pain which was statistically significant, but postoperative seroma formation, chronic groin pain, duration of hospital stay, and sensory impairment had no significant difference as compared to LWPM. We also found no recurrence rate in both mesh repair techniques at end of 3-month follow-up. The use of 3D mesh for laparoscopic inguinal hernia repair provides advantages in terms of less fixation time and easy manipulation and conformation of the mesh at the hernia site. Trial registry: CTRI/2019/05/019006.