Early results of comparison of polypropylene mesh and 75% resorbable mesh (monofilament polypropylene and poly-L-lactic acid (PLLA) mesh) for laparoscopic total extraperitoneal (TEP) inguinal hernia repair

Abstract

OBJECTIVE:Laparoscopic totally extraperitoneal (TEP) hernia repair has become increasingly widespread. Faster recovery than conventional open methods shortens the return to work. Polypropylene (PP) mesh is still in use in hernia surgery because it is an inexpensive and easily accessible patch. The post-operative chronic pain and foreign body sensation are the disadvantages of these PP patches. Poly-L-lactic acid and polypropylene (PLLA) were used in this study because of the good biocompatibility and low tissue inflammation response. We compared the early clinical outcomes of PP patch and PLLA patches.METHODS:Between January 2013 and April, 2018,469 patients with inguinal hernia underwent TEP procedure. Patients were divided into two groups. PP mesh (n=211) in group 1, PLLA mesh (n=258) in group 2. Patients were compared regarding age, gender, hernia side, ASA scores, the duration of operation, pain, time to return to work, the sensation of foreign body, seroma and hematoma.RESULTS:A total of 469 patients were analyzed retrospectively (426 male, 43 female). The mean age was 52.23±13.66 years. The operative times of the patients were 40.92±8.9 minutes in group 1, and 38.82±8.5 minutes in group 2 (p<0.05). The time to return to work was 10.2±1.47 days in Group 1 and 8.4±1.0 days in Group 2 (p<0.05). Visual Analog Scale (VAS) in group 2 was lower than in group 1 (p<0.005). In group 2, the feeling of the organic body decreased in the early and late period (p<0.005). Seroma and hematoma were less in Group 2 than in Group 1 (p<0.005). The mean follow-up period of the patients was 18 (3-63) months, two patients in Group 1, two patients in Group 2 recurred.CONCLUSION:The PLLA patch used in the TEP method is thought to be a herniated patch that can be safely used because of its ease of application and less postoperative complication rates and more rapid return to work.

The Relationship Between Small Peritoneal Flap Defects and Postoperative Seroma in TAPP Repair of Inguinal Hernias

“…Different intraoperative techniques have been suggested to prevent seroma formation, including using a drain, closure of the hernia defect with sutures, and no mesh fixation. 2,12,18,19 However, the effect of incomplete closure of peritoneal defects and peritoneal flap closure methods on seroma is still unclear. 1 .…”

Additive Manufacturing of Polyhydroxyalkanoate-Based Blends Using Fused Deposition Modelling for the Development of Biomedical Devices

“…Past and current research into wound healing patches use synthetic polymers such as polyvinyl alcohol (PVA) [ 31 ] and polycaprolactone (PCL) [ 30 ], and natural materials such as sodium alginate [ 31 ], gelatin and bacterial cellulose [ 32 , 33 ]. Tissue repair patches are also being researched for use in the repair of congenital heart defects [ 34 ], soft tissues such as abdominal wall [ 35 ], and inguinal hernia patches [ 36 ].…”