Long-term assessment of surgical and quality-of-life outcomes between lightweight and standard (heavyweight) three-dimensional contoured mesh in laparoscopic inguinal hernia repair

Arnold, Michael R.; Coakley, Kathleen M.; Fromke, Eric J.; Groene, Steve A.; Prasad, T Krishna; Colavita, Paul D.; Augenstein, Vedra A.; Kercher, Kent W.; Heniford, B. Todd

doi:10.1016/j.surg.2018.10.016

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Previous publications have reported a urinary retention rate of 7.5% when no urinary catheters were used. We surveyed the surgeons at each institution included in the trial to determine which ones routinely used Foley catheters.…”

Section: Methodsmentioning

confidence: 93%

Effect of Intraoperative Urinary Catheter Use on Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair

et al. 2022

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are commonly placed during laparoscopic inguinal hernia repair as a presumed protection against postoperative urinary retention (PUR), one of the most common complications following this operation. Data from randomized clinical trials evaluating the effect of catheters on PUR are lacking.OBJECTIVE To investigate the effect of intraoperative catheters on PUR after laparoscopic inguinal hernia repair. DESIGN, SETTING, AND PARTICIPANTSThis 2-arm registry-based single-blinded randomized clinical trial was conducted at 6 academic and community hospitals in the US from March 2019 to March 2021 with a 30-day follow-up period following surgery. All patients who presented with inguinal hernias were assessed for eligibility, 534 in total. Inclusion criteria were adult patients undergoing laparoscopic, elective, unilateral, or bilateral inguinal hernia repair. Exclusion criteria were inability to tolerate general anesthesia and failure to understand and sign the written consent form. A total of 43 patients were excluded prior to intervention.INTERVENTIONS Patients in the treatment arm had placement of a urinary catheter after induction of general anesthesia and removal at the end of procedure. Those in the control arm had no urinary catheter placement. MAIN OUTCOMES AND MEASURES PUR rate. RESULTSOf the 491 patients enrolled, 241 were randomized to catheter placement, and 250 were randomized to no catheter placement. The median (IQR) age was 61 (51-68) years, and 465 participants (94.7%) were male. Overall, 44 patients (9.1%) developed PUR. There was no difference in the rate of PUR between the catheter and no-catheter groups (23 patients [9.6%] vs 21 patients [8.5%], respectively; P = .79). There were no intraoperative bladder injuries. In the catheter group, there was 1 incident of postoperative urethral trauma in a patient who presented to the emergency department with PUR leading to a suprapubic catheter placement.CONCLUSIONS AND RELEVANCE Intraoperative urinary catheters did not reduce the risk of PUR after laparoscopic inguinal hernia repair. While their use did not appear to be associated with a high rate of iatrogenic complications, there may be a low rate of catastrophic complications. In patients who voided urine preoperatively, catheter placement did not appear to confer any advantage and thus their use may be reconsidered.

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Section: Methodsmentioning

confidence: 93%

Effect of Intraoperative Urinary Catheter Use on Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair

et al. 2022

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“…Patients who received lightweight mesh were1slightly younger (52.5 years v/s 56.2 years, P.001) and had slightly lower body mass indices (26.3 v/s 27.2, P.00001). 5 Various randomized control trials have results with significant decrease experience of chronic pain with LWM than HWM 6 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of mean Postoperative Inguinodynia in patients undergoing open Inguinal Hernia Surgery with use of standard Polypropylene Heavy Weight Mesh v/s Ultra Pro light Weight Mesh

Awais¹,

Rafi²,

Naeem³

et al. 2022

PJMHS

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Background: Various types of meshes for inguinal hernias have been discovered to combat with chronic groin pain related problems. The data regarding these findings was variable due to difference in the cut off values used in the past in different studies to label inguinodynia and local data was scarce where HWM is still highly practiced. Aim: To compare the mean postoperative inguinodynia in patients undergoing open inguinal hernia surgery with use of standard polypropylene heavy weight mesh (HWM) v/s Ultra Pro lightweight mesh (LWM). Methodology: This is a prospective randomized controlled trail conducted at department of surgery, Services Institute of Medical Sciences, from July 2019 to June 2020. Cases were divided in two groups by using radio opaque sealed envelopes labeled as A and B. Group-A underwent Lichtenstein mesh repair by Ultra Pro LWM and group B had polypropylene heavy weight mesh (HWM). Lichtenstein mesh repair was done under spinal or general anesthesia by the experienced surgeon. Duration of surgery was also calculated (from incision to closure). Patient was followed in outpatient department at 3 months where the outcome was seen and inguinodynia was assessed. Results: The mean age was in group A was 40.66±10.52 years and 40.53 ±12.56 years in group B. The mean pain Score in group A was 2.024±0.88 and in Group-B it was 2.97 ±0.85. Conclusion: Ultra Pro LWM is more effective in terms of less postoperative pain as compared to standard polypropylene heavy weight mesh in patients undergoing open inguinal hernia surgery Keywords: Postoperative, Inguinodynia, Inguinal hernia, Standard, Polypropylene heavy weight mesh, Ultra Pro light

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“…Robinson et al reported that the infection complications in all mesh types reached 42% (107 reports in 252 cases) [6]. While Arnold et al found that only three surgical site infections occurred in 1424 laparoscopic inguinal hernia repairs performed with a three-dimensional contoured mesh [8]. The infection rate varied by hernia site; for instance, the incidence of infection in ventral hernia was about 8.3% [9] and that of groin was about 0.3% [10]; however, the crude infection rate was about 5% [7].…”

Section: Introductionmentioning

confidence: 99%

Preparation and in Vitro Evaluation of New Composite Mesh Functionalized with Cationic Antimicrobial Peptide

et al. 2019

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Infection caused by bacteria in hernia repair site is a severe complication, and patients have to undergo a second surgery to remove the infected prosthesis. In this study, we developed a composite biological safe mesh with antibacterial activity. The composite mesh is composed of large pore polypropylene (PP) mesh, poly-caprolactone (PCL) and antimicrobial peptide (PEP-1), which we synthesized in our lab. Fourier transformed infrared (FTIR) spectroscopy was utilized to analyze the functional groups. The surface morphology, in vitro release characters, mechanical properties, antibacterial activities, and in vitro cytotoxicity of modified mesh were evaluated. Results showed that PEP-1 was loaded in fibers successfully and could diffuse from nanofibers to inhibit bacteria (E. coli) growth. However, the modified mesh did not show inhibition to S. aureus. The mechanical properties of fabricated mesh showed no difference with two commercial surgical meshes. What is more, modified mesh was proved to be nontoxic to human dermal fibroblasts, indicating that this method to fabricate meshes with antibacterial activity is feasible and provides a new strategy for the development of surgical meshes.

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Long-term assessment of surgical and quality-of-life outcomes between lightweight and standard (heavyweight) three-dimensional contoured mesh in laparoscopic inguinal hernia repair

Cited by 9 publications

References 25 publications

Effect of Intraoperative Urinary Catheter Use on Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair

Effect of Intraoperative Urinary Catheter Use on Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair

Comparison of mean Postoperative Inguinodynia in patients undergoing open Inguinal Hernia Surgery with use of standard Polypropylene Heavy Weight Mesh v/s Ultra Pro light Weight Mesh

Preparation and in Vitro Evaluation of New Composite Mesh Functionalized with Cationic Antimicrobial Peptide

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