Prospective randomized clinical trial comparing lightweight mesh and heavyweight polypropylene mesh in endoscopic totally extraperitoneal groin hernia repair

Chowbey, Pradeep; Garg, Nitin; Sharma, Abhiram; Khullar, Rajesh; Soni, Vandana; Baijal, Manish; Mittal, Tarun

doi:10.1007/s00464-010-1092-0

Cited by 63 publications

(71 citation statements)

References 30 publications

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“…In the present study, chronic relevant pain, according to the classification published by Loos et al [30] present 3 months post-operatively, was reported by 2.0 % of patients after lightweight mesh and 0.9 % of patients after heavyweight mesh use. A comparable study of Chowbey et al [21] showed similar results, reporting moderate to severe pain in 2.1 % patients after lightweight mesh and 1.9 % after heavyweight mesh.…”

Section: Discussionsupporting

confidence: 68%

“…There are only two RCT's comparing lightweight and heavyweight meshes in endoscopic repair with large sample sizes and at least a follow-up of 3 months [20,21]. Both studies showed slight benefits with lightweight meshes during the early post-operative period, regarding chronic pain and impairment of physical activities.…”

Section: Discussionmentioning

confidence: 99%

“…chronic pain after 3 months [9,19]. Two large RCT's showed a slight improvement in patient comfort and less foreign body feeling after lightweight mesh [20,21]. However, there is still no consensus which type of mesh should be used in laparoscopic hernia repair.…”

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confidence: 99%

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Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

et al. 2015

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Background Recurrence rates after inguinal hernia repair have been reduced to a few per cent, since mesh repair has become standard of care. Lightweight meshes reduce postoperative pain and stiffness in open anterior repair, but for endoscopic repair, the discussion about this benefit is ongoing. This study was done to analyse the effects of lightweight mesh versus heavyweight mesh following endoscopic totally extraperitoneal (TEP) hernia repair. Methods In a single-centre double-blindly randomized clinical trial, 950 patients with unilateral primary inguinal hernia were randomized to undergo endoscopic TEP using either an Ultrapro Ò or a Prolene Ò mesh. Data were collected by validated questionnaires at day 1, day 7, after 6 weeks and after 3 months, and clinical assessment was performed after 3 months. The presence of groin pain after 3 months, defined as an NRS score [3, was evaluated as the primary outcome measure. Secondary outcomes were foreign body feeling and the impact of pain and foreign body feeling on daily activities.Results At 3-month follow-up, the incidence of pain (NRS 4-10) was 2 versus 0.9 % in the lightweight and heavyweight mesh group, respectively (p = 0.17). Pain interfered with daily activities in 1.7 % of the lightweight and 1.5 % of heavyweight group. In the lightweight group, 20 % of patients reported a foreign body feeling versus 18 % in the heavyweight group (p = 0.62). No differences between the groups were observed regarding time to return to work, interference with sports and sexual activities, testicular pain and ejaculatory pain. Severe preoperative pain (OR 2.01, 95 % CI 1.21-3.35, p = 0.01) was the only independent predictor of any post-operative pain after 3 months. Conclusion Three months after TEP inguinal repair, there were no significant differences between lightweight and heavyweight mesh use regarding the incidence of pain, foreign body feeling or any other endpoint.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

et al. 2015

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“…21 It was found the incidence of chronic groin pain at 3.7% in lightweight poylpropylene mesh and 7.1% in heavyweight polypropylene mesh. 28 Authors have reported pain scores in patients receiving lightweight polypropylene mesh were consistently lower than the control group receiving heavyweight polypropylene mesh over a follow up of 1 year. 29 The pain following TEP/TAPP repairs is most commonly somatic which differs from the pain seen after open repairs, which is usually neuropathic.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of three-dimensional mesh (3D mesh) and polypropylene mesh in laparoscopic inguinal hernia repairs in adults

et al. 2017

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INTRODUCTIONThe word hernia comes from the Latin for 'Rupture' and the Greek for 'Bud'. 1 A hernia is defined as an abnormal protrusion of a viscera or tissue through a defect in its surrounding wall. Hernias of the groin comprise approximately 75% of all hernias and 95% are hernias of inguinal region. Inguinal hernias are 9 times more common in men. Over all inguinal hernia is the most common hernia in women.2 Indirect hernias represent the most common type of hernia in both men and women. Direct hernias are more common in elderly.The most common presenting symptom for a groin hernia is a dull feeling of discomfort in the groin region that is exacerbated by straining the abdominal musculature, lifting heavy objects, or defecating. These manoeuvres worsen the feeling of discomfort. 4 Factors favouring surgery include symptomatic hernia, the size of the hernia defect and the risk of incarceration. The treatment of all ABSTRACT Background: Polypropylene mesh gives risk of recurrence, owing to overall decrease in the size of mesh and increased subjective foreign body feeling from contracture and scarring. An anatomically contoured 3D mesh for laparoscopic inguinal hernia repair often requires no fixation, with minimal risk of postoperative pain and recurrence rate. Methods: This was a prospective comparative study conducted over a period of 2.5 years. The study enrolled 60 patients, 30 patients in each group. The end points of the study were mesh fixation time, post-operative pain, seroma formation, hospital stay, chronic groin pain, sensory impairment, and cost and affordability. Follow up period was 18 months.

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“…At least one study demonstrated higher rates of shrinkage for large-pore lightweight mesh compared with small-pore heavyweight meshes (83). Some studies have suggested that large-pore lightweight meshes result in superior tissue integration (84), better elasticity (85) and a lower incidence of pain (86), while other studies report a higher recurrence rate for largepore lightweight mesh in laparoscopically repaired groin hernias, especially in larger hernias (87).…”

Section: Figure 3) a To C The Difference Between Stiffness Elasticitmentioning

confidence: 99%

Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

Rastegarpour¹,

Cheung²,

Vardhan³

2016

J Plastic Surgery

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Prospective randomized clinical trial comparing lightweight mesh and heavyweight polypropylene mesh in endoscopic totally extraperitoneal groin hernia repair

Cited by 63 publications

References 30 publications

Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

A comparative study of three-dimensional mesh (3D mesh) and polypropylene mesh in laparoscopic inguinal hernia repairs in adults

Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

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