Results at 3-year follow-up of totally extraperitoneal (TEP) hernia surgery with long-term resorbable mesh

Abstract

Introduction Synthetic non-resorbable mesh is almost standard in hernia surgery. However, several studies have showed negative effects of permanent implants such as chronic inflammation and complications involving different organs bordering the mesh. Such complications can raise the risk of chronic post-operative pain (CPP). Recently promising results regarding CPP have been published in patients with Lateral Inguinal Hernia (LIH) using a slowly resorbable mesh in Lichtenstein technique. For this reason the aim of the present study was to find the effect of a slowly resorbable implant on the long-term rate of hernia recurrence and chronic post-operative pain in patients with LIH repaired with TEP procedure. Methods Prospective pilot study of TEP repair using TIGR ® Matrix Surgical Mesh in 35 primary LIH. At 3-year followup the Visual Analogue Scale (VAS) and the Inguinal Pain Questionnaire were employed to assess pain. Recurrence was determined by ultrasound and clinical examination. Results All patients completed the pain questionnaires but one patient did not attend the planned clinical examination for the 3-year follow-up. No patients had CPP, as defined in the World Guidelines for Groin Hernia Management. Almost all patients had lower VAS score in any activity 3 years following surgery in comparison to the preoperative period. Three patients (8.8%) suffered symptomatic recurrence during the 3-year follow-up. Conclusion TEP repair in patients with LIH using a synthetic long-term resorbable mesh was found to be encouraging respecting chronic post-operative pain at 3-year follow-up but at the cost of an increased risk of recurrence.

Efficacy of Laparoscopic Totally Extraperitoneal Repair for Inguinal Hernia

“…The results showed that laparoscopic totally extraperitoneal repair was associated with shorter operation duration, time-lapse before postoperative off-bed activity, and hospital stay, and less intraoperative hemorrhage volume ( P < 0.05), indicating that the laparoscopic surgery had a shorter operation duration, less intraoperative hemorrhage, and better postoperative recovery. The reason may be that the laparoscopic totally extraperitoneal repair [ 18 ] is less traumatic and benefits the patients' postoperative recovery, thereby shortening the treatment course and promoting their early recovery. In addition, patients in the study group showed significantly lower NRS scores than those in the control group ( P < 0.05).…”

Establishing Peer Consensus About the Use of Long‐Term Biosynthetic Absorbable Mesh for Hernia (Grades 2–3) as the Standard of Care

“…22 Grade 3 patients with co-morbidities and/or complex hernia should be considered for long-term biosynthetic absorbable mesh 91 23 In Grade 3 patients, if a single-stage abdominal wall repair is safe and feasible, a long-term biosynthetic absorbable mesh could be considered 80 24 The risk-benefit profile of long-term biosynthetic absorbable mesh is not widely understood 91…”