Does type of mesh used have an impact on outcomes in laparoscopic inguinal hernia?
BACKGROUND
Theoretically, a lighter and softer mesh may decrease nerve entrapment and chronic pain by creating less fibrosis and mesh contracture in laparoscopic inguinal hernia repair.


METHODS
We performed a telephone survey of patients who underwent laparoscopic inguinal hernia surgery between 2001 and 2007. We recorded patient responses for chronic pain, foreign body sensation, recurrence, satisfaction, and return to work, and then studied the effect of type of mesh (polypropylene vs polyester) on these factors.


RESULTS
Of 109 consecutive patients surveyed (mean age, 54.5 y), 67 eligible patients underwent 84 transabdominal extraperitoneal procedures and 2 transabdominal preperitoneal procedures. Patients with polypropylene mesh had a 3 times higher rate of chronic pain (P = .05), feeling of lump (P = .02), and foreign body perception (P = .05) than the polyester mesh group. Our overall 1-year recurrence rate was 5.9%. The recurrence rate was 9.3% for the polypropylene group and 2.9% for the polyester group (P = .26).


CONCLUSIONS
A lightweight polyester mesh has better long-term outcomes for chronic pain and foreign body sensation compared with a heavy polypropylene mesh in laparoscopic inguinal hernia repair. We also saw a trend toward higher recurrence in the polypropylene group.
Shah
Bhavin C
BC
Minimally Invasive & Robotic Surgery, Department of Surgery, 983280 University of Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Goede
Matthew R
MR
Bayer
Robert
R
Buettner
Shelby L
SL
Putney
Stacy J
SJ
McBride
Corrigan L
CL
Oleynikov
Dmitry
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult