title: Long-term Results of a Randomized Double-blinded Prospective Trial of a Lightweight (Ultrapro) Versus a Heavyweight Mesh (Prolene) in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair (TULP-trial).
abstract: OBJECTIVE
  The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair.
  
  
  BACKGROUND
  Lightweight meshes reduce postoperative pain and stiffness in open anterior inguinal hernia repair. The discussion about a similar benefit for laparoscopic repair is ongoing, but concerns exist about higher recurrence rates.
  
  
  METHODS
  Between March 2010 and October 2012, male patients who presented with a primary, reducible unilateral inguinal hernia who underwent day-case TEP repair were eligible. Outcome parameters included chronic pain, recurrence, foreign body feeling, and quality of life scores.
  
  
  RESULTS
  During the study period, 950 patients were included. One year postoperatively the presence of relevant pain (Numeric Rating Score 4-10) was significantly higher in the lightweight mesh group (2.9%) compared with the heavyweight mesh group (0.7%) (P = 0.01), and after 2 years this difference remained significant (P = 0.03). There were 4 (0.8%) recurrent hernias in the heavyweight mesh group and 13 (2.7%) in the lightweight group (P = 0.03). No differences in foreign body feeling or quality of life scores were detected.
  
  
  CONCLUSIONS
  In TEP hernia surgery, there was no benefit of lightweight over heavyweight meshes observed 2 years postoperatively.
authors.affiliation: *Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Utrecht, The Netherlands †Department of Surgery, UMCU Utrecht, Utrecht, The Netherlands ‡Department of Surgery, Heerlen, The Netherlands §Department of Geriatric Medicine, Diakonessenhuis Utrecht/Zeist, Utrecht, The Netherlands ¶Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Josephina P J
authors.initials: JP
authors.lastname: Burgmans
authors.forename: Charlotte E H
authors.initials: CE
authors.lastname: Voorbrood
authors.forename: Rogier K J
authors.initials: RK
authors.lastname: Simmermacher
authors.forename: Nelleke
authors.initials: N
authors.lastname: Schouten
authors.forename: Niels
authors.initials: N
authors.lastname: Smakman
authors.forename: GeertJan
authors.initials: G
authors.lastname: Clevers
authors.forename: Paul H P
authors.initials: PH
authors.lastname: Davids
authors.forename: EgbertJan M M
authors.initials: EM
authors.lastname: Verleisdonk
authors.forename: Marije E
authors.initials: ME
authors.lastname: Hamaker
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
authors.forename: Thijs
authors.initials: T
authors.lastname: van Dalen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011126:Polypropylenes; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: D011126:Polypropylenes