Lightweight Versus Heavyweight Mesh in Laparoscopic Inguinal Hernia Repair: A Meta-Analysis

A Currie, MRCS, H Andrew, MRCS, A Tonsi, MRCS, P R Hurley, MS FRCS, S Taribagil, FRCS. Croydon University Hospital

BACKGROUND: Prosthetic mesh reinforcement is standard practice for inguinal hernia repair but can cause considerable pain and stiffness around the groin and affect physical functioning. This has led to various types of mesh being engineered, with a growing interest in a lighter weight mesh. Minimally invasive approaches have also significantly reduced post-operative recovery from inguinal hernia repair. The aim of this systematic review was to compare the outcomes after laparoscopic inguinal repair using newer lightweight and traditional heavyweight mesh in published randomised controlled trials.

METHODS: Medline, Embase, trial registries, conference proceedings and reference lists were searched for controlled trials of heavyweight versus lightweight mesh for laparoscopic repair of inguinal hernia. The primary outcomes were recurrence and chronic pain. Secondary outcomes were visual analogue pain score at seven days post-operatively, seroma formation and time to return to work. Risk differences were calculated for categorical outcomes and standardised mean differences for continuous outcomes.

RESULTS: Eight trials were included in the analysis of 1667 hernias in 1592 patients. Mean study follow-up was between 2 and 60 months. There was no effect on recurrence (pooled analysis risk difference: 0.00 (95% CI: -0.01 – 0.01); p=0.86) or chronic pain (pooled analysis risk difference: -0.02 (95% CIs -0.04 – 0.00); p=0.1). Lightweight and heavyweight mesh repair had similar outcomes with regard to postoperative pain, seroma development and time to return to work.

CONCLUSION: Both mesh options appear to result in similar long- and short-term post-operative outcomes. Further long term analysis may guide surgeon selection in mesh weight for laparoscopic inguinal hernia repair.
 

View Poster