Polypropylene mesh (PPM) or Light weight mesh (LWM) in inguinal hernia surgery (TEP)- results of a prospective randomized controlled study

Objectives of study-
Mesh application in endoscopic hernia surgery is universal. Textile, weight and pore size of mesh continue to be debated. LWMs with larger pores seem to address the concerns of host response. Aim of this study was to evaluate the advantages if any of LWMs over PPMs in totally extraperitoneal (TEP) repair of inguinal hernia. Both types of meshes were used in same host to ensure more objectivity to study.
Patients and methods
30 consecutive candidates for bilateral (B/L) TEP were included without any exclusion criteria. A uniform perioperative protocol was followed with Paracetamol as an analgesic. Diclofenac (NSAID) was used for significant pain (SP) even after Paracetamol use. PPM and LWM were both used in same patient for TEP, one side being repaired with PPM and other with LWM. Side to be repaired with PPM and LWM was randomized. Patients were bind to randomization. Side specific, postoperative data were collected at the end of 1st, 2nd & 3rd week (W1, W2, W3) for soreness in ilioinguinal region (SIR), SP, spermatic cord induration (SCI), infraumbilical soreness (IUS) and seroma (Ser.). In case of bilaterally same symptom, predominant side of symptom was taken as an indicator of end points.
30 males with bilateral inguinal hernias. 39 years of mean age (17-74) were included and 60 meshes (30 LWM + 30 PPM) used. 36 direct and 30 indirect hernias (6 had both) were found. All the adverse end points were observed more with PPM as shown in the Table[ values in( ) are for LWM].
LWMs are better tolerated as seen by significantly less morbidity on LWM side of repair. Larger studies should be undertaken to further evaluate it.

Session: Podium Presentation

Program Number: S046

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