A comparative study of three-dimensional mesh (3D mesh) and polypropylene mesh in laparoscopic inguinal hernia repairs in adults
Keywords:Inguinal hernia, Tacks, Three-dimensional mesh
Background: Polypropylene mesh gives risk of recurrence, owing to overall decrease in the size of mesh and increased subjective foreign body feeling from contracture and scarring. An anatomically contoured 3D mesh for laparoscopic inguinal hernia repair often requires no fixation, with minimal risk of postoperative pain and recurrence rate.
Methods: This was a prospective comparative study conducted over a period of 2.5 years. The study enrolled 60 patients, 30 patients in each group. The end points of the study were mesh fixation time, post-operative pain, seroma formation, hospital stay, chronic groin pain, sensory impairment, and cost and affordability. Follow up period was 18 months.
Results: The mesh fixation time was less in 3D mesh, 10.6±4.31 minutes (p value- 0.0002). The incidence of severe immediate postoperative pain was higher in polypropylene mesh 10% (p value of 0.612). The postoperative seroma was less in 3D mesh, 3.3% (p value of 1.00). The mean hospital stay was shorter in 3D, 1.7±0.69 days (p value–0.005). Postoperative sensory impairment was more in polypropylene mesh, 6.6% (p value-1.00). The incidence of chronic groin pain was less in 3D (p value- 0.612). We found a higher recurrence rate at 18 months in both groups (p-value-1.00).
Conclusions: The use of three-dimensional mesh for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, decreased chronic groin pain and morbidity. Elimination of tacks and shorter hospital stay may reduce the cost of 3D mesh.
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