Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair

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Abstract
Background: Almost half the patients who undergo hernia repair with mesh report a feeling of stiffness and a foreign body in the groin. This study evaluated whether patients noticed any difference between lightweight and standard polypropylene mesh for the repair of inguinal hernia. Methods: Patients scheduled for elective repair of unilateral or bilateral, primary or recurrent inguinal hernia by the Lichtenstein technique were randomized to receive either a conventional densely woven polypropylene mesh (100–110 g/m2) or a lightweight composite multifilament mesh (polypropylene 27–30 g/m2). Quality of life was assessed using Short Form 36 before operation and 6 months after surgery. Pain was assessed by means of a visual analogue scale 2 days and 6 months after surgery. The primary outcome measure was the feeling of a foreign body in the groin at 6 months. Results: Some 122 hernias were randomized; 117 were included in the analysis of perioperative data, and 106 were re-examined after 6 months. There were no differences between the treatment groups with respect to early and late surgical complications. Use of lightweight mesh was associated with significantly less pain on exercise after 6 months (P = 0·042). In addition, fewer patients reported the feeling of a foreign body after repair with lightweight mesh (17·2 versus 43·8 per cent with conventional mesh; P = 0·003). Quality of life was improved significantly at 6 months compared with the preoperative assessment, and there were no differences between the treatment groups. Conclusion: Lightweight polypropylene mesh may be preferable for Lichtenstein repair of inguinal hernia. Larger cohorts with longer follow-up are needed before it can be recommended for routine use.
Funding Information
  • Ethicon Products, Norderstedt, Germany