Improved immediate postoperative pain following laparoscopic inguinal herniorrhaphy using self-adhering mesh
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Several synthetic meshes are available to reinforce the inguinal region following laparoscopic hernia reduction. We sought to compare postoperative pain of patients who underwent laparoscopic inguinal herniorrhaphy using self-adhering polyester mesh to those who had non-adhering, synthetic mesh implanted using absorbable tacks.
Materials and methods
This study is a retrospective review of patients who underwent primary laparoscopic inguinal herniorrhaphy at the Medical College of Wisconsin between October 2012 and July 2014. Clinical information and perioperative pain scores using the visual analog scale (VAS) were obtained to evaluate immediate pre and postoperative pain.
A total of 98 patients (88 male) underwent laparoscopic inguinal herniorrhaphy during the study interval. Forty-two patients received self-adhering mesh and 56 patients received mesh secured with tacks. Patient demographics and comorbidities did not differ significantly between the two groups. There was no difference in preoperative VAS scores between groups. The self-adhering mesh patients had a lower mean VAS change score (less pain). Postoperative complications did not differ between groups apart from a higher observed incidence of seroma in the self-adhering mesh group (p = 0.04). No hernias recurred in either group during the study interval.
Self-adhering mesh in laparoscopic inguinal herniorrhaphy resulted in less immediate postoperative pain than tacked mesh as demonstrated by VAS score. Postoperative complications were similar between the two groups. The results of this study demonstrate that laparoscopic inguinal herniorrhaphy using self-adhering mesh is comparable to tacked mesh in regards to short-term complication rates, but show a favorable advantage in regards to immediate postoperative pain.
KeywordsHernia Surgical pain Self-adhering mesh Mesh tacks Inguinal hernia pain
Daniel Davila, Melissa Helm, Irene Pourladian, Matthew Frelich, Alex Lois, and Andrew Kastenmeier declare no conflicts of interests. Dr. Jon Gould is a consultant for Torax Medical. Dr. Matthew Goldblatt receives funding support for research from WL Gore and Davol Inc. He is a speaker for Covidien and WL Gore. He is a consultant for Davol and Covidien.
DD, MH, IP, and MF facilitated all project related tasks. AK, JG, and MG provided clinical data and study oversight.
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