Surgical Endoscopy

, Volume 32, Issue 3, pp 1160–1164 | Cite as

Improved immediate postoperative pain following laparoscopic inguinal herniorrhaphy using self-adhering mesh

  • Daniel G. Davila
  • Melissa C. Helm
  • Irene S. Pourladian
  • Matthew J. Frelich
  • Andrew S. Kastenmeier
  • Jon C. Gould
  • Matthew I. Goldblatt
Article

Abstract

Background

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.

Results

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.

Conclusions

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.

Keywords

Hernia Surgical pain Self-adhering mesh Mesh tacks Inguinal hernia pain 

Notes

Disclosures

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.

Author Contributions

DD, MH, IP, and MF facilitated all project related tasks. AK, JG, and MG provided clinical data and study oversight.

References

  1. 1.
    Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83(5):1045–1051 v–vi CrossRefPubMedGoogle Scholar
  2. 2.
    Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM (2002) Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 4:CD002197Google Scholar
  3. 3.
    Bresnahan E, Bates A, Wu A, Reiner M, Jacob B (2014) The use of self-gripping (progrip) mesh during laparoscopic total extraperitoneal (TEP) inguinal hernia repair: a prospective feasibility and long-term outcomes study. Surg Endosc 29:2690–2696CrossRefPubMedGoogle Scholar
  4. 4.
    Birk D, Hess S, Garcia-Pardo C (2013) Low recurrence rate and low chronic pain associated with inguinal hernia repair by laparoscopic placement of parietex ProGrip mesh: clinical outcomes of 220 hernias with mean follow-up at 23 months. Hernia 17(3):313–320CrossRefPubMedGoogle Scholar
  5. 5.
    Teng YJ, Pan SM, Liu YL, Yang KH, Zhang YC, Tian JH, Han JX (2011) A meta-analysis of randomized trails of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg Endosc 25:2849–2858CrossRefPubMedGoogle Scholar
  6. 6.
    Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB (2011) Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified lichtenstein repairs. Ann Surg 254(5):709–714CrossRefPubMedGoogle Scholar
  7. 7.
    Chastan P (2009) Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh. Hernia 13(2):137–142CrossRefPubMedGoogle Scholar
  8. 8.
    Pedano N, Pastor C, Arredondo J, Poveda I, Ruiz J, Monton S et al (2012) Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions. Langenbeck’s Arch Surgery/Deutsche Gesellschaft Fur Chirurgie 397(2):291–295CrossRefGoogle Scholar
  9. 9.
    Kingsnorth A, Gingell-Littlejohn M, Nienhuijs S, Schule S, Appel P, Ziprin P et al (2012) Randomized controlled multicenter international clinical trial of self-gripping parietex ProGrip polyester mesh versus lightweight polypropylene mesh in open inguinal hernia repair: interim results at 3 months. Hernia 16(3):287–294CrossRefPubMedGoogle Scholar
  10. 10.
    Verhagen T, Zwaans WAR, Loos MJA, Charbon JA, Scheltinga MRM, Roumen RMH (2016) Randomized clinical trial comparing self-gripping mesh with a standard polypropylene mesh for open inguinal hernia repair. BJS 103:812–818CrossRefGoogle Scholar
  11. 11.
    Li J, Ji Z, Li Y (2014) The comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: the results of meta-analysis. Ann Surg 259:1080–1085CrossRefPubMedGoogle Scholar
  12. 12.
    Pandanaboyana S, Mittapallim D, Rao A, Prasad R, Ahmad N (2014) Meta-analysis of self-gripping mesh (Progrip) versus sutured mesh in open inguinal hernia repair. Surgeon 12(2):87–93CrossRefPubMedGoogle Scholar
  13. 13.
    Feng Z, Zhou J, Ren F, Liu D (2014) Self-gripping mesh versus sutured mesh in open inguinal hernia repair: system review and meta-analysis. Am J Surg 207(5):773–781CrossRefGoogle Scholar
  14. 14.
    Ferzli GS, Edwards E, Al-Khoury G, Hardin RM (2008) Postherniorrhaphy groin pain and how to avoid it. Surg Clin N Am 88:203–216CrossRefPubMedGoogle Scholar
  15. 15.
    Schwab R, Willms A, Kroger A, Becker HP (2006) Less chronic pain following mesh fixation using a fibrin sealant in TEP inguinal hernia repair. Hernia 10(3):272–277CrossRefPubMedGoogle Scholar
  16. 16.
    Cavallaro G, Campanile FC, Rizzello M, Greco F, Iorio O, Iossa A et al (2013) Lightweight polypropylene mesh fixation in laparoscopic incisional hernia repair. Minim Invasive Ther Allied Technol 22(5):283–287CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Daniel G. Davila
    • 1
  • Melissa C. Helm
    • 1
  • Irene S. Pourladian
    • 1
  • Matthew J. Frelich
    • 1
  • Andrew S. Kastenmeier
    • 1
  • Jon C. Gould
    • 1
  • Matthew I. Goldblatt
    • 1
  1. 1.Department of Surgery, Division of General SurgeryMedical College Of WisconsinMilwaukeeUSA

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