Comparison of self-fixating mesh with conventional polypropylene mesh in lichtenstein’s tension free inguinal hernia repair

Abstract

Background: Post-operative pain is a disabling complication of inguinal hernia repair. Sutures that are used to anchor the mesh are blamed for tissue tension and nerve entrapment leading to postoperative pain. Self-fixating mesh, a bicomponent mesh with resorbable polylactic acid gripping system can produce a tension-free repair without sutures, reducing the potential of post-operative pain. The objectives of the study were to compare postoperative pain, the operating time and the efficacy in terms of recurrence among patients undergoing Lichtenstein’s inguinal hernia repair with self-fixating mesh and conventional polypropylene mesh. Methods: A prospective observational study was conducted among 120 patients. Half of them underwent Lichtenstein’s inguinal hernia repair with self-fixating mesh which did not require sutures and the other half with conventional polypropylene mesh which were anchored with polypropylene sutures. Time taken to complete surgery was noted. Postoperative pain was charted using a visual analogue scale at 15 days, 3 months, 6 months and at 1 year during the follow up.Results: Median postoperative pain score and operating time was significantly lower in patients who underwent repair with self-fixating mesh. None of the patients had recurrence at the end of 1 year follow up period. Conclusions: Self-fixating mesh can reduce the postoperative pain and the operating time in patients undergoing Lichtenstein’s inguinal hernia repair when compared with a conventional polypropylene mesh. The self-fixating mesh is as efficacious as conventional polypropylene mesh in preventing recurrences.