FROM PROSTHETIC HERNIOPLASTY TO XENOGRAFT FOR TISSUE ENGINEERING IN INGUINAL HERNIA REPAIR: A PROSPECTIVE RANDOMIZED, DOUBLE-BLIND, CONTROLLED TRIAL COMPARING LICHTENSTEIN’S REPAIR WITH POLYPROPYLENE MESH VERSUS SURGISIS IHM.

Abstract

A253 Aims: Although polypropylene (PP) mesh is the preferred material for tension-free hernioplasty, because has reduced the recurrence rate below 1%, some problems with its use are still to be addressed (postoperative pain, long-term discomfort, infections, intestinal obstruction and fistulization). In order to answer to these disadvantages, a new absorbable collagen-based material for xenograft (the porcine small intestinal submucosa mesh), has recently been developed for hernia repair. Aim of our study is to evaluate the safety and efficacy of the Lichtenstein’s hernioplasty using Surgisis IHM 8x13cm, 4 plies (SIHM, Cook Surgical Inc.), as a mesh, and to compare it with the traditional Lichtenstein procedure performed with PP. Methods: A prospective, randomised, double-blinded comparison of Lichtenstein’s repair with PP mesh versus SIHM was carried out at the Department of Emergency Surgery of St Orsola-Malpighi University Hospital with the participation of 2 surgeons who accepted to standardise the Lichtenstein’s procedures with the two different types of meshes. Results: From july 2002 up to now 55 male patients submitted to Lichtenstein’s repair of inguinal hernia with a 6 month minimum follow-up were enrolled. 28 subjects were treated with SIHM mesh, while 27 with PP mesh. The post-hernioplasty pain/discomfort (tested with visual analogue scale and simple verbal scale) and parenteral/oral analgesic consumption were statistically significant lower in SIHM group. Conclusions: Lichtenstein’s hernioplasty using the SIHM has a promising safety and efficacy.