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Minimally invasive preperitoneal single-layer mesh repair versus standard Lichtenstein hernia repair for inguinal hernia: a prospective randomized trial

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Abstract

Purpose

To compare a minimally invasive preperitoneal (MIP) single-layer mesh repair with the standard Lichtenstein hernia repair (LHR) for inguinal hernia in terms of operative characteristics, recovery, complications, recurrence and chronic pain.

Method

Two hundred and twenty male patients diagnosed with primary inguinal hernia were randomized to either MIP or LHR methods. MIP repair consisted of a single-layer polypropylene mesh developed by our group placed preperitoneally using the Kugel technique. Patients were followed for a minimum of 2 years. Chronic pain was assessed by Sheffield’s pain score.

Results

One hundred and one patients in MIP group and 105 patients in LHR group were included in the analysis. Most patients were diagnosed with indirect hernia (n = 79 for MIP, n = 81 for LHR). Surgery was slightly but significantly shorter for MIP (38.2 ± 7.4 vs. 40.3 ± 6.6, p = 0.031). Early complications such as cord edema, hematoma, scrotal edema, and wound infection were infrequent in both groups. Recurrence was detected in three patients in MIP and one patient in LHR. Chronic pain score was similar with both methods within the first year, but significantly lower for MIP at 24 months (0.66 ± 0.06 vs. 0.87 ± 0.07, p = 0.03).

Conclusion

MIP single-layer mesh repair is as effective and safe as LHR, with the additional benefits of minimally invasive nature, less chronic pain at 2 years and low polypropylene load when compared with the original Kugel patch.

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Acknowledgments

Thanks to surgical nurses Mrs. Meryem Eren and Mrs. Necla Karademir for their valuable contributions in making mesh.

Conflict of interest

The authors declare that there are no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Konya Education and Research Hospital, P.N. 42100, Konya, Turkey

    K. Arslan, B. Erenoglu, E. Turan, H. Koksal & O. Dogru

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  1. K. Arslan
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  2. B. Erenoglu
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  3. E. Turan
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  4. H. Koksal
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Correspondence to K. Arslan.

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Arslan, K., Erenoglu, B., Turan, E. et al. Minimally invasive preperitoneal single-layer mesh repair versus standard Lichtenstein hernia repair for inguinal hernia: a prospective randomized trial. Hernia 19, 373–381 (2015). https://doi.org/10.1007/s10029-014-1306-9

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  • DOI: https://doi.org/10.1007/s10029-014-1306-9

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