Skip to main content
SpringerLink
Log in

Randomized trial comparing self gripping semi re-absorbable mesh (PROGRIP) with polypropylene mesh in open inguinal hernioplasty: the 6 years result

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Objectives

The use of absorbable polylactic acid hook self-gripping polypropylene mesh in open inguinal hernia may potentially reduce operative time and enhance patient recovery. The objective of this randomized trial is to compare the outcomes following self-gripping mesh repair to polypropylene mesh secured with sutures in open inguinal hernioplasty.

Method

Eligible patients aged 18–80 years old, who had primary unilateral uncomplicated inguinal hernia, were randomized into either Polypropylene (PL) group or PROGRIP (PG) group just before the placement of mesh intra-operatively by computer generated code. The primary outcome was the time from mesh placement to end of operation, whereas secondary outcomes included the total operative time, amount of analgesic used, length of post-operative stay, seroma formation, chronic discomfort, chronic pain score and recurrence. The study has been registered in http://www.clinicaltrial.gov carrying an ID of NCT00960011. Patients were followed-up in outpatient clinic for up to 6 years after operation.

Results

From March 2009 to April 2016, 45 patients were included. The mean age of PG group (n = 22) was 62.0 ± 15.7 years old while that of the PL group was 62.6 ± 4.9 years old (n = 23). There was no significant difference regarding the smoking habit, drinking habit, comorbidities, previous hernia operation and Nyhus type of hernia between the two groups. The size of defects, the time of groin dissection and the size of incision were similar. In the PG group, there was significant reduction in the time for mesh placement (11.8 ± 3.1 vs. 21.0 ± 6.2 min, p < 0.001) and total operative time (39.2 ± 9.8 vs. 47.7 ± 8.0 min, p = 0.003). There was one recurrence in PL group and nil in PG group. Although there was a significant difference in paresthesia between 2 groups after operation, the difference disappears with time and comparable from post-operative 1 year onwards. There was no difference in chronic pain, chronic discomfort, affect daily activities, palpable mesh demonstrated throughout the whole study period till 6 years after operation.

Conclusions

The use of polylactic acid self-gripping mesh in open inguinal hernia repair effectively reduces the operating time with comparable long-term surgical outcome with traditional polypropylene mesh.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Lau H, Lee F (2002) A prospective comparative study of needlescopic and conventional endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc 16(12):1737–1740

    Article  CAS  PubMed  Google Scholar 

  2. She WH, Lo OSH, Fan JKM, Poon JTC, Law WL (2011) Needlescopic totally extraperitoneal hernioplasty for unilateral inguinal hernia in adult patients. Asian J Surg 34(1):23–27

    Article  PubMed  Google Scholar 

  3. Kim JH, An CH, Lee YS, Kim HY, Lee JI (2015) Single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP): experience of 512 procedures. Hernia 19(3):417–422

    Article  CAS  PubMed  Google Scholar 

  4. Wijerathne S, Agarwal N, Ramzi A, Liem DH, Tan WB, Lomanto D (2016) Single-port versus conventional laparoscopic total extra-peritoneal inguinal hernia repair: a prospective, randomized, controlled clinical trial. Surg Endosc 30(4):1356–1363

    Article  PubMed  Google Scholar 

  5. Choi BJ, Jeong WJ, Lee IK, Lee SC (2016) Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial. Hernia 20(6):789–795

    Article  CAS  PubMed  Google Scholar 

  6. Sevonius D, Montgomery A, Smedberg S, Sandblom G (2016) Chronic groin pain, discomfort and physical disability after recurrent groin hernia repair: impact of anterior and posterior mesh repair. Hernia 20(1):43–53

    Article  CAS  PubMed  Google Scholar 

  7. Nikkolo C, Lepner U (2016) Chronic pain after open inguinal hernia repair. Postgrad Med 128(1):69–75

    Article  PubMed  Google Scholar 

  8. Zwaans WAR, Verhagen T, Roumen RMH, Scheltinga MRM (2015) Factors determining outcome after surgery for chronic groin pain following a Lichtenstein hernia repair. World J Surg 39(11):2652–2662

    Article  PubMed  Google Scholar 

  9. Nikolova S, Harrison M, Sutton M (2016) The impact of waiting time on health gains from surgery: evidence from a national patient-reported outcome dataset. Health Econ 25(8):955–968

    Article  PubMed  Google Scholar 

  10. Amid PK, Shulman AG, Lichtenstein IL (1995) The Lichtenstein open “tension-free” mesh repair of inguinal hernias. Surg Today 25(7):619–625

    Article  CAS  PubMed  Google Scholar 

  11. Köhler G, Lechner M, Mayer F, Köckerling F, Schrittwieser R, Fortelny RH et al (2015) Self-gripping meshes for lichtenstein repair. Do we need additional suture fixation? World J Surg [Internet] 40(2):298–308

    Article  Google Scholar 

  12. Bignell M, Partridge G, Mahon D, Rhodes M (2012) Prospective randomized trial of laparoscopic (transabdominal preperitoneal-TAPP) versus open (mesh) repair for bilateral and recurrent inguinal hernia: incidence of chronic groin pain and impact on quality of life: results of 10 year follow-up. Hernia 16(6):635–640

    Article  CAS  PubMed  Google Scholar 

  13. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A (2015) Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia 19(3):355–366

    Article  CAS  PubMed  Google Scholar 

  14. Prakash P, Bansal VK, Misra MC, Babu D, Sagar R, Krishna A et al (2016) A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair. J Minim Access Surg 12(2):154–161

    Article  PubMed  PubMed Central  Google Scholar 

  15. Burgmans JPJ, Voorbrood CEH, Simmermacher RKJ, Schouten N, Smakman N, Clevers G et al (2016) Long-term results of a randomized double-blinded prospective trial of a lightweight (Ultrapro) versus a heavyweight mesh (prolene) in laparoscopic total extraperitoneal inguinal hernia repair (TULP-trial). Ann Surg 263(5):862–866

    Article  PubMed  Google Scholar 

  16. Muschalla F, Schwarz J, Bittner R (2016) Effectivity of laparoscopic inguinal hernia repair (TAPP) in daily clinical practice: early and long-term result. Surg Endosc 30(11):4985–4994

    Article  PubMed  Google Scholar 

  17. Batabyal P, Haddad RL, Samra JS, Wickins S, Sweeney E, Hugh TJ (2016) Inguinal hernia repair with Parietex ProGrip mesh causes minimal discomfort and allows early return to normal activities. Am J Surg 211(1):24–30

    Article  PubMed  Google Scholar 

  18. Wang Y, Zhang X (2015) Short-term results of open inguinal hernia repair with self-gripping Parietex ProGrip mesh in China: A retrospective study of 90 cases. Asian J Surg 39(4):218–224

    Article  PubMed  Google Scholar 

  19. Sanders DL, Nienhuijs S, Ziprin P, Miserez M, Gingell-Littlejohn M, Smeds S (2014) Randomized clinical trial comparing self-gripping mesh with suture fixation of lightweight polypropylene mesh in open inguinal hernia repair. Br J Surg 101(11):1373–1382 (discussion 1382)

    Article  CAS  PubMed  Google Scholar 

  20. Yilmaz A, Yener O, Kaynak B, Yiğitbaşi R, Demir M, Burcu B et al (2013) Self-gripping Covidien™ ProGrip™ mesh versus polypropylene mesh in open inguinal hernia repair: multicenter short term results. Prague Med Rep 114(4):231–238

    Article  CAS  PubMed  Google Scholar 

  21. Rönkä K, Vironen J, Kössi J, Hulmi T, Silvasti S, Hakala T et al (2015) Randomized multicenter trial comparing glue fixation, self-gripping mesh, and suture fixation of mesh in lichtenstein hernia repair (FinnMesh study). Ann Surg 262(5):714–719 (discussion 719–20)

    Article  PubMed  Google Scholar 

  22. Nikkolo C, Vaasna T, Murruste M, Seepter H, Suumann J, Tein A et al (2015) Single-center, single-blinded, randomized study of self-gripping versus sutured mesh in open inguinal hernia repair. J Surg Res 194(1):77–82

    Article  PubMed  Google Scholar 

  23. Pandanaboyana S, Mittapalli 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):87–93

    Article  PubMed  Google Scholar 

  24. 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(6):1080–1085

    Article  PubMed  Google Scholar 

  25. Hajighasemi M, Nocek BP, Tchigvintsev A, Brown G, Flick R, Xu X et al (2016) Biochemical and structural insights into enzymatic depolymerization of polylactic acid and other polyesters by microbial carboxylesterases. Biomacromolecules 17(6):2027–2039

    Article  CAS  PubMed  Google Scholar 

  26. Kingsnorth A, Gingell-Littlejohn M, Nienhuijs S, Schüle 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 [Internet] 16(3):287–294

    Article  CAS  Google Scholar 

  27. Sanders DL, Nienhuijs S, Ziprin P, Miserez M, Gingell-Littlejohn M, Smeds S (2014) Randomized clinical trial comparing self-gripping mesh with suture fixation of lightweight polypropylene mesh in open inguinal hernia repair. Br J Surg [Internet] 101(11):1373–1382

    Article  CAS  Google Scholar 

  28. Jorgensen LN, Sommer T, Assaadzadeh S, Strand L, Dorfelt A, Hensler M et al (2012) Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair. Br J Surg [Internet] 100(4):474–481

    Article  Google Scholar 

  29. Rönkä K, Vironen J, Kössi J, Hulmi T, Silvasti S, Hakala T et al (2015) Randomized multicenter trial comparing glue fixation, self-gripping mesh, and suture fixation of mesh in lichtenstein hernia repair (FinnMesh study). Ann Surg [Internet] 262(5):714–720

    Article  Google Scholar 

  30. Porrero JL, Castillo MJ, Pérez-Zapata A, Alonso MT, Cano-Valderrama O, Quirós E et al (2014) Randomised clinical trial: conventional Lichtenstein vs. hernioplasty with self-adhesive mesh in bilateral inguinal hernia surgery. Hernia [Internet] 19(5):765–770

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong

    J. K. M. Fan, J. Yip, D. C. C. Foo, O. S. H. Lo & W. L. Law

Authors
  1. J. K. M. Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Yip
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. C. C. Foo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. O. S. H. Lo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. L. Law
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. L. Law.

Ethics declarations

Conflict of interest

JKMF declares no conflict of interest. JY declares no conflict of interest. DCCF declares no conflict of interest. OSHL declares no conflict of interest. WLL declares no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals preformed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study after detail explanation of possible complications of open inguinal hernia repair. Patients were then given at least 48 h for consideration of participating in the clinical trial before operation.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fan, J.K.M., Yip, J., Foo, D.C.C. et al. Randomized trial comparing self gripping semi re-absorbable mesh (PROGRIP) with polypropylene mesh in open inguinal hernioplasty: the 6 years result. Hernia 21, 9–16 (2017). https://doi.org/10.1007/s10029-016-1545-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-016-1545-z

Keywords

Search

Navigation