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Polytetrafluoroethylene versus polypropylene mesh during laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia: short- and long-term results of a double-blind clinical randomized controlled trial

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Abstract

Purpose

Aim of the study is to compare macroporous (> 1 mm2) polytetrafluoroethylene mesh (LP-PTFE) versus microporous (< 1 mm2) polypropylene mesh (SP-PPL) in terms of postoperative acute and chronic discomfort and pain, difficulty in mesh handling and long-term recurrence rate.

Methods

Fifty-two patients with bilateral hernia were enrolled in this double-blind randomized controlled trial (NCT02023203). Each hernia, in the same patient, was randomized to implant LP-PTFE or SP-PPL mesh during totally extraperitoneal laparoscopic hernia repair. Patients were followed at 7 days, 1, 3, 6, 12 and 60 months after surgery. Visual analog scale (VAS) score was employed to evaluate the outcomes. Student’s t test was used in case of normally distributed continuous variables, while the nonparametric Mann–Whitney U test was used in case of not normally distributed variables. Chi square test was used for analysis of categorical variables.

Results

Median VAS discomfort score with SP-PPL was significantly higher than LP-PTFE at 1 and 3 months after surgery (p = 0.003 in both cases). LP-PTFE showed significantly lower median score than SP-PPL at 7 days after surgery (p = 0.025) regarding pain at movement. Testicular pain was lower in case of LP-PTFE than SP-PPL at 7 days, 1 and 3 months after surgery (p = 0.005, p = 0.004 and p = 0.004, respectively). LP-PTFE was significantly more difficult to handle (p = 0.001). At 60 months, one recurrence was observed in the LP-PTFE group (p = 1.0000).

Conclusions

LP-PTFE has less postoperative discomfort and pain up to 3 months after surgery, without differences after that period, although it shows more difficulty in handling and recurrences occur even if not statistically significant.

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Acknowledgments

The authors are grateful to Juan Manuel Praena for his advice on the statistical analysis and Dr. Jean Carrasquillo for the translation support.

Funding

There are no grant support or financial relationship for the present study.

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Authors and Affiliations

  1. Unit of Innovation in Minimally Invasive Surgery, Department of General and Digestive Surgery, University Hospital “Virgen del Rocio”, University of Sevilla, Sevilla, Spain

    I. Alarcón, A. Balla, J. R. Soler Frías, A. Barranco & S. Morales-Conde

  2. Unit of General and Digestive Surgery, Hospital Quironsalud Sagrado Corazón, Sevilla, Spain

    I. Alarcón, J. Bellido Luque & S. Morales-Conde

  3. Department of General Surgery and Surgical Specialties “Paride Stefanini”, Sapienza, University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    A. Balla

Authors
  1. I. Alarcón
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  4. A. Barranco
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Corresponding author

Correspondence to A. Balla.

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Conflicts of interest

Dr. Isaias Alarcón, Dr. Andrea Balla, Dr. Joan Ricard Soler Frias, Dr. Antonio Barranco, Dr. Juan Bellido Luque and Prof. Salvador Morales-Conde have no conflicts of interest or financial ties to disclose.

Ethical approval

This study complied the current law of Spain.

Human and animal rights

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

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Informed consent was obtained from all individual participants included in the study.

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Alarcón, I., Balla, A., Soler Frías, J.R. et al. Polytetrafluoroethylene versus polypropylene mesh during laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia: short- and long-term results of a double-blind clinical randomized controlled trial. Hernia 24, 1011–1018 (2020). https://doi.org/10.1007/s10029-020-02200-y

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