Randomized clinical trial of laparoscopic hernia repair comparing titanium-coated lightweight mesh and medium-weight composite mesh
- 493 Downloads
The use of lightweight meshes in incisional hernia repair could have beneficial effects on quality of life. This study aimed to compare a new titanium-coated lightweight mesh with a standard composite mesh after laparoscopic incisional hernia repair.
A randomized controlled single-center clinical trial was designed using the basic principle of one unit, one surgeon, one technique (midline incisional hernia with a laparoscopic approach), and two meshes: a lightweight titanium-coated mesh (group 1) and a medium-weight collagen-polyester composite mesh (group 2) used in 102 patients. The primary end points were pain and recurrence. The secondary end points were morbidity and patient outcomes (analgesic consumption, return to everyday activities).
The postoperative complication rates were similar for the two meshes. Pain was significantly less common in group 1 than in group 2 at 1 month (P = 0.029) but was similar for the two groups at 6 months and 1 year. There was a significant difference between the two groups in the average use of analgesics: 6.1 days in group 1 versus 1.6 days in group 2 (P < 0.001). The lightweight group returned to everyday activities after 6.9 days versus 9.7 days for the composite group (P < 0.001). The rate of recurrence did not differ between the two groups at the 2-year follow-up evaluation.
The light titanium-covered polypropylene mesh was associated with less postoperative pain in the short term, lower analgesic consumption, and a quicker return to everyday activities than the Parietex composite medium-weight mesh. The recurrence rates at 2 years showed no difference between the two groups.
KeywordsLaparoscopy Morbidity Pain Parietex composite medium-weight mesh Recurrence Titanium-coated lightweight mesh
Alfredo Moreno-Egea, Andrés Carrillo-Alcaraz, and Víctor Soria-Aledo have no conflicts of interest or financial ties to disclose.
- 2.Bittner R, Schmedt CG, Leibl BJ et al (2011) Early postoperative and one-year results of a randomized controlled trial comparing the impact of extralight titanized polypropylene mesh and traditional heavyweight polypropylene mesh on pain and seroma production in laparoscopic hernia repair (TAPP). World J Surg 35(8):1791–1797CrossRefPubMedGoogle Scholar
- 11.Schug-Pass C, Tamme C, Tannapfel A et al (2006) A lightweight polypropylene mesh (TiMesh) for laparoscopic intraperitoneal repair of abdominal wall hernias: comparison of biocompatibility with the DualMesh in an experimental study using the porcine model. Surg Endosc 20:402–409CrossRefPubMedGoogle Scholar
- 16.Moreno-Egea A (2002) In: Morales-Conde S (ed) Laparoscopic ventral hernia repair. Springer Verlag, Paris, pp 139–159Google Scholar