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Hernia

, Volume 15, Issue 5, pp 511–515 | Cite as

Multicentric observational study of pain after the use of a self-gripping lightweight mesh

  • M. Á. García UreñaEmail author
  • M. Hidalgo
  • X. Feliu
  • M. Á. Velasco
  • S. Revuelta
  • R. Gutiérrez
  • A. Utrera
  • J. L. Porrero
  • M. Marín
  • C. Zaragoza
Original Article

Abstract

Introduction

Investigation in the field of inguinal hernia surgery is now focused on postoperative pain. The extended use of lightweight meshes and alternative methods of fixation may play a relevant role in the reduction of pain. In this study, a new self-gripping lightweight polypropylene mesh is tested.

Methods

A multicentric, observational study was scheduled to prospectively evaluate this new mesh. Ten centers agreed to participate. Only primary, type 1 or 2 uncomplicated hernias in adults were included. The mesh was placed as a Lichtenstein procedure without any fixation. A complete pain questionnaire was followed at 1 week, and at 1, 3 and 6 months postoperatively. The principal goal of the study was to evaluate maximum pain score at 6 months. Pain was assessed by a visual analog scale. A total of 256 patients were operated. Mean operative time was 35.6 min; 76.2% of patients were operated in an ambulatory setting.

Results

There were a few postoperative complications: 2 wound infections, 17 seromas, 21 hematomas, 6 orchitis. The incidence of acute pain was 27.3% at week 1 and 7.5% at month 1. The incidence of chronic pain was 3.6% at month 3 and 2.8% at month 6. No recurrences or long-term complications were observed.

Conclusion

This self-gripping mesh can be used safely in type 1 and 2 primary, uncomplicated inguinal hernia with minimal morbidity and most patients under ambulatory setting. The registered incidence of chronic pain is lower than 3%.

Keywords

Inguinal hernia Chronic pain Mesh Polypropylene Hernioplasty 

Supplementary material

Supplementary material 1 (WMV 1601 kb)

References

  1. 1.
    Koninger J, Redecke J, Butters M (2004) Chronic pain after hernia repair: a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg 389:361–365PubMedCrossRefGoogle Scholar
  2. 2.
    Poobalan AS, Bruce J, King PM, Chambers WA, Krukowski ZH, Smith WC (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88:1122–1126PubMedCrossRefGoogle Scholar
  3. 3.
    Courtney CA, Duffy K, Serpell MG, O’Dwyer PJ (2002) Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 89:1310–1314PubMedCrossRefGoogle Scholar
  4. 4.
    Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76PubMedCrossRefGoogle Scholar
  5. 5.
    O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. Br J Surg 92:166–170PubMedCrossRefGoogle Scholar
  6. 6.
    Paajanen H (2007) A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia. Hernia 11:335–339PubMedCrossRefGoogle Scholar
  7. 7.
    Chastan P (2009) Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh. Hernia 13:137–142PubMedCrossRefGoogle Scholar
  8. 8.
    Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy (1986). Pain Suppl 3:S1–S226Google Scholar
  9. 9.
    Nienhuijs SW, Rosman C, Strobbe LJ, Wolff A, Bleichrodt RP (2008) An overview of the features influencing pain after inguinal hernia repair. Int J Surg 6:351–356PubMedCrossRefGoogle Scholar
  10. 10.
    Aasvang EK, Gmaehle E, Hansen JB, Gmaehle B, Forman JL, Schwarz J, Bittner R, Kehlet H (2010) Predictive risk factors for persistent postherniotomy pain. Anesthesiology 112:957–969PubMedCrossRefGoogle Scholar
  11. 11.
    Klinge U, Junge K, Stumpf M, AP AP, Klosterhalfen B (2002) Functional and morphological evaluation of a low-weight, monofilament polypropylene mesh for hernia repair. J Biomed Mater Res 63:129–136PubMedCrossRefGoogle Scholar
  12. 12.
    Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48PubMedCrossRefGoogle Scholar
  13. 13.
    Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Heikkinen TJ (2006) Three-year results of a randomized clinical trial of lightweight or standard polypropylene mesh in Lichtenstein repair of primary inguinal hernia. Br J Surg 93:1056–1059PubMedCrossRefGoogle Scholar
  14. 14.
    Khan N, Bangash A, Sadiq M, Ul Hadi A, Hamid H (2010) Polyglactine/polypropylene mesh vs propylene mesh: is there a need for newer prosthesis in inguinal hernia? Saudi J Gastroenterol 16:8–13PubMedCrossRefGoogle Scholar
  15. 15.
    Koch A, Bringman S, Myrelid P, Smeds S, Kald A (2008) Randomized clinical trial of groin hernia repair with titanium-coated lightweight mesh compared with standard polypropylene mesh. Br J Surg 95:1226–1231PubMedCrossRefGoogle Scholar
  16. 16.
    Agarwal BB, Agarwal KA, Sahu T, Mahajan KC (2010) Traditional polypropylene and lightweight meshes in totally extraperitoneal inguinal herniorrhaphy. Int J Surg 8:44–47Google Scholar
  17. 17.
    Shah BC, Goede MR, Bayer R, Buettner SL, Putney SJ, McBride CL, Oleynikov D (2009) Does type of mesh used have an impact on outcomes in laparoscopic inguinal hernia? Am J Surg 198:759–764PubMedCrossRefGoogle Scholar
  18. 18.
    Akolekar D, Kumar S, Khan LR, de Beaux AC, Nixon SJ (2008) Comparison of recurrence with lightweight composite polypropylene mesh and heavyweight mesh in laparoscopic totally extraperitoneal inguinal hernia repair: an audit of 1,232 repairs. Hernia 12:39–43PubMedCrossRefGoogle Scholar
  19. 19.
    Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long-term pain after hernia surgery. Ann Surg 244:212–219PubMedCrossRefGoogle Scholar
  20. 20.
    Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400PubMedCrossRefGoogle Scholar
  21. 21.
    Pascual G, Rodriguez M, Gomez-Gil V, Garcia-Honduvilla N, Bujan J, Bellon JM (2008) Early tissue incorporation and collagen deposition in lightweight polypropylene meshes: bioassay in an experimental model of ventral hernia. Surgery 144:427–435PubMedCrossRefGoogle Scholar
  22. 22.
    Costello CR, Bachman SL, Grant SA, Cleveland DS, Loy TS, Ramshaw BJ (2007) Characterization of heavyweight and lightweight polypropylene prosthetic mesh explants from a single patient. Surg Innov 14:168–176PubMedCrossRefGoogle Scholar
  23. 23.
    Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V (2002) Impact of polymer pore size on the interface scar formation in a rat model. J Surg Res 103:208–214PubMedCrossRefGoogle Scholar
  24. 24.
    Hidalgo M, Castillo MJ, Eymar JL, Hidalgo A (2005) Lichtenstein inguinal hernioplasty: sutures versus glue. Hernia 9:242–244PubMedCrossRefGoogle Scholar
  25. 25.
    Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 7:13–16PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • M. Á. García Ureña
    • 1
    Email author
  • M. Hidalgo
    • 2
  • X. Feliu
    • 3
  • M. Á. Velasco
    • 4
  • S. Revuelta
    • 5
  • R. Gutiérrez
    • 6
  • A. Utrera
    • 9
  • J. L. Porrero
    • 7
  • M. Marín
    • 8
  • C. Zaragoza
    • 10
  1. 1.Department of SurgeryHenares HospitalCosladaSpain
  2. 2.Clínica Nuestra Señora del RosarioMadridSpain
  3. 3.Hospital General de IgualadaBarcelonaSpain
  4. 4.Hospital Universitario de Puerto RealCádizSpain
  5. 5.Hospital Marqués de ValdecillaSantanderSpain
  6. 6.Complejo Hospitalario de ToledoToledoSpain
  7. 7.Hospital Santa CristinaMadridSpain
  8. 8.Hospital Universitario ValmeSevillaSpain
  9. 9.Hospital Juan Ramón JiménezHuelvaSpain
  10. 10.Hospital General Universitario de ValenciaValenciaSpain

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