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Prolene hernia system versus Lichtenstein repair for inguinal hernia: a meta-analysis

  • E. DeckerEmail author
  • A. Currie
  • M. K. Baig
Part of the following topical collections:
  1. Forum on primary monolateral uncomplicated inguinal hernia



Lichtenstein repair is standard practice for inguinal herniorrhaphy, but there is increasing public concern in the use of mesh and postoperative chronic pain. New mesh technology, such as the prolene hernia system, has a preperitoneal component to reinforce the myopectineal orifice aim to reduce the risk of recurrence and chronic pain. This meta-analysis compares outcomes using prolene hernia system versus lichenstein repair for inguinal hernias.


Randomized-controlled trials comparing prolene hernia system and Lichtenstein repair were identified using Embase, Medline, and published conference abstracts. Primary outcomes were recurrence and chronic pain. Secondary outcomes were mean operating time, composite complications, surgical reintervention, and time to normal activities. Odds ration and standardized mean differences were calculated.


1377 hernia repairs were identified from a total of 7 trials. Mean follow-up was 12–91 months. There was no difference between the techniques for recurrence [pooled analysis odds ratio: 0.86 (95% CI 0.32–2.28); p = 0.76] and chronic pain [pooled analysis odds ratio: 1.00 (95% CIs 0.65–1.55); p = 1]. Prolene hernia system demonstrated a shorter time to return to normal activities [pooled weighted mean difference − 0.54 (95% CI − 1.07 to − 0.01); p = 0.04]. Other outcomes were similar in mean operating time, composite complications, and surgical reintervention.


Both prolene hernia system and Lichenstein repair appear comparable acceptable techniques for inguinal herniorrhaphy. Further longer-term studies of new mesh technologies will improve information available to surgeons and their patients.


Meta-analysis Lichtenstein Prolene hernia system Recurrence Long-term follow-up 



The authors would like to thank Drs. Magnusson and Kingsnorth for providing further information and data for inclusion in this meta-analysis.

Compliance with ethical standards

Conflict of interest

The authors have neither conflict of interest nor funding for this meta-analysis.

Ethical approval

This was deemed to not be required.

Human and animal rights

This article does not contain any direct involvement of human participants as it is comprised of data from papers already published.

Informed consent

Informed consent was not necessary for this study


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General SurgeryWorthing HospitalWorthingUK

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