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The use of self-gripping (Progrip™) mesh during laparoscopic total extraperitoneal (TEP) inguinal hernia repair: a prospective feasibility and long-term outcomes study

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An Erratum to this article was published on 20 February 2015

Abstract

Background

The use of self-gripping mesh during laparoscopic TEP inguinal hernia repairs may eliminate the need for any additional fixation, and thus reduce post-operative pain without the added concern for mesh migration. Long-term outcomes are not yet prospectively studied in a controlled fashion.

Methods

Under IRB approval, from January 2011–April 2013, 91 hernias were repaired laparoscopically with self-gripping mesh without additional fixation. Patients were followed for at least 1 year. Demographics and intraoperative data (defect location, size, and mesh deployment time) are recorded. VAS is used in the recovery room (RR) to score pain, and the Carolinas Comfort Scale ™ (CCS), a validated 0–5 pain/quality of life (QoL) score where a mean score of >1.0 means symptomatic pain, is employed at 2 weeks and at 1 year. Morbidities, narcotic usage, days to full activity and return to work, and CCS scores are reported.

Results

Sixty two patients, with 91 hernias repaired with self-gripping mesh, completed follow-up at a mean time period of 14.8 months. Seventeen hernias were direct defects (average size 3.0 cm). Mesh deployment time was 193.7 s. RR pain was 1.1/10 using a VAS. Total average oxycodone/acetaminophen (5 mg/325 mg) usage = 5.0 tablets, days to full activity was 1.6, and return to work was 4.2 days. Thirteen small asymptomatic seromas were palpated without any recurrences or groin tenderness, and all seromas resolved by the 6 month visit. Transient testis discomfort was reported in five patients. Urinary retention was 3.2 %. Mean CCS™ scores at the first visit for groin pain laying, bending, sitting, walking, and step-climbing were 0.2, 0.5, 0.4, 0.3, and 0.3, respectively. At the first post op visit, 4.8 % had symptomatic pain (CCS > 1). At 14.8 months, no patients reported symptomatic pain with CCS scores for all 62 patients averaging 0.02, (range 0–0.43). There are no recurrences thus far.

Conclusions

Self-gripping mesh can be safely used during laparoscopic TEP inguinal hernia repairs; our cohort had a rapid recovery, and at the 1-year follow-up visit, there were no recurrences and no patients reported any chronic pain as defined by a CCS™ > 1.

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Disclosures

Dr. Brian Jacob provides consulting services for Covidien (New Haven, CT). Bresnahan Erin, Bates Andrew, Wu Andrew, Reiner Mark and Jacob Brian have financial interests to disclose.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai Medical Center, New York, USA

    Erin Bresnahan, Andrew Wu, Mark Reiner & Brian Jacob

  2. Department of Surgery, Mount Sinai Hospital, New York, USA

    Andrew Bates & Brian Jacob

  3. Metabolic, Endocrine and Minimally Invasive Surgery, Icahn Mount Sinai School of Medicine, New York, USA

    Andrew Wu

  4. Department of Surgery, Laparoscopic Surgical Center of New York, New York, USA

    Brian Jacob

Authors
  1. Erin Bresnahan
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  2. Andrew Bates
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  3. Andrew Wu
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  4. Mark Reiner
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  5. Brian Jacob
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Correspondence to Andrew Bates.

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Bresnahan, E., Bates, A., Wu, A. et al. The use of self-gripping (Progrip™) mesh during laparoscopic total extraperitoneal (TEP) inguinal hernia repair: a prospective feasibility and long-term outcomes study. Surg Endosc 29, 2690–2696 (2015). https://doi.org/10.1007/s00464-014-3991-y

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  • DOI: https://doi.org/10.1007/s00464-014-3991-y

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