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A preliminary evaluation of two different meshes in minimally invasive inguinal hernia surgery

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Abstract

Background

Many meshes are available for use in laparoscopic inguinal hernia repair. The surgeon must consider several factors when choosing a mesh for hernia repair including clinical outcomes, cost, and ease of use. The purpose of this study was to compare two different lightweight polypropylene meshes for laparoscopic and robotic inguinal hernia repairs.

Methods

Subjects were randomized immediately before surgery. Data were reported in N (%) and median [Q1–Q3], comparisons of mesh insertion time were tested using a 2 × 2 ANOVA on the ranked times, comparisons between categorical variables were tested with Fisher’s Exact, and all data were analyzed using SAS® 9.4 (SAS Institute, Inc.).

Results

Between January 2015 and June 2016, 50 subjects were enrolled; two were excluded. Of 48 eligible subjects, most were Caucasian (N = 42, 88%), male (N = 37, 77%), with a median age of 63, and were randomized evenly between 3DMax™ mesh and Ultrapro® mesh. Robotic mesh placement significantly increased insertion time regardless of mesh type (p < .0001). When comparing NASA-TLX self-assessment surveys, there was no significant difference between the meshes in difficulty of placement. The type of mesh did not significantly impact the insertion time regardless of robot use (p = 0.523).

Conclusion

Our data demonstrate that mesh insertion times comparing two different lightweight polypropylene meshes were not significantly different. Increased insertion times associated with robotic repair are likely due to the mechanics of robotic suturing and associated learning curve. Our data suggest that these meshes can be used interchangeably based on the surgeon’s preference.

Clinical trial registration number: NCT01825187.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, New Hanover Regional Medical Center, 2131 South 17th Street, Wilmington, NC, 28402, USA

    Jordan A. Bilezikian, Paul L. Tenzel, Robert G. Johnson, William F. Powers IV & William W. Hope

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  1. Jordan A. Bilezikian
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  2. Paul L. Tenzel
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  3. Robert G. Johnson
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  4. William F. Powers IV
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  5. William W. Hope
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Correspondence to William W. Hope.

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Disclosures

Outside the submitted work, Dr. Hope has received payment for consultancy from CR Bard and WL Gore, for expert testimony in legal cases, and for lectures/speakers’ bureau from CR Bard, WL Gore, and Intuitive Surgical. Drs. Bilezikian, Tenzel, Johnson and Powers have no conflicts of interest or financial ties to disclose.

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Bilezikian, J.A., Tenzel, P.L., Johnson, R.G. et al. A preliminary evaluation of two different meshes in minimally invasive inguinal hernia surgery. Surg Endosc 35, 1342–1347 (2021). https://doi.org/10.1007/s00464-020-07512-9

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  • DOI: https://doi.org/10.1007/s00464-020-07512-9

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