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Impact of Polypropylene Amount on Functional Outcome and Quality of Life after Inguinal Hernia Repair by the TAPP Procedure Using Pure, Mixed, and Titanium-coated Meshes

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Abstract

Background

Laparoscopic inguinal hernia repair requires the use of prosthetic material. This prospective, single-center study was intended to investigate the impact of the amount of polypropylene (PP) mesh used in hernia repair on functional results and quality of life.

Methods

For this series, 672 consecutive patients with primary inguinal hernia undergoing transabdominal preperitoneal hernia repair (TAPP) using a heavyweight PP mesh (Prolene 10 × 15 cm, 1.5 g, group I, n = 232), a mixed PP- and Polyglactin mesh (Vypro II, 10 × 15 cm, 0.53 g, group II, n = 217), or a light-weight titanized PP mesh (Ti-Mesh, 10 × 15 cm, 0.24 g, group III, n = 223) were compared in terms of postoperative complications (seroma, wound healing disorders), quality of life score (pain development, physical condition, urologic disorders), and hernia recurrence.

Results

During a 12-month follow-up there were no significant differences in the recurrence rate (1.3%-1.7%). Patients with a pure PP mesh (group I) showed significantly more postoperative seromas (12.1% versus 4.1%/1.8%), foreign body sensations (9.1% versus 5.5%/3.5%), and sensitivity to weather changes (5.6% versus 3.2%/2.2%) compared to groups II and III. In all groups, the quality of life score was improved postoperatively. However, among those patients in our series with few preoperative complaints, the postoperative quality of life was worsened when heavy-weight PP meshes (group I+II) were used but significantly improved when light-weight titanized PP meshes were used.

Conclusions

Comparable functional results, fewer postoperative complications, and improved quality of life can be achieved by reducing the amount of PP in meshes used for laparoscopic hernia repair by TAPP procedure.

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References

  1. Klinge U, Junge K, Stumpf M, et al. Functional and morphological evaluation of a lowweight, monofilament polypropylene mesh for hernia repair. J Biomed Mater Res 2002;63:129–136

    Article  PubMed  CAS  Google Scholar 

  2. Junge K, Klinge U, Rosch R, et al. Functional and morphologic properties of a modified mesh for inguinal hernia repair. World J Surg 2002;26:1472–1480

    Article  PubMed  Google Scholar 

  3. Bittner R, Kraft K, Schmedt CG, et al. Risks and benefits of laparoscopic hernioplasty (TAPP)—5 years of experience in 3,400 hernia repairs. Chirurg 1998;69:854–858

    Article  PubMed  CAS  Google Scholar 

  4. Tamme C, Scheidbach H, Hampe C, et al. Totally extraperitoneal endoscopic inguinal hernia repair (TEP): results of 5,203 hernia repairs. Surg Endosc 2003;17:190–195

    Article  PubMed  CAS  Google Scholar 

  5. Avtan L, Avci C, Bulut T, et al. Mesh infections after laparoscopic inguinal hernia repair. Surg Laparosc Endosc 1997;7:192–195

    Article  PubMed  CAS  Google Scholar 

  6. EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh: metaanalysis of randomized controlled trials. Ann Surg 2002;235:322–332

    Google Scholar 

  7. Hume RH, Bour J. Mesh migration following laparoscopic inguinal hernia repair. J Laparoendosc Surg 1996;6:333–335

    PubMed  CAS  Google Scholar 

  8. McCormack K, Scott NW, Go PM, et al. EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003;1:CD001785

    PubMed  Google Scholar 

  9. Klosterhalfen B, Klinge U, Hermanns B, et al. Pathology of traditional surgical nets for hernia repair after long-term implantation in humans. Chirurg 2000;71:43–51

    PubMed  CAS  Google Scholar 

  10. Schumpelick V, Klosterhalfen B, Muller M, et al. Minimized polypropylene mesh for preperitoneal net plasty (PNP) of incisional hernias. Chirurg 1999;70:422–430

    Article  PubMed  CAS  Google Scholar 

  11. Schultz L, Graber J, Pietrafitta J, et al. Laser laparoscopic herniorraphy: a clinical trial preliminary results. J Laparoendosc Surg 1990;1:41–45

    PubMed  CAS  Google Scholar 

  12. Birkmeyer JD, Stukel TA, Siewers AE, et al. Surgeon Volume and Operative Mortality in the United States. N Engl J Med 2003;22:2117–2127

    Article  Google Scholar 

  13. Koninger J, Redecke J, Butters M. Chronic pain after hernia repair: a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg 2004;389:361–365

    Article  PubMed  Google Scholar 

  14. Kumar S, Wilson RG, Nixon SJ, et al. Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 2002;89:1476–1479

    Article  PubMed  CAS  Google Scholar 

  15. Awad SS, Fagan SP. Current approaches to inguinal hernia repair. Am J Surg 2004;188:9S–16S

    Article  PubMed  Google Scholar 

  16. Bay-Nielsen M, Nilsson E, Nordin P, et al. Swedish Hernia Data Base the Danish Hernia Data Base. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. Br J Surg 2004;91:1372–1376

    Article  PubMed  CAS  Google Scholar 

  17. Bringman S, Heikkinen TJ, Wollert S, et al. Early results of a single-blinded, randomized, controlled, Internet-based multicenter trial comparing Prolene and Vypro II mesh in Lichtenstein hernioplasty. Hernia 2004;8:127–134

    Article  PubMed  Google Scholar 

  18. Schardey HM, Schopf S, Rudert W, et al. Titanised polypropylene meshes: first clinical experience with the implantation in TAPP technique and the results of a survey in 22 German surgical departments (German). Zentralbl Chir 2004;129:363–368

    Article  PubMed  CAS  Google Scholar 

  19. Schmidbauer S, Ladurner R, Hallfeldt KK, et al. Heavy-weight versus low-weight polypropylene meshes for open sublay mesh repair of incisional hernia. Eur J Med Res 2005;10:247–253

    PubMed  CAS  Google Scholar 

  20. Heikkinen T, Wollert S, Osterberg J, et al. Early results of a randomised trial comparing Prolene and VyproII mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias. Hernia 2005;9:1–7

    Google Scholar 

  21. McCormack K, Wake BL, Fraser C, et al. Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair: a systematic review. Hernia 2005;9:109–114

    Article  PubMed  CAS  Google Scholar 

  22. Eypasch E, Wood-Dauphinee S, Williams JI, et al. The Gastrointestinal Quality of Life Index. A clinical index for measuring patient status in gastroenterologic surgery. Chirurg 1993;64:264–274

    PubMed  CAS  Google Scholar 

  23. Scheidbach H, Tamme C, Tannapfel A, et al. In vivo studies comparing the biocompatibility of various polypropylene meshes and their handling properties during endoscopic total extraperitoneal (TEP) patchplasty: an experimental study in pigs. Surg Endosc 2004;18:211–220

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Herz-Jesu-Hospital Muenster-Hiltrup, Westfalenstr. 109, D-48165, Muenster, Germany

    Ruediger Horstmann MD, Matthias Hellwig MD, Claus Classen MD & Susanne Röttgermann MD

  2. Department of General Surgery, Münster University Hospital, Waldeyerstr. 1, D-48149, Muenster, Germany

    Daniel Palmes MD

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  1. Ruediger Horstmann MD
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  2. Matthias Hellwig MD
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  3. Claus Classen MD
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  4. Susanne Röttgermann MD
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  5. Daniel Palmes MD
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Correspondence to Ruediger Horstmann MD.

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Horstmann, R., Hellwig, M., Classen, C. et al. Impact of Polypropylene Amount on Functional Outcome and Quality of Life after Inguinal Hernia Repair by the TAPP Procedure Using Pure, Mixed, and Titanium-coated Meshes. World J. Surg. 30, 1742–1749 (2006). https://doi.org/10.1007/s00268-005-0242-3

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