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Partially absorbable composite mesh versus non-absorbable polypropylene mesh in laparoscopic repair of inguinal hernia in a tertiary care center

Rohit Kumar Gohil, Tapan Kumar Nayak, Sanjay Kumar Mahapatra, Dibakar Sarkar, Sanjay Kujur, Saroja Dash.




Abstract

Background: The choice of mesh is far more important than the technique used as a determinant of patient outcome. Randomized studies have compared polypropylene and modified composite mesh (polypropylene and polyglactin) and found decreased foreign body reactions and post-operative complications and improved long-term quality of life with the use of composite mesh. However, a limited number of studies have been done comparing the early outcomes such as inguinodynia, the presence of a seroma or hematoma, foreign body sensation, testicular problems, and the return to normal work activities.

Aims and Objectives: The primary objective was to assess and compare the early outcome of non-absorbable polypropylene mesh vs. partially absorbable composite mesh in laparoscopic inguinal hernia repair. The secondary objective was to compare the complications associated with both types of mesh hernioplasty.

Materials and Methods: A total of 50 cases of elective reducible indirect inguinal hernia patients admitted to the Department of Surgery, VIMSAR, Burla, were included in our study. The total group was split into Group A and Group B of 25 cases each. All patients underwent laparoscopic inguinal hernia repair transabdominal prepeitoneal. The partially absorbable composite lightweight meshes are used in Group A, and the non-absorbable polypropylene meshes are used in Group B. After surgery, comparison between the two groups was made on the basis of parameters such as age distribution, inguinodynia, analgesia, foreign body sensation, presence of a lump (hematoma or seroma), return to work activities, and recurrence.

Results: The mean age of patients is 50.24 ± 12.994 years. The majority of the patients were in the age group of 51–60 years. Initially, there was no significant difference in transient neuralgia between the two groups, but after 6 weeks, Group A had significantly less pain. Foreign body sensation is significantly more in Group B, but later, this was not significant.

Conclusion: Based on the results of this study, composite mesh may be recommended for use in laparoscopic inguinal hernia repair owing to the less pain, less foreign body sensation, and earlier return to work.

Key words: Composite Mesh; Non-absorbable Mesh; Transabdominal Pre-peritoneal Mesh Repair






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