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TEP With Long-Term Resorbable Mesh in Patients With Indirect Inguinal Hernia.

Journal article
Authors Fernando Ruiz-Jasbon
Kristina Ticehurst
Jukka Ahonen
Jonny Norrby
Marie-Louise Ivarsson
Published in JSLS : Journal of the Society of Laparoendoscopic Surgeons
Volume 22
Issue 1
ISSN 1938-3797
Publication year 2018
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Clinical Sciences
Language en
Links dx.doi.org/10.4293/JSLS.2017.00076
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Absorbable implant; Chronic pain and recurrence; Hernia; Indirect inguinal hernia
Subject categories Clinical Medicine

Abstract

The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh. This is the first human study to use long-term degradable mesh with the TEP approach.This study was prospective, including 35 primary IHs surgically treated with TEP repair using TIGR Mesh (Novus Scientific Pte, Ltd, Singapore). At the 1-year follow-up recurrence was assessed by clinical examination and the incidence of pain or discomfort was assessed before and after surgery by Visual Analog Scale (VAS) and Inguinal Pain Questionnaire (IPQ).After 12 months, no patients had chronic pain. Only 1 (2.8%) patient reported pain using the VAS (score = 2), and 4 patients reported pain that could easily be ignored. All 4 patients reported less pain 1 year after the operation using both IPQ and VAS, compared with the preoperative assessment. One patient (2.8%) developed a recurrence 20 months after the primary operation.TEP repair using a synthetic long-term resorbable mesh was found to be safe and promising regarding pain and discomfort at 1-year follow-up in patients with IH. Longer follow-up is necessary to establish the risk of recurrence.

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