Hernia repair is one of the most commonly performed surgical procedures worldwide. The number of surgical techniques and available equipment is considerable and several alternatives have been introduced and suggested over the years. Common to them all is that none is "perfect", and complication rates - most commonly discomfort and pain (up tp 15-20% of patients ) and hernia recurrence (up to 10-15%) continues to be a problem.
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| Resorbable polylactic acid (PLA) microgrips, from Covidien |
A recent sutureless mesh was introduced by Covidien (Parietene ProGrip TM) with the idea that this would
Now the DANGRIP Study Group have performed a randomized multicentre clinical trial comparing a self-gripping mesh (Parietene Progrip®) and sutured mesh for open primary repair of uncomplicated inguinal hernia by the Lichtenstein technique. Patients were assessed before surgery, on the day of operation, and at 1 and 12 months after surgery. The primary endpoint was moderate or severe symptoms after 12 months, including a combination of chronic pain, numbness and discomfort.
The intention-to-treat population comprised 163 patients with self-gripping mesh and 171 with sutured mesh. The 12-month prevalence of moderate or severe symptoms was 17·4 and 20·2 per cent respectively (P = 0·573). There were no significant differences between the groups in postoperative complications (33·7 versus 40·4 per cent; P = 0·215), rate of recurrent hernia within 1 year (1·2 per cent in both groups) or quality of life.
The authors conclude that, the avoidance of suture fixation using a self-gripping mesh was not accompanied by a reduction in chronic symptoms after inguinal hernia repair.
For the full study details, please see:
Jorgensen, L. N., Sommer, T., Assaadzadeh, S., Strand, L., Dorfelt, A., Hensler, M., Rosenberg, J. and for the Danish Multicentre DANGRIP Study Group (2012), Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair. Br J Surg. doi: 10.1002/bjs.9006
Hernia mesh is used to repair hernias. It holds a long term repair at the site and it varies in material and sizes.
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