Publication:

Impact of different meshes on patient reported outcomes and complications following TEP repair: a comparative approach

Background Minimally invasive inguinal hernia surgery originated in the early 1990s and is gaining popularity in the field of general surgery. A mesh provides a tension-free repair with strengthening of the abdominal wall. This study was undertaken to compare traditional polypropylene and lightweight meshes in TEP inguinal hernioplasty in terms of post-operative patient reported outcomes.

Methods A total of 65 patients were enrolled in the study. Patients were divided into 3 groups i.e. Polypropylene (21), TiMesh-16 (24) and Ultrapro (20) based on mesh used. Assessment of pain was done using visual analogue scale (VAS). Patient reported outcomes were observed on 1st post-operative day (POD), 7th day, 1 month, 6 months and 1 year. Data was analysed using SPSS software ver.22.

Results A total of 94 hernias were operated in 65 patients. Mean operative time in both unilateral and bilateral cases was not significant and showed no correlation with type of mesh used. Mean VAS score of prolene group was significantly more than Ultrapro and TiMesh groups on POD1, POD7, 1 month and 6 months, showing p=0.027 (POD1), p=0.002 (POD7), p=0.017 (1 month) and p=0.00 (6 months) respectively. Patients in LWM groups showed earlier return to activities than Prolene group. No recurrence was observed in either group on 1 year follow-up. Among the study patients, complications of TEP observed were accidental rupture of peritoneum, scrotal swelling, seroma, sub-cutaneous emphysema and conversion to lichtenstein mesh hernioplasty.

Conclusions As per the observations, Light weight mesh placement in TEP Hernioplasty results in better patient reported outcomes.