Long-term Results of a Randomized Double-blinded Prospective Trial of a Lightweight (Ultrapro) Versus a Heavyweight Mesh (Prolene) in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair (TULP-trial).

Abstract:

OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior inguinal hernia repair. The discussion about a similar benefit for laparoscopic repair is ongoing, but concerns exist about higher recurrence rates. METHODS:Between March 2010 and October 2012, male patients who presented with a primary, reducible unilateral inguinal hernia who underwent day-case TEP repair were eligible. Outcome parameters included chronic pain, recurrence, foreign body feeling, and quality of life scores. RESULTS:During the study period, 950 patients were included. One year postoperatively the presence of relevant pain (Numeric Rating Score 4-10) was significantly higher in the lightweight mesh group (2.9%) compared with the heavyweight mesh group (0.7%) (P = 0.01), and after 2 years this difference remained significant (P = 0.03). There were 4 (0.8%) recurrent hernias in the heavyweight mesh group and 13 (2.7%) in the lightweight group (P = 0.03). No differences in foreign body feeling or quality of life scores were detected. CONCLUSIONS:In TEP hernia surgery, there was no benefit of lightweight over heavyweight meshes observed 2 years postoperatively.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Burgmans JP,Voorbrood CE,Simmermacher RK,Schouten N,Smakman N,Clevers G,Davids PH,Verleisdonk EM,Hamaker ME,Lange JF,van Dalen T

doi

10.1097/SLA.0000000000001579

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

862-6

issue

5

eissn

0003-4932

issn

1528-1140

journal_volume

263

pub_type

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