Pikli Batabyal1, Richard L Haddad1, Jaswinder S Samra1, Simon Wickins1, Edmund Sweeney2, Thomas J Hugh3. 1. Northern Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St. Leonards, NSW, Australia. 2. Department of Anaesthesia, North Shore Private Hospital, University of Sydney, Sydney, NSW, Australia. 3. Northern Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St. Leonards, NSW, Australia. Electronic address: tom.hugh@sydney.edu.au.
Abstract
BACKGROUND: The type of inguinal hernia repair used depends on many factors but predominantly the surgeon's training, interpretation of the literature, and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed as an outpatient procedure using 2 different mesh types. METHODS: Analysis was undertaken on 540 consecutive patients who underwent inguinal hernia repair between January 2007 and December 2012. Short-term outcomes were compared between those repaired with conventional polypropylene mesh and those with Parietex ProGrip mesh. RESULTS: Most patients were male (89%) and the mean age was 63 years. The median operative time was 50 minutes for unilateral hernias and 90 minutes for bilateral hernias. The use of Parietex ProGrip mesh reduced the operative time to 40 minutes for unilateral hernias (P < .01) and 75 minutes for bilateral hernias (P < .01). After unilateral hernia repair, 88% of the patients were discharged home within 4 hours of operation. There was no mortality and the overall complication rate was 7.4%. One patient developed a pulmonary embolus but the remainder of the complications were minor. Twenty-four hours postoperatively, 74% of the patients were either totally pain free or had minimal discomfort. At 4 weeks, 97% of the patients were either pain free or had minimal discomfort. Patients who underwent unilateral inguinal hernia repair with Parietex ProGrip mesh had the most rapid return to normal activities (10 vs 14 days, P < .04). CONCLUSIONS: Open anterior inlay mesh repair is safe and results in minimal postoperative pain and early return to normal activities. ProGrip mesh resulted in a shorter operative time and more rapid return to normal activities compared with polypropylene mesh (10 vs 14 days).
BACKGROUND: The type of inguinal hernia repair used depends on many factors but predominantly the surgeon's training, interpretation of the literature, and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed as an outpatient procedure using 2 different mesh types. METHODS: Analysis was undertaken on 540 consecutive patients who underwent inguinal hernia repair between January 2007 and December 2012. Short-term outcomes were compared between those repaired with conventional polypropylene mesh and those with Parietex ProGrip mesh. RESULTS: Most patients were male (89%) and the mean age was 63 years. The median operative time was 50 minutes for unilateral hernias and 90 minutes for bilateral hernias. The use of Parietex ProGrip mesh reduced the operative time to 40 minutes for unilateral hernias (P < .01) and 75 minutes for bilateral hernias (P < .01). After unilateral hernia repair, 88% of the patients were discharged home within 4 hours of operation. There was no mortality and the overall complication rate was 7.4%. One patient developed a pulmonary embolus but the remainder of the complications were minor. Twenty-four hours postoperatively, 74% of the patients were either totally pain free or had minimal discomfort. At 4 weeks, 97% of the patients were either pain free or had minimal discomfort. Patients who underwent unilateral inguinal hernia repair with Parietex ProGrip mesh had the most rapid return to normal activities (10 vs 14 days, P < .04). CONCLUSIONS: Open anterior inlay mesh repair is safe and results in minimal postoperative pain and early return to normal activities. ProGrip mesh resulted in a shorter operative time and more rapid return to normal activities compared with polypropylene mesh (10 vs 14 days).
Authors: Charles P Shahan; Nathaniel N Stoikes; Esra Roan; James Tatum; David L Webb; Guy R Voeller Journal: Surg Endosc Date: 2016-07-21 Impact factor: 4.584
Authors: José Bueno-Lledó; Antonio Torregrosa; Brenda Arguelles; Omar Carreño; Providencia García; Santiago Bonafé; José Iserte Journal: Int J Surg Case Rep Date: 2017-03-16