A Randomised Control Trial in Comparison of Polypropylene Mesh Versus Polyester Mesh in Open Inguinal Hernia Repair

Abstract

One of the most common surgical problems presenting to the surgical OPD is Inguinal Hernia. Surgery being the main treatment for hernia, surgical techniques of inguinal hernia have undergone great development over centuries and decades. Lichtenstein’s tensionless hernia repair has revolutionized the procedure. It is one of the first surgeries learnt by a surgery resident. While hernia recurrence rates have drastically been brought down by the placement of mesh, post operative pain has become more troublesome in hernioplasty. Polyester is a softer pliable material than the routinely used polypropylene mesh offering the benefit of less post operative pain and improved quality of life Prospective single blinded randomized control trial involving 144 patients assigned to receive lichtenstein repair with polyester mesh (n=72) or polypropylene mesh (n=72). All the patients were operated on by a single surgeon to maintain uniformity and made sure that ilioinguinal, iliohypogastric and genitofemoral nerves were identified intraoperatively and preserved. Patients were observed in the hospital and visual analogue score for pain was recorded postoperatively at 12 hours, 24 hours, 48 hours, 1 week, 1 month and 3 months complications were also noted down and analyzed using two sample t test for continuous variable and Chi-square test for categorical variables. The conclusion from this study is that usage of Polyester mesh is comparable and slightly superior to that of Polypropylene in view of Post operative Pain, duration of Stay in the Hospital and patient acceptance. Further studies are needed to find the optimal mesh for inguinal hernia repair.