Improved recurrence rates after groin hernia surgery have led to chronic pain becoming the most troublesome postoperative complication. Self-gripping mesh was developed to decrease the risk for development of chronic pain. The aim of this nationwide cohort study was to compare recurrence rate and chronic pain 1 year after an open, anterior mesh repair of inguinal hernias with either a self-gripping mesh or other lightweight mesh.
All operations registered as open anterior mesh repair (Lichtenstein) in the Swedish Hernia Registry between September 2012 and October 2016 were selected. At 1 year after repair, patients were sent a pain questionnaire assessing chronic pain. We compared the prevalence of chronic pain and reoperation for recurrence using lightweight, sutured mesh or self-gripping mesh.
We analyzed the 1,803 repairs using self-gripping mesh and 16,567 repairs using lightweight mesh. We found no difference in the prevalence of chronic pain 1 year after the hernia repair between self-gripping mesh and sutured lightweight mesh (OR 0.92, CI 95% 0.80–1.06, P = .257). There was no increase in reoperation for recurrence when using self-gripping mesh (HR 0.71, CI 95% 0.45–1.14, P = .156). Mean operation time was considerably less when using self-gripping mesh (43 vs 70 minutes; P > .001).
The use of self-gripping mesh does not decrease the incidence of chronic pain and reoperation for recurrence compared with lightweight, sutured mesh for open anterior mesh repair of inguinal hernias. Furthermore, the use of self-gripping mesh is associated with a clinically important, lesser operation time.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Nationwide prevalence of groin hernia repair.PLoS One. 2013; 8e54367
- A clinician’s guide to patient selection for watchful waiting management of inguinal hernia.Ann Surg. 2011; 253: 605-610
- The tension-free hernioplasty.Am J Surg. 1989; 157: 188-193
- Open mesh versus non-mesh for repair of femoral and inguinal hernia.Cochrane Database Syst Rev. 2002; 4: CD002197
- Chronic pain after mesh repair of inguinal hernia: A systematic review.Am J Surg. 2007; 194: 394-400
- Risk factors for long-term pain after hernia surgery.Ann Surg. 2006; 244: 212-219
- Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair.Br J Surg. 2012; 99: 29-37
- Chronic postoperative pain: The case of inguinal herniorrhaphy.Br J Anaesth. 2005; 95: 69-76
- Comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: A meta-analysis of long-term results.Surgery. 2018; 163: 351-360
- Measuring patients’ experiences and outcomes.BMJ. 2009; 339: 2495
- The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies.Int J Surg. 2014; 12: 1495-1499
- Hernia registers and specialization.Surg Clin North Am. 1998; 78: 1141-1155
- Validation of an inguinal pain questionnaire for assessment of chronic pain after groin hernia repair.Br J Surg. 2008; 95: 488-493
- The Swedish personal identity number: Possibilities and pitfalls in healthcare and medical research.Eur J Epidemiol. 2009; 24: 659-667
- Regression models and life-tables.JR Stat Soc. 1972; 34: 187-220
- Patient-reported rates of chronic pain and recurrence after groin hernia repair.Br J Surg. 2018; 105: 106-112
- Decreasing prevalence of chronic pain after laparoscopic groin hernia repair: A nationwide cross-sectional questionnaire study.Surg Today. 2018; 48: 796-803
- International guidelines for groin hernia management.Hernia. 2018; 22: 1-165
- Long-term comparison of recurrence rates between different lightweight and heavyweight meshes in open anterior mesh inguinal hernia repair: A nationwide population-based register study.Ann Surg. 2019; https://doi.org/10.1097/SLA.0000000000003219
- Patient-related risk factors for recurrence after inguinal hernia repair: A systematic review and meta-analysis of observational studies.Surg Innov. 2015; 22: 303-317
- The HIPPO trial, a randomized double-blind trial comparing self-gripping Parietex Progrip Mesh and Sutured Parietex mesh in Lichtenstein hernioplasty: A long-term follow-up study.Ann Surg. 2017; 266: 939-945
- Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair.Br J Surg. 2013; 100: 474-481
- Reoperation as surrogate endpoint in hernia surgery. A three year follow-up of 1565 herniorrhaphies.Eur J Surg. 1998; 164: 45-50
- Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) study group. Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair.Br J Surg. 2010; 97: 600-608
Published online: December 12, 2019
Accepted: November 11, 2019
© 2019 Elsevier Inc. All rights reserved.
ScienceDirectAccess this article on ScienceDirect
- Re: Chronic pain and risk for reoperation for recurrence after inguinal hernia repair using self-gripping meshSurgeryVol. 169Issue 5
- PreviewWe read with interest the report by Axman et al1 entitled “Chronic pain and risk for reoperation for recurrence after inguinal hernia using self-gripping mesh.” We found this subject relevant because chronic pain after inguinal hernia repair remains one of the main postoperative complications than can cause chronic distress to patients. The authors reported a rate of 15% of patients with chronic pain after inguinal hernia repair, and although in their methods section they reported to have recorded how the surgeon handled the nerves, these data were not published.