The effect of mesh type on pain, quality of life and postoperative complications in patients undergoing total extraperitoneal (TEP) technique for laparoscopic inguinal hernia repair.

Abstract

This study aims to compare the effects of anatomical polypropylene mesh (APM) and non-anatomical polypropylene mesh (NAPM) on postoperative pain, quality of life, and complications in patients undergoing inguinal hernia repair using the laparoscopic total extraperitoneal (TEP) technique. In this single-center, retrospective study, data from 88 patients who underwent surgery using the TEP technique between January and November 2023 and met the eligibility criteria were analyzed (APM group: n = 44; NAPM group: n = 44). The primary endpoint of the study was to compare the effect of APM and NAPM mesh types on postoperative 6th-hour VAS scores. The comparison of SF-36 questionnaire results and VAS scores at other time points was defined as the secondary endpoints of the study. The mean (SD) postoperative 6th-hour VAS score was significantly lower in the APM group than in the NAPM group [2.20 (0.90) vs. 2.98 (1.19); p = 0.001]. In addition, the mean (SD) VAS scores at the 1st hour, 24th hour, and 10th day were significantly lower in favor of the APM group (p = 0.008, p = 0.001, and p = 0.030, respectively). However, the mean (SD) VAS scores at the 3rd postoperative month were similar between the groups (p = 0.909). No significant difference was observed between the two groups in the SF-36 questionnaire results (p > 0.05). The postoperative complication rates were similar between the groups (APM: 13.7%, NAPM: 11.4%; p = 0.603). The operation time was significantly shorter in the APM group (p = 0.018). The use of APM for laparoscopic inguinal hernia repair reduces early postoperative pain and shortens operation time. However, it offers similar results to NAPM in terms of quality of life and development of postoperative complications. These findings suggest that APM may be an effective alternative to laparoscopic inguinal hernia repair; however, we are of the opinion that larger-scale, prospective, and randomized-controlled studies are needed to better evaluate long-term outcomes.