A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair

Am J Surg. 2013 Jun;205(6):726-36. doi: 10.1016/j.amjsurg.2012.07.046. Epub 2013 Apr 3.

Abstract

Background: A systematic analysis was conducted of randomized controlled trials (RCTs) comparing lightweight mesh (LWM) with heavyweight mesh in laparoscopic inguinal hernia repair.

Methods: Data extracted from the included RCTs were analyzed according to the principles of meta-analysis.

Results: Eleven RCTs encompassing 2,189 patients were analyzed. In a fixed-effects model, operating time, postoperative pain, and recurrence rate were statistically similar between LWM and heavyweight mesh. LWM was associated with fewer perioperative complications and a reduced risk for developing chronic groin pain. There was also a reduced risk for developing other groin symptoms, such as foreign body sensations, but it was not statistically significant.

Conclusions: The use of LWM for laparoscopic inguinal hernia repair is not associated with an increased risk for hernia recurrence. LWM reduces the incidence of chronic groin pain, groin stiffness, and foreign body sensations. Therefore, LWM may routinely be used in laparoscopic inguinal hernia repair. However, high-quality RCTs with longer follow-up periods are required to validate these findings.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chronic Pain / etiology*
  • Equipment Design
  • Groin*
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / instrumentation
  • Humans
  • Laparoscopy*
  • Randomized Controlled Trials as Topic
  • Surgical Mesh / adverse effects*