Multicentre Randomised Controled Trial Comparing the Effect of a New Self-gripping Lightweight Polyester Mesh and a Normal Sutured Lightweight Polyester Mesh on the Incidence of Chronic Inguinodynia in Lichtenstein Hernioplasty.

INTRODUCTION

In 1984 Lichtenstein popularized routine use of a heavy weight polypropylene mesh fixed with non-absorbable sutures to create a tension-free hernioplasty. This technique became the gold standard in many clinics due to its low rate of recurrence and direct post-operative pain6. Focus has now shifted to the occurrence of chronic pain and neuralgia after Lichtenstein hernioplasty. Chronic post-operative pain has been defined as pain lasting more than 3 months after surgery. The surgical repair technique seems to be an important etiologic factor in this. This includes aspects like type of mesh used, manner of fixation of the prosthetic material and handling of the cutaneous nerves.

The aim of this study is to investigate differences in incidence of chronic post-operative pain between the two types of fixation for the same mesh. The mesh used is ligthweight and made of polyester. The mesh will be fixated by either non-adsorbable sutures, according to Lichtenstein, or by small microhooks on the lower surface of the mesh (Parietex Progrip Mesh, Covidien).

Rationale for the Parietex Progrip Mesh

To reduce post-operative chronic pain it is thought being important to use low weight large pore size oligofilament meshes fixed with a minimal use of devices or no devices at all. This both to minimize compression/entrapment neuropathy and inflammation. The Parietex Progrip mesh biocompatibility is enhanced using low-weight monofilament isoelastic polyester with large pores. The hydrophilic characteristics of polyester are known to cause less shrinkage and fibrotic tissue formation than the more standard polypropylene.