Self-gripping Mesh in Inguinal Hernia Repair

Background: Inguinal hernia repair is a common procedure that general surgeons undertake with different techniques aiming for a better outcome. Aim of the work: Comparison between self-gripping mesh and sutures for mesh fixation in open [Lichtenstein] inguinal repair. Patients and Methods: This study is a prospective trial. Fifty adult males scheduled for inguinal hernia repair were classified into two groups: group A [n=25] underwent inguinal repair with self-gripping mesh; group B [n=25]  underwent inguinal repair with mesh fixation using proline sutures. Results: The mean operative time was 37.4 ±13.5 and 48.81±14.7 minutes in groups A and B, respectively. The incidence of seroma, scrotal edema, and wound infection was 4%, 8%, and 8%  in the group [A] compared to 12%, 24%, 12% in the group [B], respectively. No recurrence was reported in either group. However, 12%  and 80% in groups A and B had mild postoperative pain [p < 0.001]. After three months of surgery, no cases of chronic groin pain reported in the group [A] compared to three in the group [B] [p> 0.05]. The mean time to return to normal activities in a group [A] was 2.51days and 5.97 days in the group [B] [p < 0.001]. Mean pain visual analogue scale [VAS] scores at 6 months were 0.5 [0.4 to 1.5] in the self-gripping mesh group and 8.6 [3.3 to 12.5] in sutured mesh group [p < 0.01]. The mean cost of ProGrip mesh was higher than the mean cost of polypropylene mesh [4508 VS 555 LE] [p < 0.001]. Conclusion: Lichtenstein open inguinal hernia repair with ProGrip low-density polyester mesh is a safe, with short operative time, simple and effective method for inguinal hernia repair and may improve patient general health, reduce postoperative pain and improve quality of life. However, its high price makes its use questionable in low economic settings.