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Efficacy of Macroporous Polytetrafluoroethylene Mesh in Laparoscopic Hernia Repair (PTFE)

H

Hospitales Universitarios Virgen del Rocío

Status

Completed

Conditions

Hernia, Inguinal

Treatments

Procedure: Totally Extraperitoneal laparoscopic inguinal hernia repair

Study type

Interventional

Funder types

Other

Identifiers

NCT02023203
LP-PTFE

Details and patient eligibility

About

Inguinal hernia repair is one of the most commonly performed surgeries around the world. It accounts for approximately 75% of all abdominal wall hernias and presents a lifetime risk of 27% in males and 3% in females. Since the modern concept of surgical hernia repair described by Bassini in 1887, with the technique that bears his name, several techniques have been developed in the last century in order to improve surgical outcomes after inguinal hernia repair.

Different open repairs, such as anterior (Shouldice, McVay) or posterior (Stoppa) approach were described and developed, until Lichtenstein described the tension-free hernioplasty concept supported by the use of a prosthetic mesh to repair the hernia defect. Notable Improvements were observed with this technique in terms of recurrence, pain, and discomfort in comparison with previous tension repairs. Considerable advantages over open repair have been obtained with the introduction of minimally invasive surgery to inguinal hernia repair, in terms of patient comfort and recurrence rates.

Regarding prosthetic material, meshes have evolved since the first Dacron mesh used by Lichtenstein. First generation meshes were manufactured using more material and for this reason they have been described as heavyweight meshes. New generation meshes have been designed with less material in order to diminish the inflammatory response and foreign body reaction, providing less chronic pain with similar recurrence rates than heavyweight meshes. The density (or weight) of the mesh, measured in g/m2, is inversely proportional to the size of the pore and lately it has been reported that one of the main aspects related to prosthetic materials is pore size. Large pore meshes use less material, consequently they have been associated with a better tissue ingrowth. The large pore of lightweight meshes is conditioned by the less amount of material used.

All previous studies compare both light and heavyweight polypropylene meshes But in order to get a proper comparison of the behavior of meshes in the inguinal region it is important to include the material and the pore size. The aim of our study is to compare patient-reported outcomes with the use of either a Polytetrafluoroethylene (PTFE) large pore mesh (LP-PTFE) vs a small pore polypropylene mesh (SP-PPL).

Full description

Patients fitted for laparoscopic bilateral inguinal hernia repair will be randomized to recieve one of both meshes on study in both inguinal sides.

Enrollment

100 patients

Sex

Male

Ages

20 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • male patients
  • 20-80 years old
  • Primary Bilateral Hernia

Exclusion criteria

  • Women
  • BMI >35
  • Recurrent hernias
  • Previous infraumbilical laparotomy
  • Inguinoscrotal hernias

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Crossover Assignment

Masking

Double Blind

100 participants in 2 patient groups

LP PTFE
Experimental group
Description:
Placement of Large Pore PTFE mesh for inguinal hernia treatment
Treatment:
Procedure: Totally Extraperitoneal laparoscopic inguinal hernia repair
SP-PPL
Active Comparator group
Description:
Placement of Small Pore polypropylene mesh for inguinal hernia treatment
Treatment:
Procedure: Totally Extraperitoneal laparoscopic inguinal hernia repair

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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