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Study: Open inguinal repair w self gripping mesh, interesting pain outcomes.
I found this interesting not because of the novel mesh used but because it involved a very common Lichtenstein approach and reported pain/ neuralgia problems in around 50% of patients in all but one persons hands. Reoccurrence rates were the typical 1-3% upon with the success of this method was founded.
The numbers are somewhat alarming although it doesn’t quantify well how debilitating these outcomes were.
Really puts a spotlight on pain being as Critical an outcome as reoccurrence.
Outcome of open inguinal hernia repair using sutureless self-gripping mesh – a retrospective single cohort study
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I am reminded of two tendentious questions whether it is true that the Liectenstein operation is really the gold standard or, as some supporters of minimal repair argue, a more invasive operation for the nerves. second question: from this study it emerges that only one patient was treated with local anesthesia (unfortunately there is no data related to the outcomes based on anesthesia) .. I have read, albeit occasionally, that the prevalence of chronic pain has been related to various causes, including age, pre-operative pain, but also the type of anesthesia … obviously I refer elements taken from targeted follow-ups, now on anesthesia, sometimes on the procedure
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My takeaway from this is that the Chief Surgeon was probably taught proper anatomy when he or she was a student, and learnt to properly discern the tissues/nerves etc in the area.
The younger surgeons were probably taught a simplified curriculum with the idea that using mesh would not require more….
What will happen in the years to come?
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