Do we have to rethink slit-mesh technique in endoscopic inguinal hernia repair? - A matched pair analysis.

INTRODUCTION

Due to a lack of evidence, the use of slit meshes in laparo-endoscopic hernia repair is a topic of controversial debate. Therefore, further studies are needed on this key question.

METHODS

This retrospective analysis of prospectively recorded data from the Herniamed Registry compared the perioperative and 1-year follow-up outcomes after laparo-endoscopic inguinal hernia repair with slit mesh versus non-slit mesh. Matching was performed for 1,028 pairs.

RESULTS

A significant difference was identified in the recurrence rate on 1-year follow-up in favor of the slit mesh (0.6% vs 1.8%; p = 0.023). No such systematic difference was found for any of the other outcome variables (intraoperative complications, general complications, postoperative complications, complication-related reoperations, pain at rest, pain on exertion, and pain requiring treatment on 1-year follow-up).

CONCLUSION

The use of a slit mesh versus a non-slit mesh in laparo-endoscopic inguinal hernia repair is associated with a significantly lower recurrence rate. There is no relation with any other outcome criteria. Since the use of a slit mesh in laparo-endoscopic inguinal hernia repair seems to influence the outcome, this topic should be further investigated.