Aim: Lichtenstein Inguinal hernia repair is one of the most common surgical procedures performed throughout the world. Albeit a number of techniques have been described but at present Lichtenstein tension free mesh repair is the standard of care in the treatment of inguinal hernia.. This study aims to compare the heavy and light weight meshes used in their management.

Material & Methods: This is a  prospective comparative study on outcomes between Heavy (Polypropylene) and light (Polypropylene+polyglactin) weight mesh in Lichtenstein repair of inguinal hernia patients admitted in Department of Surgery, J.A. Group of hospital associated with Gajra Raja Medical College, Gwalior from April.2017-Dec.2018. Comprising 30 patients in each group

Results: A total of 60 patients were studied (30 patients in each group). Age group of 31-50 yrs had highest incidence of inguinal hernia. Males are more commonly affected by inguinal hernia than females. Foreign body sensation in heavy mesh group is significantly higher than light mesh group. Average of 15.00% of the patients had foreign body sensation in Heavy mesh group, where as in light group average was 10%. Chronic pain was also more common in heavy mesh group. Stiffness around incisional site was complained by 10% of overall patients in the heavy mesh group whereas no patients had this complaint in light mesh group. Recurrence was neither seen in heavy mesh group nor in light weight mesh group patients.

Conclusion: Inguinal hernia is seen predominantly in elderly male population, most common complications after inguinal hernia surgeries are Chronic pain, Foreign body sensation, Recurrence, Stiffness around incisional site. In my study light mesh has been proved to be better than heavy mesh to be used as prosthesis in inguinal hernia

Keywords: Comparative, Hernia, Heavy, Light, Lichtenstein, Polypropylene, Polypropylene+polyglactin

1. Fitzgibbons RJ, Giobbie HA, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M et al.Watchful waiting v/s repair of inguinal hernia in minimally symptomatic men: A randomized clinical trial. JAMA 2006;295:285-92.  
2. Akolekar D, Kumar S, Khan LR, de Beaux AC, Nixon SJ. Comparison of recurrence with light weight composite polypropylene mesh and heavy weight mesh in laparoscopic totally extraperitoneal inguinal hernia repair: An audit of 1,232 repairs. Hernia 2008;12:39-43.  
3. Champault G, Bernard C, Rizk N, Polliand C. Inguinal hernia repair: the choice of prosthesis outweighs that of technique. Hernia 2007;11(2):125-8
4. Bittner R, Leibl BJ, Kraft B, Schwarz J. One-year results of a prospective, randomized clinical trial comparing four meshes in laparoscopic inguinal hernia repair. Hernia 2011;15:503-10.  
5. Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R. Chronic pain after mesh repair of inguinal hernia: A systematic review.Am J Surg 2007;194:394-400.   

6. Rutkow IM.A selective history of groin hernia surgery in the early 19^th The anatomic atlas of Astley Cooper, Franz Hesselbach, Antonio Scarpa, and Jules-GermainCloquet. SurgClin North Am 1998 Dec;78(6):921-40.
7. Sajid MS, Leaver C, Baig MK, Sains P.Systematic review and meta-analysis of the use of light weight versus heavy weight mesh in open inguinal hernia repair. Br J Surg2012;99(1):29-37.
8. Petro CC, Nahabet EH, Criss CN, Orenstein SB, Von Recum HA, Novitsky YW, Rosen MJ. Central failures of light weight monofilament polyester mesh causing hernia recurrence: a cautionary note.2015;19(1):155-9
9. Wani PM, Shah RA, Para SA, Bhat PA. Comparison of Outcome between Light weight Mesh & Heavy Weight Mesh in Lichtenstein Groin Hernia Repair. JMSCR 2015;3(8):7143-49.
10. Ganesh Babu KM, Rajashekar N, Nagaraj KN. Inguinal hernia repair using light and heavy polypropylene mesh: a comparative study. J Evolution Med Dent Sci 2016;5(23):1221-24.
11. Gogate AS, Medikeri AS. Comparison of heavy- and light-weight composite mesh in pain reduction among patients with inguinal hernia: a 1-year randomized control trial. Int J Med Res Health Sci2017;6(5): 135-138.
12. Nasiruddin S, Suresh S, Jayanth DH. A comparative study between light and heavy polypropylene mesh in lichtensteinrepair of inguinal hernia.IntSurg J 2017;4:3933
13. Chui LB, Ng WT, Sze YS, Yuen KS, Wong YT, Kong CK. Prospective, randomized, controlled trial comparing light weight versus heavy weight mesh in chronic pain incidence after TEP repair of bilateral inguinal hernia.SurgEndosc 2010;24:2735-8
14. Krishna A, Misra MC, Bansal VK, Kumar S, Rajeshwari S, Chabra A. Laparoscopic inguinal hernia repair Transabdominal preperitoneal versus totally extraperitoneal approach: A prospective randomized controlled trial.  Surg Endo sc 2012 ;26:639-49.

Dr Himanshu Chandel

Associate Professor, Department of Surgery, Gajra Raja Medical College, Gwalior, MP, India