Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Surgical Innovation
• Biomaterials in Medicine
• Hernia Repair Techniques

Background:

• Permanent meshes are standard for inguinal hernia repair but can cause chronic pain.
• Absorbable meshes are proposed as an alternative to mitigate pain concerns.
• Concerns exist regarding the efficacy and recurrence rates associated with absorbable meshes.

Purpose of the Study:

• To evaluate the advantages and limitations of fully absorbable meshes in inguinal hernia repair.
• To compare postoperative pain and recurrence rates between absorbable and permanent meshes.
• To provide an overview of current evidence on absorbable mesh use in hernia surgery.

Main Methods:

• Systematic review and meta-analyses of studies from PubMed, Embase, Cochrane, and Psychinfo.
• Inclusion of case series, cohort studies, and randomized controlled trials (RCTs).
• Focus on adult patients undergoing inguinal hernia repair with fully absorbable mesh.

Main Results:

• No significant difference in recurrence rates (18-month median follow-up) between absorbable and permanent meshes.
• Lower crude chronic pain rates observed with absorbable meshes (2.1%) compared to permanent meshes (7.6%) in RCTs (1-year follow-up).
• Medial hernias showed higher susceptibility to recurrence with absorbable meshes (P < .0005); no serious adverse events reported.

Conclusions:

• Absorbable meshes offer comparable recurrence rates to permanent meshes in inguinal hernia repair.
• Patients may experience reduced chronic pain following surgery with absorbable mesh use.
• Absorbable meshes represent a viable option for inguinal hernia repair with a favorable pain profile and acceptable recurrence rates.