Comparison of Self-adhering Mesh and Conventional Mesh in Inguinal Hernia Repair.

Comparison of Cousin Biotech® Adhesix™ Versus Conventional Mesh in Open Anterior Inguinal Hernia Repair: a Multi-centre, Randomised, Double-blinded, Controlled Clinical Trial.

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA), Orbis Medical Centre, VieCuri Medical Centre

Inguinal hernia repair coincides with a high rate of postoperative pain, extending to over a year in 10-20% of patients. Although this is of major concern, early postoperative pain also has an important impact on patients and their ability to regain normal work and activities. Since inguinal hernia repair is the most frequently performed operation worldwide, a small reduction in loss of workdays can already have significant impact on financial issues. As for the origin of the pain, it might be the result of local inflammation caused by the mesh material, but also by nerve entrapment due to fixation techniques. The development of a new mesh which enables sutureless fixation, Cousin Biotech® Adhesix™, may overcome pain related to fixation techniques used in the open hernia repair procedure according to Lichtenstein. Furthermore, the Cousin Biotech® Adhesix™ mesh has already been in use in our institutions and surgeons familiarized themselves with the application. The investigators would like to conduct a multicentre randomised controlled clinical trial to compare the difference in early postoperative pain after unilateral primary inguinal hernia repair in males. The procedures will be performed in day surgery. Early postoperative pain is defined as the pain during the first month, with a special interest in the first two weeks. In addition, the investigators want to measure the possible benefit in terms of time to return to work, daily activities, quality of life, operation length, complications and long term postoperative pain.

Inclusion Criteria: Male Primary, unilateral inguinal hernia Age ≥18 years Social status: professionally employed ASA-score I-III Signed informed consent Elective surgery Exclusion Criteria: Female Bilateral and/or recurrent inguinal hernia Femoral or scrotal hernia Vasectomy Social status: unemployed Chronic use of pain medication Symptomatic acute hernia (i.e. bowel obstruction, incarceration, strangulation, peritonitis or perforation of bowel contents) ASA-score IV or above Incapacitated adult or no signed informed consent Patient is unable to speak Dutch