STRENGTHS AND WEAKNESSES OF LAPAROSCOPIC AND OPEN MESH INGUINAL-HERNIA REPAIR - A RANDOMIZED CONTROLLED EXPERIMENTAL-STUDY

There are no objective data available on the relative strengths of ing uinal hernia repairs. The aim of this randomized controlled study was to measure the force required to disrupt laparoscopic and open mesh re pairs in a porcine model. Eleven pigs had inguinal hernia repair follo wing randomization to an open mesh group (n=5) or a transabdominal pre peritoneal laparoscopic group (n=6). Four weeks after operation the pi gs were killed and the pelvic girdles were mounted in a test jig on a mechanical testing machine. The applied disruption forces were measure d and recorded. Mean(s.d.) force required to disrupt the normal inguin al canal (n=11) was 68.6(30.1)N with no difference between groups. The open mesh repair required 110.3(41.4)N and the laparoscopic mesh 220. 0(95.2) N. Both open and laparoscopic mesh repairs were stronger than the normal side (P <0.03). The laparoscopic mesh repair was stronger t han the open mesh repair (P=0.04). This model provides a standardized method for mechanically testing inguinal hernia repairs in pigs. It co nfirms that both open and laparoscopic mesh hernia repairs are stronge r than the non-herniated normal side at 4 weeks after operation. Lapar oscopic mesh repair is Stronger than open mesh repair. The weakest poi nts of the repairs correlate well with those identified in clinical re ports.