Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (4): 548-552.doi: 10.3969/j.issn.2095-4344.2367

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Changes of abdominal wall mechanics and pain after tension-free inguinal hernia repair with polypropylene mesh

Li Quanxi1, Shen Yu1, Wan Wei1, Sun Shanzhi2   

  1. 1Department of Hepatobiliary Surgery, 2Information Center, Second People’s Hospital of Lianyungang, Lianyungang 222023, Jiangsu Province, China
  • Received:2019-12-27 Revised:2020-01-06 Accepted:2020-03-11 Online:2021-02-08 Published:2020-11-21
  • Contact: Li Quanxi, Department of Hepatobiliary Surgery, Second People’s Hospital of Lianyungang, Lianyungang 222023, Jiangsu Province, China
  • About author:Li Quanxi, Chief physician, Department of Hepatobiliary Surgery, Second People’s Hospital of Lianyungang, Lianyungang 222023, Jiangsu Province, China

Abstract: BACKGROUND: Chronic pain after tension-free inguinal hernia repair is a common postoperative complication. An important cause of chronic pain is nerve injury. 
OBJECTIVE: To observe the effect of iliohypogastric nerve preposition on chronic pain after inguinal hernia repair and analyze its mechanics. 
METHODS: Totally 76 male inguinal hernia patients, from August 2013 to November 2016, aged 36-95 years in Second People’s Hospital of Lianyungang were selected. The patients were all treated with large-size polypropylene non-absorbable mesh insertion. The iliohypogastric nerve was placed in front of the mesh. Pain was followed up at 3, 6, and 12 months after operation. This study was approved by the Ethics Committee of Second People’s Hospital of Lianyungang.  
RESULTS AND CONCLUSION: (1) No chronic pain or recurrence was found in the 76 patients at 3, 6 and 12 months after surgery. (2) The pressure included vertical pressure and tangent pressure formed from intra-abdominal pressure on abdominal wall, directly affecting abdominal wall and artificial repair materials. This was the basic cause of the relative mechanical relationship between nerve and mesh. (3) The results showed that the tension-free inguinal hernia repair with the iliohypogastric nerve preposition could reduce the incidence of postoperative chronic pain, which may be related to the effect of postoperative abdominal pressure on tissue repair, especially the repair around the mesh. 

Key words: materials, polypropylene mesh, inguinal hernia, iliohypogastric nerve, tension-free hernioplasty, postoperative chronic pain, abdominal pressure

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