Quality of life in patients after laparoscopic hernioplasty: relapse of the disease and chronic pain syndrome

Objective. The main factors of reducing the quality of life of patients after surgical treatment of inguinal hernias are recurrence of the disease (R) and the development of chronic pain syndrome (CPS).Material and methods. The results of surgical treatment of 1897 patients with inguinal hernias who underwent laparoscopic hernioplasty using the TARR method are analyzed. The aim of the study was to identify the causes of CPS development and recurrence of inguinal hernia, depending on the type and size of the mesh, as well as the technical features of the operation. In 842 patients, a self - fixing ProGrip ™ mesh was used, in 1054 patients - a light composite VYPRO II mesh.Results. In group 1, recurrence of inguinal hernia was noted in 1 patient (0.12%) with a small size of mesh (less than 120 cm2), in group 2 (control) - in 7 (0.66%), including when using relatively large mesh (more than 140 cm2). The cause of recurrence is the migration of the mesh due to its insufficient size or fixation. CPS was observed in 1 patient of the main group, whereas in the control group there were 13 such patients. The reasons are directly related to the method of fixing the mesh: direct contact of the metal bracket with a nerve branch or the development of a scar in the area of the suture or fixing element.Conclusions. A self-fixing implant of sufficient size (at least 10x15 cm), which ensures the" sticking " of the mesh over the entire surface, reliably protects the patient from both the development of CBC and the recurrence of the disease. An indirect cause of relapse may also be an increase in the patient's body weight after surgery.