Comparison of short- and long-term outcomes using heavy- (3DMax™ Mesh) and lightweight (3DMax™ Light Mesh) mesh in inguinal hernia repair

Summary Purpose Inguinal hernia repair is one of the most common surgeries worldwide, with synthetic mesh as the standard of care. With interest in the potential of mesh weight to impact long-term outcomes, we compared short- and long-term safety and effectiveness outcomes of inguinal hernia repair using comparable heavy- and lightweight mesh. Methods A registry-based retrospective observational study of patients undergoing elective open and laparo-/endoscopic inguinal hernia repair with heavy- (3DMax™ Mesh; Davol Inc., subsidiary of C.R. Bard, Inc., BD) and lightweight (3DMax™ Light Mesh Davol Inc., subsidiary of C.R. Bard, Inc., BD) mesh was performed using data collected prospectively from the Herniamed registry. Perioperative, postoperative, and 1‑year clinical outcomes (complications and recurrences) were reported and compared between groups in unadjusted analyses. Results Of the hernia operations performed at more than 800 centers in the registry, 2420 patients with 3DMax™ Mesh and 9033 with 3DMax™ Light Mesh met the inclusion criteria. Most procedures were performed laparoscopically. There were no significant differences between these comparable heavy- and lightweight meshes in terms of interoperative complications, general complications, postoperative complications, or complication-related reoperations in the unadjusted analyses. Furthermore, there was no significant difference between mesh weights in terms of recurrence, trocar hernia, secondary hemorrhage, seroma, and infection at 1‑year follow-up. While heavyweight mesh was associated with significantly higher pain at rest ( p = 0.014) and pain upon exertion ( p = 0.035) at 1 year versus lightweight mesh, this could not be shown for pain requiring treatment at 1 year. Conclusion Postoperative complications and 1‑year outcomes did not significantly differ between inguinal hernia repair performed with heavy- and lightweight meshes in unadjusted analyses. These outcomes demonstrate the safety and performance of such mesh for inguinal hernia repair regardless of mesh weight, although additional studies with longer follow-up periods and multivariable analyses adjusting for confounders are needed.