A study to estimate the optimal mesh size during Lichtenstein inguinal hernioplasty

ABSTRACT Background: The pathophysiology of recurrence after Lichtenstein inguinal hernioplasty is multifaceted and comprises both technical and non-technical patient-related factors. Here, along with other risk factors, we look into the causal relationship between hernial recurrence and the mesh size determined by the inguinal floor diameter as evaluated intraoperatively. Methods: This prospective study collected data on 70 adult patients with unilateral primary inguinal hernias. The patient’s demographic data, anthropometric measurements (height, weight, and body mass index), associated comorbidities, the side of the hernia, the direct or indirect hernia, the duration of the hernia, and the mesh size according to the intraoperatively measured inguinal floor diameter were all evaluated to see if there was a correlation between any of these factors and the hernial recurrence. Results: Significant correlations between hernial recurrence and lower urinary tract symptoms ( P = 0.0001), diabetes mellitus with hypertension ( P 0.0001), and surgical site infections were found. A statistically significant correlation was also found between the mesh size and the hernial recurrence, with the mean length and width of the mesh being, respectively, 13.6571 ± 0.1774 and 6.5143 ± 0.1820 (cm) for non-recurrence patients and 13.1400 ± 0.1140 and 6.2200 ± 0.2683 (cm) for recurrence patients. Conclusions: Hernial recurrence has been correlated with lower urinary tract symptoms, diabetes mellitus with hypertension, surgical site infection, and the use of a comparatively smaller mesh size.