Does the Weight Matter? Short-Term Outcomes of Lightweight Versus Heavyweight Three-Dimensional Anatomical Mesh in Minimally Invasive Inguinal Hernia Repair

Background: The type of mesh used in inguinal hernia repairs remains controversial. There are limited data looking at specific mesh-related complications. The objective of this study is to assess postoperative 90-day outcomes in lightweight (LW) and heavyweight (HW) anatomical mesh in minimally invasive inguinal hernia repairs. Methods: A retrospective single-center database was queried for all adult minimally invasive inguinal hernia repairs with anatomical mesh from July 2016 to March 2021. Demographics and surgical outcomes were analyzed. Univariate analysis and multivariate logistic regression were performed. Results: Six hundred forty-seven minimally invasive inguinal hernia repairs were performed with 423 (65.3%) using HW and 224 (24.7%) using LW mesh. There was no difference in mean body mass index between the groups (26.9 – 4.2 kg/m² in the LW group and 27.1 – 4.2 kg/m² in the HW group; P = .69). There was no difference in type of mesh fixation used in either group, with tacker being the most common. There was no difference in postoperative emergency department (ED) visit (P = .625), readmission rates (P = .562), or postoperative complications between the two groups. Fifty patients presented with seroma within 90 days. There were five recurrences in each group and only one surgical site infection in the LW within 90 days. Multivariate logistic regression was performed, and predictors of seroma formation included age (odds ratio [OR] 1.02; confidence interval [CI] 1–1.04; P = .02) and hypertension (HTN) (OR 1.8; CI 1.03–3.4; P = .039). HW mesh was not associated with seroma formation (OR 1.04; CI 0.5–1.9; P = .895). Similarly, HW mesh was not associated with surgical site occurrences (SSO) (OR 1.04; CI 0.5–1.8; P = .872). HTN was associated with SSO (OR 1.74; CI 1–3.05; P = .048). Conclusion: Our study did not favor the use of LW or HW mesh when comparing postoperative complications or clinical outcomes. HW mesh was not associated with either seroma formation or SSO.