Comparison of Hernia Repair Using Tissue Reinforcement With the Remaining Sac Versus Polypropylene Mesh in Patients With Indirect Inguinal Hernia: A Randomised, Controlled, Double-Blind Clinical Trial.

BACKGROUND: Indirect inguinal hernia is a common condition that often requires surgical intervention. This study compares two surgical approaches for hernia repair: tissue reinforcement using the remaining sac and polypropylene mesh repair. METHODS: A randomised, controlled, double-blind clinical trial was conducted on 132 patients aged 18-82 diagnosed with indirect inguinal hernia. Participants were randomly assigned to two intervention groups: one undergoing polypropylene mesh repair and the other using tissue reinforcement with the remaining sac. Key outcomes, including recurrence rates, postoperative complications, pain intensity, recovery time and hospital stay, were assessed at multiple intervals. RESULTS: Both techniques demonstrated comparable safety and efficacy. Recurrence rates were low in both groups (1.5% in the mesh group vs. 3% in the tissue reinforcement group, at one-year follow-up, p = 0.56). Postoperative complications, including seroma and haematoma, were identical (3% in both groups). Pain intensity (mean VAS score: 5.7 vs. 5.6, p = 0.847) and recovery time (6.7 days vs. 6.6 days, p = 0.960) were similar between the two approaches. CONCLUSION: Both polypropylene mesh and tissue reinforcement techniques are effective and safe for indirect inguinal hernia repair, with minimal differences in outcomes. Surgical decisions should be tailored to individual patient needs and clinical scenarios. These findings provide evidence supporting the flexibility of surgical approaches in managing indirect inguinal hernias. TRIAL REGISTRATION: IRCT20230410057871N3.