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Videosurgery and Other Miniinvasive Techniques
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1/2023
vol. 18
 
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General surgery
abstract:
Original paper

Assessment of feasibility and safety of cyanoacrylate glue versus absorbable tacks for inguinal hernia mesh fixation. A prospective comparative study

Muthana Haroon
1
,
Stefan Morarasu
2
,
Bianca Codrina Morarasu
3
,
Osama Al-Sahaf
1
,
Emmanuel Eguare
1

  1. Department of Surgery, Naas General Hospital, Naas, Ireland
  2. 2nd Department of Surgical Oncology, Regional Institute of Oncology, Iasi, Romania
  3. 2nd Internal Medicine Department, Saint Spiridon University Hospital, Iasi, Romania
Videosurgery Miniinv 2023; 18 (1): 90–98
DOI: https://doi.org/10.5114/wiitm.2022.119780
Online publish date: 2022/09/24
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Introduction
Mesh fixation is one of the most important steps in laparoscopic inguinal hernia repair. Tacks are often used and provide reliable fixation but they increase the risk of bleeding and chronic pain. To decrease chronic pain, absorbable tacks have been more recently developed. Another method is fixation via glue, which is the most minimally invasive approach, but it may theoretically lead to higher rates of fixation failure. Aim: To analyse the intraoperative mesh fixation success rate and postoperative outcomes between cyanoacrylate and absorbable tacks in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

Material and methods
Adult patients who underwent TAPP hernia repair were included prospectively. Patients were split into two groups: the study group (LB) in which the mesh was fixed with cyanoacrylate glue and the control group (AT) in which absorbable tacks were used. Main outcomes were fixation success rate, early postoperative pain, chronic pain, patient reported outcomes and recurrence rate.

Results
The mesh fixation success rate when using LB was 96.70% (n = 88), while in the AT group, the mesh fixation success rate was 100% (n = 120). Patients in the AT group had significantly higher pain scores than patient in the LB group (p < 0.001, 95% CI). There was no significant difference in chronic pain, patient reported outcomes or recurrences between the two groups.

Conclusions
Cyanoacrylate glue is a safe option for mesh fixation in transabdominal preperitoneal laparoscopic inguinal hernia repair with improved early postoperative pain and similar chronic pain, patient reported outcomes and recurrence when compared to absorbable tack fixation.

keywords:

transabdominal preperitoneal, laparoscopic surgery, hernia, tack fixation, glue fixation, hernia surgery
  
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