“PROSPECTIVE RANDOMISED COMPARATIVE STUDY OF USE OF FIBRIN GLUE VS. TACKERS AS METHOD OF MESH FIXATION IN LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL (TAPP) HERNIA REPAIR”

Abstract

BACKGROUND: Fixation of mesh in pre-peritoneal space is an important step in laparoscopic TAPP hernia repair. Mesh dislocation is one of the most frequent causes responsible for recurrence. Of the many factors inuencing postoperative pain, the technique of xation has been reported to be one of the most signicant determinants. So mesh xation with adhesives instead of mechanical devices has been proposed as a mean to reduce the incidence of postoperative pain. AIM: To compare clinical outcome and morbidity of xation of mesh using brin glue and tackers in trans-abdominal pre-peritoneal inguinal hernia repair METHODOLOGY: We did a prospective randomized comparative study in which we enrolled 50 patients undergoing laparoscopic hernia repair (TAPP). Those who met our inclusion criteria were randomized for study purpose after obtaining informed consent, in 25 patients mesh xed with tackers (group A) and in other 25 patients mesh xed with brin glue (group B). Patients were compared for intraoperative time required for mesh xation, early and late postoperative pain, time required to resume normal daily physical activity, length of hospital stay, hernia recurrence and seroma formation. Postoperative follow up was done up to six months. RESULTS: Two groups were comparable in terms of demographic variables. We observed that postoperative pain, time required resuming normal daily activity and incidence of seroma formation was less in group B (Mesh xed with glue). There was no signicant difference in length of hospital stay in both groups and no evidence of hernia recurrence in both groups during follow up period. CONCLUSION: It can be concluded that xation of mesh with brin glue when compared with tackers, seems to reduce postoperative pain, time to resume daily activities and incidence of seroma formation with no difference in length of hospital stay, early hernia recurrence with longer operative time.