Use of human fibrin glue versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty of inguinal hernia

Abstract

Objective To evaluate the uses of human fibrin glue versus staples for mesh fixation in laparoscopic transabdominal preperitoneal (TAPP) hernioplasty of inguinal hernia as regards postoperative pain, operative time, hospital stay, morbidity, and return to work. Background Inguinal hernia is one of the commonest conditions encountered in clinical practice. This procedure is increasingly performed with laparoscopy. Many surgeons prefer to cover the hernia gap with a mesh to prevent recurrence. During laparoscopic surgery, the mesh is generally fixed with staples or tissue glue. We designed a trial that aims to determine whether mesh fixation with glue might cause less postoperative pain than fixation with staples during TAPP repair. Patients and methods Between August 2015 and August 2016, this prospective randomized study included 40 patients presented with inguinal hernia. Patients were randomized into two groups: group I mesh was fixed by fibrin glue and the group II mesh was fixed using staples. After TAPP hernioplasty, patients were followed up at 7–10 days to assess postoperative pain and within 6–12 months to detect recurrence. Results A total of 40 patients, 20 in each group, were considered. Two cases in group II presented with severe pain postoperative, while no cases presented with severe pain in group I. On the other hand, nine cases in group II had mild pain in comparison with two cases in group one and this difference was statistically significant. Conclusion There is less postoperative pain in mesh fixation with fibrin glue and less analgesia is needed after the operation compared with mesh fixation with staples.