Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker

Abstract

Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up. One hundred patients aged 18 to 60 years having inguinal hernia admitted in Poona Hospital and Research Centre, Pune, between October 2012 and November 2014 for laparoscopic hernia surgery and ready to participate in this study were included. All of them underwent laparoscopic repair of hernia by total extra peritoneal (TEP) method following sample surgical protocol in all of them except for method of mesh fixation. Mean time calculated from insertion of the first trocar to beginning of skin suturing was 54.9 min in tacker group and 50.3 min in fibrin glue group with no statistically significant difference between the two. The incidence of urinary retention was significantly higher in tacker (34 %) as compared to fibrin glue (12 %) group. Incidence of hematoma was significantly higher in tacker group in 15-day follow-up, but there was no significant difference in hematoma formation at hernial sites in both groups after 15 days of follow-up. The incidence of neuralgia was significantly higher in the tacker group (24 %) compared with the fibrin glue group (2 %). Significantly, more number of people in the fibrin glue group 68 and 90 %, respectively, returned to work during 15 and 30 days follow-up as compared to the tacker group 46 and 64 %. Fibrin glue can be considered as an alternative to tacker for mesh fixation.

Mesh fixation with fibrin glue versus tacker in laparoscopic totally extraperitoneal inguinal hernia repair

“…10 However, in few studies the incidence of postoperative urinary retention was significantly more in the tacker group when compared to the fibrin glue group and the incidence correlated with the number of tackers used. 12,13 Even though mesh hernioplasty has drastically reduced the recurrence rates of hernia, it is associated with the morbidity of chronic postoperative pain which can severely impair the quality of life. 14 A variety of etiologies have been proposed for the cause of chronic pain following hernia repair.…”

Surgical Results of Total Ekstraperitoneal (TEP) Hernia Repairs in 115 Inguinal Hernia Patients

“…Shinde et al [17] and Ceccarelli et al [18] reported an average hospital stay of 1 day, while Chandra et al [19] reported an average hospital stay of 2.26 days. All of the patients in our study were discharged on the postoperative first day.…”

Cost comparison of fibrin sealant versus tack screws for mesh fixation in laparoscopic repair of inguinal hernia

“…These studies typically mention that FS is preferable to tissue-penetrating fixation as it is likely to prevent chronic pain. However, studies lack adequate followup to investigate this claim [8,[17][18][19]. By not including chronic pain in our cost analysis, we miss a substantial cost difference between the two alternatives that would undoubtedly favor FS.…”

“…Adverse events of laparoscopic inguinal hernia repair include neuralgia and seroma [6][7][8][9]. An area of interest is the choice of fixation device used in securing a prosthetic mesh over the compensated tissue in the abdominal wall.…”