Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial

Abstract

Background: Cyanoacrylate glue (Glubran 2) is a synthetic adhesive mesh fixation material. Its utility is being evaluated in laparoscopic total extraperitoneal (TEP) inguinal hernia repair (IHR). A multicentre randomized controlled trial was performed comparing Glubran 2 to standard of care absorbable tacks, particularly assessing chronic postoperative inguinal pain and its effects.Materials and Methods: Patients undergoing elective TEP IHR at 2 centers from 2017 to 2019 were randomly assigned to Glubran 2 or absorbable tack mesh fixation, and followed for 6 months. All other aspects of surgery and aftercare remained the same. Surgeons documented operative and fixation time, and the placement of fixation on standardized diagrams. Via a questionnaire, aspects of inguinal pain were evaluated before surgery, and at various timepoints postoperatively over 6 months. Postoperative clinical factors were also collected.Results: A total of 106 operative sides were randomized to either glue (51) or tack (55) mesh fixation over a 14-month period. Similar median operative times between tack (83.0 min) and glue fixation (75.0 min) were observed. There were no significant surgical complications or observed hernia recurrences in either group. There was no significant difference in pain scores between the 2 groups at all time-points after analysis through mixed effects modeling. Temporal pain profiles over time were also similar. Totally, 55% of patients in the glue group had returned to work within 2 weeks of surgery. There was no increase in complications or pain scores despite regular lateral fixation of glue in these patients. Conclusion:Adding to known data, we observed no significant difference in postoperative pain, demonstrating that cyanoacrylate glue is a viable and safe alternative fixation method to absorbable tacks in laparoscopic TEP IHR. As secondary outcomes, cyanoacrylate glue permits some patients to return to work early, and we observed regular lateral mesh glue fixation without increased pain or complications.

Analysis of the Effect and Efficiency of Tension-Free Hernia Repair and Traditional Surgery in The Treatment of Hernia

“…As a direct tissue suture method, not only does it cause a large amount of bleeding during the operation but also causes great pain after the operation. This could hinder recovery and the recurrence rate is also high [8][9][10] . Tension-free hernia repair is based on the anatomy of the inguinal hernia.…”

Application Effect of Combining Image‐Text Communication‐Based Healthcare Education with Shifting of Attention on Child Patients Undergoing Inguinal Hernia Repair under General Anesthesia

“…Young children with incomplete perception of the disease may experience extreme fear of surgery as well as postoperative pain, and due to their strong dependency on their parents, they tend to cry and shout hardly after surgery because of pain [ 14 , 15 ]. By analyzing the clinical features of previous cases, the study performed image-text communication-based healthcare education combined with shifting of attention in the perioperative period to child patients undergoing inguinal hernia repair under general anesthesia, and further education was given to their parents to assist the medical staff in better completing the intervention plan; such child patients were included in RG for comparative analysis with those received routine intervention in CG, and the results were as follows.…”

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

“…Moreover, studies comparing n-butyl-2-cyanoacrylate to tacks in TAPP procedures are scarce. To our knowledge two studies [ 29 , 30 ] have compared n-butyl-2-cyanoacrylate to tacks in laparoscopic hernia repair, but in both studies repair was done in a total extra-peritoneal fashion (TEP). Both studies showed that n-butyl-2-cyanoacrylate is similar to tacks in terms of mesh fixation, chronic pain and risk of recurrence.…”