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

Abstract

Background: The advent of mesh was a breakthrough in the field of hernia surgery. Mechanical methods of mesh fixation are hypothesized to cause more tissue trauma than nonmechanical methods. The present study was conducted to study the outcomes of mesh fixation using fibrin glue, a nonmechanical method versus tackers in totally extraperitoneal repair (TEP) of unilateral inguinal hernia. Methods: A randomized controlled single blinded study was conducted in India from June 2017 to March 2019. Patients diagnosed with unilateral uncomplicated inguinal hernia with a hernial sac of size not more than 5 cm were invited to participate in the study. Sample size was 60 patients randomized into groups just before mesh fixation. In group A mesh was fixed using tackers while in group B mesh was fixed using fibrin glue. Patients were followed-up prospectively for 3 months. Results: There was no statistical difference between the two groups with respect to operating time. Average hospital stay and pain scores at all follow-ups were better for fibrin glue group. There was no difference in the incidence of postoperative urinary retention, seroma formation and hematoma formation between the two groups. Patients of fibrin glue group had early restart of daily activities at 15 days follow-up when compared to tacker group. Conclusion: Fibrin glue fixation technique should be advocated over tackers for mesh fixation in TEP considering the better outcomes and cost-effectiveness of the technique.

Prospective comparative study of mesh fixation in laparoscopic TEP hernia repair using tacker versus cyanoacrylate versus fibrin glue tep mesh fixation with cyanoacrylate

“…22 Main disadvantage of using fibrin glue and cyanoacrylate is their adherence to instruments mandating repeated cleaning; this is more with cyanoacrylate than fibrin glue. 23 The major limitations of this study are its short follow period of 3 months. This period is insufficient to comment and compare on hernia recurrence among groups.…”

Laparoscopic Removal of an Infected Mesh Following TEP Procedure for Femoral Hernia with Omental Patch Closure of a Peritoneal Defect

“…At our institution, TEP approach is the standard procedure for treating groin hernias. Moreover, we use a non-absorbable tack (CAPSURE ® , Bard, USA) for mesh fixation, although the usefulness of tissue glue and self-gripping mesh has been recently reported [ 7 , 8 ].…”

Comparative Study of Different types of Mesh Fixation during Laparoscopic Repair of Inguinal Hernia

“…Also Nizam et al, 19 talked about it. However, when comparing postoperative groin pain, a meta-analysis in favor of adhesive fibrin mesh fixation was associated with less postoperative pain than staples or staples.…”