Comparison between Fibrin Glue vs Mechanical Mesh Fixation in Laparoscopic Inguinal Hernia Repair, A Prospective Study

Abstract

Abstract Background Inguinal hernia repair is one of the most common surgical procedure in general surgery. The rate of occurrence of inguinal hernia is about 27– 43% in men and 3– 6% in women. An open or laparoscopic approach can be used. Mesh repair is recommended either by an open procedure or laparoscopic technique. There is no consensus on the best method to do inguinal hernia repair either open or laparoscopic. Objective To compare between glue vs mechanical mesh fixation in laparoscopic inguinal hernia repair as regard operative time, blood loss, hospital stay and short term complications. Patients and Methods This is a prospective comparative cohort study between fibrin glue versus mechanical mesh fixation in laparoscopic inguinal hernia repair. This study was conducted at (the General surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Between September 2022 and February 2023 with post-operative follow-up for maximum 6 months. Results There are many postoperative complications such seroma, numbness, wound infection and early recurrence. Early recurrence after open hernia repair which can occur in up to 63% of patients and affects quality of life in 5– 10% so there is increase in usage of the laparoscopic method to decrease the post-operative complication. Mesh fixation in laparoscopic inguinal hernia repair (LIHR) remains highly debated, being largely influenced by individual-surgeon preferences, the use of tackers or staples increase postoperative pain and associated with chronic and immediate postoperative pain and may risk neurovascular injury. Non-penetrative methods of mesh fixation using tissue glue have been used for LIHR, and been associated with improved postoperative complications and chronic pain. Conclusion The use fibrin glue in mesh fixation for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, less seroma/hematoma rate and less wound infection. Whereas early recurrence and numbness was found to be similar in both groups.