Comparison of Absorbable Tuckers and N-Butyl Cyanoacrylate Glue in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Single General Surgeon’s Experience

Abstract

Aim: Laparoscopic inguinal hernia surgery is performed in many centers today. Mesh fixation is an important step in this procedure. In this study, we aim to show our results in total extraperitoneal repair of inguinal hernias using absorbable tuckers and n-butyl cyanoacrylate glue for mesh fixation. Materials and Methods: All surgeries were performed by a single surgeon. The surgeries were performed in Private Erdem Hospital İstanbul and Al Zahra Hospital Dubai between January 2015 and February 2022. Mesh fixation of the patients was applied in a randomized manner using absorbable tucker and glue. The patients were compared in terms of postoperative visual pain score (VAS), opioid need, length of hospital stay, duration of surgery, presence of recurrence and chronic pain. Results: A total of 226 patients were operated. Absorbable tucker were used for mesh fixation in 138 patients, and glue was used in 88 patients. The age and gender distribution of the patients were similar in both groups. No patient had any major complications or mortality during or after surgery. There was no conversion to open surgery. Operation time was similar in both groups. In the glue group, VAS was found to be significantly lower at the 8th hour after surgery. There was also a significant reduction in opioid requirement in the same group. The same-day discharge rate in the glue group was statistically significantly higher than in the absorbable tucker group. All patients were followed up for at least six months. Recurrence was observed in two patients (one patient in each group). The number of patients with chronic pain was significantly higher in the absorbable stapler group than in the other group. Conclusion: The use of glue for mesh fixation in laparoscopic extraperitoneal inguinal hernia repair is a safe method. Fixation with glue is clearly advantageous comparing to absorbable tuckers in terms of postoperative pain, early discharge, and chronic pain.

Keywords

• n-butyl cyanoacrylate
• laparoscopic hernia repair
• mesh fixation
• total extraperitoneal hernia repair