Comparison of post-operative pain following mesh fixation using human fibrin glue versus staples in transabdominal preperitoneal inguinal hernia repair

Abstract

Abstract Purpose Postoperative pain and other potential complications related to fixation of mesh prostheses using staples and other traumatic penetrating devices in laparoscopic trans-abdominal preperitoneal (TAPP) hernioplasty prompted us to explore the use of non-traumatic human fibrin glue for mesh fixation. The aim of the current study was to compare postoperative pain in patients who underwent TAPP inguinal hernia repair, where the mesh fixation was done using human fibrin glue and staples. Methods The current study was a randomized controlled trial done between January 2021 and June 2022. Patients with a diagnosis of primary, uncomplicated, inguinal hernia were included in the study. 72 patients were enrolled, and after randomization, patients were allocated into two groups of 36: an experimental group where mesh was fixed with human fibrin glue and a control group with tackers. At one month after surgery, postoperative pain was assessed using the Visual Analog Scale (VAS). Results No significant difference was seen in the total time for surgery between the experimental arm and the control arm. There was a significant difference in duration of hospital stay between the mesh fixation with fibrin glue and with tackers (p < 0.05). Patients in the fibrin glue group had a lower incidence of seroma formation within the 7th postoperative day, lesser postoperative pain, and better quality of life (QoL) at 1 month post-op. Conclusion Considering the better outcomes of the technique, fibrin glue fixation should be preferred over tackers for mesh fixation in TAPP.