Fibrin glue versus tacked fixation of mesh in laparoscopic transabdominal preperitoneal repair of inguinal hernia: A prospective study

Background: Hernia repair is a frequently performed procedure within the field of general surgery. The common primary
method is the trans-abdominal pre-peritoneal (TAPP) procedure which has the advantages of early recovery and minimal
postoperative discomfort.
Objectives: The purpose of this study was to examine the effects of fibrin glue and stapler fixation on post-operative
discomfort, cost, and early recurrence in TAPP inguinal hernia repair.
Patients and Methods: 33 patients with inguinal hernias who received TAPP inguinal hernia repair were included in this
prospective, randomized comparative research. The patients were split into two groups: Group I: fibrin glue was used to
fix the mesh in 15 patients. Group II: Tacker was used to fix the mesh in 18 patients. Every patient received follow-up care
for a minimum of six to twelve months.
Results: There were no variations between the two groups’ age, sex, or risk factors for the development of hernias.
Patients presented preoperatively by recurrent hernias reported in 3 cases in group I and 7 cases in group II. In terms
of operative time, there was no differences between the two groups. In both groups, there were no postoperative early
recurrences or problems during the procedure. All patients were discharged on the first postoperative day, except for one
case per group that was discharged on the second. There were five cases (33.3%) in the fibrin glue group and four cases
(22.2%), in the tacker group suffered from post-operative scrotal edema. In both groups, two patients experienced a postoperative hematoma. In group I, there were 2 patients with minor hydrocele following surgery, whereas group II had 3
cases. The amount of post-operative groin discomfort and how long it lasted varied significantly between the two groups;
the fibrin glue group experienced a shorter pain duration (P value 0.037). In the fibrin glue group, return to work occurred
more quickly (P value=0.028), and everyday activities were resumed earlier. Compared to tacker (group II), fibrin glue
consumable (group I) was less expensive per case.
Conclusion: In the short-term follow-up, fibrin glue, as opposed to tacker mesh fixation, had the benefit of reducing postoperative discomfort and allowing for an earlier return to work and everyday activities. As a safe and affordable substitute for disposable absorbatack, fibrin glue works well.