Cyanoacrylate Glue Versus Suture Fixation of Mesh in Adult Inguinal Hernioplasty

Abstract

Background: Tissue glues have been present for over twenty years and are used in surgery for a variety of indications. Use of N butyl- 2-cyanoacrylate based in inguinal hernia surgery were practiced for the first time in the mid-nineties. These non-suture techniques was aimed to decrease the chronic groin pain after hernioplasty without adversely affecting the outcomes Aim of the work: this study was designed to compare the operative outcomes of mesh fixation with glue versus that with suture. The primary objective was to compare pain in the immediate postoperative period and also to compare chronic postoperative pain. Patients and Methods: This prospective randomized study was performed Between January 2018 and January 2019 on 40 patients with unilateral inguinal hernia for whom open hernioplasty was done in the Department of surgery, Al-Azhar University Hospital, Damietta. Results: in the present study, there was significant difference in postoperative pain perception at 24 hours, at one week and at one month (p < 0.05) between glue group and suture group with lesser pain perception in the glue group. After the first month the difference between the two groups was non-significant. The mean operative time which was 44.35 min in the glue group and 57.33 min in suture group showed significant difference. As regard to the postoperative complications, the postoperative hematoma, infection and seroma were lesser in glue group but the difference was not significant. There was no recurrence in both groups. Conclusions: Cyanoacrylate glue for mesh fixation in Lichtenstein repair of adult inguinal hernia shows advantages over mesh fixation by sutures in terms of immediate and chronic post-operative pain, operative time, and postoperative complications.