Cynoacrylate surgical glue as an alternative to suturing for mesh fixation in lichtenstein hernia repair (original) (raw)
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IOSR Journals , 2019
Background: In recent years, general surgeons who perform inguinal hernia repair have paid attention tosuccessful reduction in the recurrence rate. The Lichtenstein technique is widely used because it is easy to learn and is associated with a low rate of complication and recurrences. Today, the new objective in primary hernia surgery should be to reduce complications such as chronic pain. Chronic pain after hernia repair can be disabling, with considerable impact on quality of life and there is evidence to suggest increased use of health services by patients who have chronic pain Methods: This study is a prospective study of glue mesh fixation for primary unilateral inguinal hernia's during the period December 2017-November 2018, Government Rajaji Hospital, Madurai Medical college. Number of cases studied is 60 were recruited for the study based on the eligibility criteria and informed written consent. Relevant data regarding history, clinical examination and investigations were collected and properly recorded. The patients would then be divided into (Group A) cyanoacrylate glue fixation of the mesh & (Group B) suture mesh fixation. short-term outcomes like length of operation time, pain, postoperative analgesia requirement within 24hrs, hematoma, seroma, long term out comes like chronic pain, sensation of extraneous body, recurrence & time to return to work/normal activities were monitored in frequent intervals for 1 st month, 3 rd month, 6 th month & 1 year These parameters were analyzed using chi square test & P value. Results:This study compares the post-operative morbidity of mesh fixation with cyanoarcylate glue in lichtenstein Hernioplasty over sutures. Cyanoarcylate glue for mesh fixation in the Lichtenstein repair of inguinal hernia shows advantages over sutures, including less duration of operating time(0.01) lower incidence of complications such as post-operative pain(0.017), post-operative analgesia requirement, seroma formation(0.03), foreign body sensation(0.01), chronic discomfort and duration of hospital stay(0.01). Conclusion: Our study favours the use of cyanoarcylate glue for hernia mesh fixation in Lichtenstein Hernioplasty which is better tolerated than sutures and is not associated with an increased risk of hernia recurrence.
Hernia, 2010
Purpose To investigate pain and other complications following inguinal hernioplasty performed by the Lichtenstein technique with mesh fixation by fibrin glue or sutures. Methods Five hundred and twenty patients were enrolled in this 12-month observational multicenter study and received either sutures or fibrin glue (Tissucol Ò /Tisseel Ò ) based on the preference of the surgeon. Pain, numbness, discomfort, recurrence, and other complications were assessed postoperatively and at 1, 3, 6, and 12 months. Pain intensity was assessed by a visual analog scale (VAS; 0 [no pain] to 10 [worst pain]). Results One hundred and seventy-one patients received sutures and 349 received fibrin glue. During the early postoperative phase, 87.4% of patients in the fibrin glue group and 76.6% of patients in the sutures group were complication-free (P = 0.001). Patients who received fibrin glue were also less likely to experience hematoma/ ecchymosis than those in the suture group (both P = 0.001). The mean pain score was significantly lower in the fibrin group than the sutures group (2.5 vs. 3.2,
Ain Shams Journal of Surgery, 2022
Objectives: The Lichtenstein technique is currently the first to repair unilateral primary groin hernias. We aimed to conduct long lateral chain cyanoacrylate as tissue adhesive glue for open inguinal hernias mesh Fixation. Methodology: 60 patients of inguinal hernia repair were divided randomly into two groups, Group A, sutures did mesh fixation. Group B, mesh fixation was done with cyanoacrylate glue. Postoperative pain was measured with VAS by direct interview or phone call at 24 hours, 48 hours, seven days, 15 days, one month, three months, and six months after the operation. Results: There was a statistically significant difference regarding the postoperative pain with a p-value <0.05 between two study groups after 24 hours of operation and after 15 days, 1, 3, and 6 months, with a low mean score among the glue group, which indicated low pain score among glue group. There was a statistically significant difference with p-value <0.05 between the two study groups regarding operative time with low mean duration among group used glue, which indicated that using glue instead of suture will consume less time in operation. Conclusion: Mesh fixation with glue causes less postoperative pain, both acute and chronic, than the classical suture fixation, with similar morbidity and recurrence rates.
International Surgery Journal, 2019
Background: Hernia is one of the oldest maladies known and suffered by humans. It has been known since ages and will be known for centuries to come as long as human beings prompt to stand and walk. Lichtenstein hernia repair is the most common procedure followed surgery but with some devastating complications such as chronic groin pain (CGP). The search for the most appropriate method to fix mesh and to reduce complications is still on and this study aims for the same.Methods: A comparative prospective study conducted in Department of General Surgery, Bangalore medical college & Research institute from November-2016 to May-2018. 100 patients falling into inclusion criteria were taken to study with randomization, 50 in each group (prolene vs Fibrin-glue). Postoperatively patient was assessed for complications, recovery time and Data collected was statistically analyzed using appropriate statistical test and p<0.05 was taken significant.Results: Most common age group presenting wit...
Gastroenterology & Hepatology: Open Access
Background: The Lichtenstein technique for open hernia repair is associated to a high rate of postoperative chronic groin pain, mainly related to the mesh fixation technique. This randomized controlled trial was aimed to compare the classical suture fixation with glue fixation of the mesh. Methods: Forty-five male patients with primary unilateral groin hernia were randomized to undergo open hernia repair with suture fixation (Group A) or cyanoacrylate glue fixation of the mesh (Group B). Primary outcome was early and late postoperative pain. Secondary endpoints were use of painkillers after 24 hours, morbidity rate and recurrence rate. Results: Early postoperative pain and pain between 48 hours and 1 month after surgery were significantly lower in Group B. Only two patients had chronic pain, and both were in Group A. Clinical recurrences were two, both in Group A. Conclusion: This trial demonstrates that mesh fixation with glue is a safe procedure that causes less early and late postoperative pain than the classical suture fixation in open mesh repair of groin hernias.
International Journal of Surgery Science, 2019
Background: Controversies exist as to the best method of mesh fixation in Lichtenstein hernioplasty. The aim of this study was to compare cyanoacrylate glue fixation with suture fixation of mesh, with regards to recurrence rate and chronic groin pain. Methods: This was a prospective randomized controlled study conducted in a perpheral hospital over a period of seven years. One hundred and fifty six patients of Lichtenstein hernia repair were included. Mesh was fixed by sutures and cyanoacrylate glue in 78 patients each. Only those patients were completed the follow up of 4 years were included in the final analysis. Results: The mean operative time in suture fixation was 62.56 + 10.31 versus 52.12 + 8.68 minutes in glue fixation (p<0.0001). The intra-operative complication rates did not differ significantly between the two techniques (p = 0.7613). The post-operative pain scores were significantly lesser in the glue group [5.78 + 0.17 versus 6.71 + 0.29, p = 0.0341]. Among the suture fixation group four (12.90%) patients had chronic groin pain, at the end of four-year follow up, as compared to three (10.71%) patients in the glue group (p = 0.7342). The severity of chronic groin pain was also not found to be statistically different [5.23 + 0.09 in suture group versus 5.18 + 0.11 in glue group, p = 0.7954]. The recurrence rates were similar between the two groups. Conclusion: The frequency and severity of chronic groin pain, and recurrence rate do not depend on the method of mesh fixation.
Canadian journal of surgery. Journal canadien de chirurgie, 2010
We sought to determine the efficacy of sutures, human fibrin glue and N-butyl-2-cyanoacrylate for mesh fixation in patients undergoing the plug and mesh procedure for groin hernia. A total of 156 patients with 167 inguinal hernias (11 bilateral) underwent a plug and mesh procedure and were randomly assigned to received either sutures (n = 59 hernias), human fibrin glue (n = 52) or N-butyl-2-cyanoacrylate (n = 56) for mesh fixation. The overall morbidity rate was 38.98% in the suture group, 9.62% in the fibrin glue group and 10.71% in the N-butyl-2-cyanoacrylate group (suture v. fibrin glue, p < 0.001; suture v. N-butyl-2-cyanoacrylate, p < 0.001). There was no significant difference in morbidity between the fibrin glue and N-butyl-2-cyanoacrylate groups. Overall, short-term morbidity was significantly higher in the suture group (27.12%) than in the fibrin glue (9.62%, p = 0.01) or N-butyl-2-cyanoacrylate (8.93%, p = 0.004) groups, but there was no significant difference betwee...
Videosurgery and Other Miniinvasive Techniques, 2012
Introduction: With an average incidence rate of 11%, chronic pain is considered the most serious complication of inguinal hernioplasty after surgical site infection. One of the proposed solutions to this problem is to use tissue adhesive for mesh fixation, which helps prevent nerve and tissue damage. Aim: The goal of this study was to compare mesh fixation with the use of sutures vs. adhesive in Lichtenstein's inguinal hernia repair in a randomized, double-blind one-center study. Material and methods: The study group consisted of 41 males with primary inguinal hernia undergoing Lichtenstein's repair (20-adhesive; 21-suture) and remaining in follow-up from July 2008 to November 2010. Randomization took place during the operation. The follow-up was performed by one surgeon (blinded) according to a pre-agreed schedule; the end-of-study unblinding was performed during the last follow-up visit, usually 16 months postoperatively. Results: In 1 patient from the "adhesive" group, a recurrence was observed one year after the initial repair. The early postoperative pain was less intense in this group. In later postoperative periods the method of mesh fixation had no influence on the pain experienced by the patient. Other complications were not correlated with the method of mesh fixation. Conclusions: In this randomized, one-center double-blind clinical study of males with primary inguinal hernia it has been show during follow-up that the use of Glubran 2 cyanoacrylate adhesive for mesh implant fixation yields similar recurrence and chronic pain rates as the classical suture technique. In the early postoperative period, the pain reported by these patients was relatively weaker; patients undergoing adhesive mesh fixation experienced a quicker return to daily household activities.