DOI: http://dx.doi.org/10.18203/2349-2902.isj20191267

Effectiveness of fibrin glue in comparision to polypropylene suture for mesh fixation in lichtenstein inguinal hernia repair

Rajkumar Parameshwar Narayanakar, Kushal Kumar Talagavara Radhakrishna, Madhuri G. Naik

Abstract


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 with hernia was from 41-50 years (29%) with M: F ration 5.6:1. Laterality being right: left: bilateral:: 58%: 36% :6% respectively. Type of hernia being Indirect: Direct:: 66%: 34% respectively. Duration of surgery, recovery to ADL and postoperative complications like seroma, chronic groin pain, foreign-body sensation was significantly less with fibrin glue compared to prolene group. Postoperative Haematoma, local numbness and recurrence were comparable and the difference in the result was statistically insignificant.

Conclusions: Through our study from the above-mentioned benefits, it can be concluded that use of fibrin Glue in mesh fixation is a safe and acceptable method and can be used as a better alternative for prolene suture for mesh fixation in Liechtenstein’s hernioplasty.


Keywords


Chronic groin pain, Fibrin glue, Polypropylene suture, Prolene mesh, Lichtenstein repair, Mesh fixation

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References


Basile F, Biondi A, Donati M. Surgical approach to abdominal wall defects: history and new trends. Int J Surg. 2013;11:S20–3.

Campanelli G, Bruni PG, Morlacchi A, Lombardo F, Cavalli M. History and Evolution of Hernia Surgery. In: Campanelli G, editor. The Art of Hernia Surgery. Cham: Springer Int Publishing; 2018: 3–6.

Principles of surgery. Inguinal hernias. 10th ed, chap 37, page 1495. - Google Search. Available at: http://ebooks4medical.com/schwartzs-principles-surgery-absite-board-review-10th-edition/. Accessed on 3 January 2018.

Amid PK. Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia. 2004;8:1–7.

Cunningham J, Temple WJ, Mitchell P, Nixon JA, Preshaw RM, Hagen NA. Cooperative Hernia Study: Pain in the Postrepair Patient. Ann Surg. 1996;224(5):598–602.

Sajid MS, Leaver C, Baig MK, Sains P. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg. 2012;99:29e37.

Jeyakumar S, Chitrambalam TG, Chandrasekaran S. Glue versus suture for mesh fixation in open inguinal hernia repair. Int Surg J. 2018;5(4):1443.

Karigoudar A, Gupta AK, Mukharjee S, Gupta N, Durga CK. A Prospective Randomized Study Comparing Fibrin Glue Versus Prolene Suture for Mesh Fixation in Lichtenstein Inguinal Hernia Repair. Indian J Surg. 2016;78(4):288–92.

Demetrashvili Z. Chronic Pain Following Lichtenstein Inguinal Hernia Repair: A Single Surgeon’s Experience. Open Access J Surg. 2016;1(2).

Nowobilski W, Dobosz M, Wojciechowicz T, Mionskowska L. Lichtenstein inguinal hernioplasty using butyl-2-cyanoacrylate versus sutures. Preliminary experience of a prospective randomized trial. EurSurg Res Eur Chir Forsch Rech Chir Eur. 2004;36(6):367–70.

Basu I, Bhoj SS, Mukhopadhyay AK. Retrospective Study on Prevalence of Primary and Recurrent Inguinal Hernia and its Repairs in Patients Admitted to a Tertiary Care Hospital. Indian Med Gaz. 2013;11.

Arslani N, Patrlj L, Kopljar M, Rajković Z, Altarac S, Papeš D, et al. Advantages of new materials in fascia transversalis reinforcement for inguinal hernia repair. Hernia J Hernias Abdom Wall Surg. 2010;14(6):617–21.

Paajanen H, Kössi J, Silvasti S, Hulmi T, Hakala T. Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg. 2011;98(9):1245–51.

Odobasic A, Krdzalic G, Hodzic M, Hasukic S, Sehanovic A, Odobasic A. The role of fibrin glue polypropylene mesh fixation in open inguinal hernia repair. Med Arch Sarajevo Bosnia Herzeg. 2014;68(2):90–3.

Testini M, Lissidini G, Poli E, Gurrado A, Lardo D, Piccinni G. A single-surgeon randomized trial comparing sutures, N-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair. Can J Surg J Can Chir. 2010;53(3):155–60.

Girish TU, yetigadda DR. A Comparative Study of Fibrin Glue versus Sutured Mesh Fixation for Lichtenstein Inguinal Hernia Repair. Int J Med Health Res. 2016;2(3):15-20.

Charles NR, Christian LB, Sen T, Mahapatra S, Joshi BR. A Two Year Retrospective Study of Congenital Inguinal Hernia at Western Regional Hospital, Nepal. J Nep Med Assoc. 2000;39:172- 5.

Nadeem S, Shams M. Mesh hernioplasty : surgeons’ training ground? Pak J Surg. 2007;23(2):113–6.

Campanelli G, Pascual MH, Hoeferlin A, Rosenberg J, Champault G, Kingsnorth A, et al. Randomized, controlled, blinded trial of Tisseel/Tissucol for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: results of the TIMELI trial. Ann Surg. 2012;255(4):650–7.

Liu H, Zheng X, Gu Y, Guo S. A meta-analysis examining the use of fibrin glue mesh fixation versus suture mesh fixation in open inguinal hernia repair. Dig Surg. 2014;31(6):444–51.